Preauricular sinus and cyst

Preauricular sinus and cyst
Other namesCongenital auricular fistula, Congenital preauricular fistula, Ear pit,[1]: 782  or a Preauricular cyst[2]
Preauricular sinus on right ear
SpecialtyOtorhinolaryngology 
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A preauricular sinus is a common congenital malformation characterized by a nodule, dent or dimple located anywhere adjacent to the external ear.[3] Frequency of preauricular sinus differs depending the population: 0.1–0.9% in the US, 0.9% in the UK, and 4–10% in Asia and parts of Africa.[4]

Preauricular sinuses are inherited features, and most often appear unilaterally. They are present bilaterally in 25–50% of cases.

Presentation

Complications

Occasionally a preauricular sinus or cyst can become infected.[5] Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often.[6] Preauricular sinuses can be excised surgically, but often present a high risk of recurrence.[7]

Causes

Preauricular sinuses and cysts result from developmental defects of the first and second pharyngeal arches.[8] This and other ear malformations are sometimes associated with renal anomalies.[9] In rare circumstances these pits may be seen in genetic conditions such as branchio-oto-renal syndrome; however these conditions are always concurrent with other health concerns.[10]

Treatment

Courses of treatment typically include the following:

  • Draining the pus occasionally as it can build up a strong odor
  • Antibiotics when infection occurs.
  • Surgical excision is indicated with recurrent fistular infections, preferably after significant healing of the infection. In case of a persistent infection, infection drainage is performed during the excision operation. The operation is generally performed by an appropriately trained specialist surgeon e.g. an otolaryngologist or a specialist General Surgeon.
  • The fistula can be excised as a cosmetic operation even though no infection appeared. The procedure is considered an elective operation in the absence of any associated complications.

See also

References

  1. ↑ Freedberg IM, Fitzpatrick TB (2003). Fitzpatrick's Dermatology in General Medicine (6th ed.). McGraw-Hill. ISBN 978-0-07-138076-8.
  2. ↑ Rapini RP, Bolognia JL, Jorizzo JL (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  3. ↑ Scheinfeld NS, Nozad V (18 March 2008). "Preauricular Sinuses". MedScape. Retrieved 24 February 2009.
  4. ↑ Kim HJ, Lee JH, Cho HS, Moon IS (September 2012). "A case of bilateral postauricular sinuses". Korean Journal of Audiology. 16 (2): 99–101. doi:10.7874/kja.2012.16.2.99. PMC 3936561. PMID 24653881.
  5. ↑ James WD, Berger TG, et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
  6. ↑ Ludwig S, Strobel S, Marks SD, Smith PK, El Habbal MH, Spitz L (2008). Visual Handbook of Pediatrics and Child Health. Lippincott Williams & Wilkins. p. 517. ISBN 978-0-7817-9505-0.
  7. ↑ Leopardi G, Chiarella G, Conti S, Cassandro E (December 2008). "Surgical treatment of recurring preauricular sinus: supra-auricular approach". Acta Otorhinolaryngologica Italica. 28 (6): 302–5. PMC 2689545. PMID 19205595.
  8. ↑ "Preauricular Sinus". Stedman's Medical Spellchecker. 2006. Retrieved 24 Feb 2009. cited in WrongDiagnosis.com
  9. ↑ Wang RY, Earl DL, Ruder RO, Graham JM (August 2001). "Syndromic ear anomalies and renal ultrasounds". Pediatrics. 108 (2): E32. doi:10.1542/peds.108.2.e32. PMID 11483842.
  10. ↑ "Branchiootorenal syndrome". Genetic and Rare Diseases Information Center (GARD).

Bibliography

Further reading

  • Tan T, Constantinides H, Mitchell TE (November 2005). "The preauricular sinus: A review of its aetiology, clinical presentation and management". International Journal of Pediatric Otorhinolaryngology. 69 (11): 1469–74. doi:10.1016/j.ijporl.2005.07.008. PMID 16125253.
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