Preauricular sinus and cyst

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A preauricular sinus (also known as a congenital auricular fistula, a congenital preauricular fistula, a Geswein hole, an ear pit, or a preauricular cyst) is a common congenital malformation characterized by a nodule, dent or dimple located anywhere adjacent to the external ear. 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. Comparative frequency is known to be higher in Africans and Asians than in Caucasians.

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

Video Preauricular sinus and cyst

Causes

Preauricular sinuses and cysts result from developmental defects of the first and second pharyngeal arches. This and other congenital ear malformations are sometimes associated with renal anomalies. They may be present in Beckwith-Wiedemann syndrome, and in rare cases, they may be associated with branchio-oto-renal syndrome.

Maps Preauricular sinus and cyst

Complications

Occasionally a preauricular sinus or cyst can become infected.

Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often. Preauricular sinuses can be excised with surgery which, because of their close proximity to the facial nerve, is performed by an appropriately trained, experienced surgeon (e.g. a specialist General Surgeon, a Plastic Surgeon, an otolaryngologist (Ear, Nose, Throat surgeon) or an Oral and Maxillofacial Surgeon).

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Treatment

Courses of treatment typically include the following:

• Draining the pus once awhile 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.

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See also

• Branchial cleft cyst
• Thyroglossal cyst
• Lachiewicz Sibley syndrome
• List of cutaneous conditions

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References

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Bibliography

• Leopardi G1, Chiarella G, Conti S, Cassandro E. (2008). "Surgical treatment of recurring preauricular sinus: supra-auricular approach". Acta Otorhinolaryngol Ital. 28 (6): 302-5. PMC 2689545 . PMID 19205595. CS1 maint: Multiple names: authors list (link)
• Kim JR1, Kim do H1, Kong SK2, Gu PM1, Hong TU1, Kim BJ1, Heo KW3. (2014). "Congenital periauricular fistulas: possible variants of the preauricular sinus". Int J Pediatr Otorhinolaryngol. 78 (11): 1843-8. doi:10.1016/j.ijporl.2014.08.005. PMID 25190621. CS1 maint: Multiple names: authors list (link)

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External links

• The preauricular sinus: A review of its aetiology, clinical presentation and management International Journal of Pediatric Otorhinolaryngology (2005) 69, 1469--1474

Source of article : Wikipedia