Preauricular sinus and cyst
|Preauricular sinus and cyst|
|Preauricular sinus on right ear|
|Classification and external resources|
A preauricular sinus (also known as a congenital auricular fistula, a congenital preauricular fistula, a Geswein hole, an ear pit,:782 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 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.
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 a Head and Neck specialist).
Courses of treatment typically include the following:
- Antibiotics when infection occurs (e.g., Co - Amoxiclav 7 days course). Topical anti-staphylococcal ointment may be applied if necessary.
- 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.
- Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
- Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
- Noah S Scheinfeld; Valerie Nozad (Mar 18, 2008). "Preauricular Sinuses". Retrieved 24 Feb 2009.
- Hong Jun Kim; Jae Heon Lee; Hyun Sang Cho; In Seok Moon (2012-09-20). "A Case of Bilateral Postauricular Sinuses". Korean J Audiol. 16 (2): 99–101. doi:10.7874/kja.2012.16.2.99. PMC . PMID 24653881.
- From Stedman's Medical Spellchecker cited in WrongDiagnosis.com (2006). "Preauricular Sinus". Retrieved 24 Feb 2009.
- Raymond Y. Wang; Dawn L. Earl; Robert O. Ruder; John M. Graham Jr. "Syndromic Ear Anomalies and Renal Ultrasounds".
- James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
- Stephen Ludwig, Stephan Strobel, Stephen D. Marks, Pete K. Smith, Ph.D., Magdi H. El Habbal, M.D., Lewis Spitz Visual Handbook of Pediatrics and Child Health Published by Lippincott Williams & Wilkins, 2008; page 517. ISBN 0-7817-9505-2
- Michael Hawke Ear Disease Published by PMPH-USA, 2003; page 5. ISBN 1-55009-241-3
- 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 . PMID 19205595.
- 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.
- The preauricular sinus: A review of its aetiology, clinical presentation and management International Journal of Pediatric Otorhinolaryngology (2005) 69, 1469—1474