Preauricular sinus and cyst

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Preauricular sinus and cyst
Preauricular sinus.jpg
Preauricular sinus on right ear
Classification and external resources
Specialty otolaryngology
ICD-10 Q18.1
ICD-9-CM 744.4
DiseasesDB 34576
MedlinePlus 003304

A preauricular sinus (also known as a congenital auricular fistula, a congenital preauricular fistula, a Geswein hole, an ear pit,[1]:782 or a preauricular cyst[2]) 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. Comparative frequency is known to be higher in Africans and Asians than in Caucasians.[4]

Preauricular sinuses are inherited features, and most often appear unilaterally. They are present bilaterally in 25 to 50% of cases.[citation needed]

Causes[edit]

Preauricular sinuses and cysts result from developmental defects of the first and second pharyngeal arches.[5] This and other congenital ear malformations are sometimes associated with renal anomalies.[6] They may be present in Beckwith–Wiedemann syndrome, and in rare cases, they may be associated with branchio-oto-renal syndrome.[citation needed]

Complications[edit]

Occasionally a preauricular sinus or cyst can become infected.[7]

Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often.[8] 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).[9]

Treatment[edit]

Courses of treatment typically include the following:[citation needed]

  • 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.

See also[edit]

References[edit]

  1. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0. 
  3. ^ Noah S Scheinfeld; Valerie Nozad (Mar 18, 2008). "Preauricular Sinuses". Retrieved 24 Feb 2009. 
  4. ^ 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 3936561Freely accessible. PMID 24653881. 
  5. ^ From Stedman's Medical Spellchecker cited in WrongDiagnosis.com (2006). "Preauricular Sinus". Retrieved 24 Feb 2009. 
  6. ^ Raymond Y. Wang; Dawn L. Earl; Robert O. Ruder; John M. Graham Jr. "Syndromic Ear Anomalies and Renal Ultrasounds". 
  7. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  8. ^ 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
  9. ^ Michael Hawke Ear Disease Published by PMPH-USA, 2003; page 5. ISBN 1-55009-241-3

Bibliography[edit]

External links[edit]