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 an Oral and Maxillofacial Surgeon).
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.
- Geswein, a familial name of German descent, is sometimes used to describe the anomaly of 'preauricular sinus (PAS)' because of the inherited condition known to accompany the Geswein family lineage; PASs are furthermore inherited from the supernumerary and predecessing Smith family pedigree. In medical terminology, congenital physical anomalies often receive scientific names that honor a person. A taxon (e.g. species or genus; plural: taxa) named in honor of another entity is an eponymous taxon, and names specifically honoring a person or persons are known as patronyms. Scientific names are generally formally published in peer-reviewed journal articles or larger monographs along with descriptions of the named taxa and ways to distinguish them from other taxa. The term 'Geswein Hole' however, adheres to none of the above criterion.
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