Preauricular sinus and cyst

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Preauricular sinus and cyst
Preauricular sinus.jpg
Preauricular sinus on right ear
Specialty Otorhinolaryngology Edit this on Wikidata

A preauricular sinus (also known as a congenital auricular fistula, a congenital preauricular fistula, a Geswein hole,[1] an ear pit,[2]:782 or a preauricular cyst[3]) is a common congenital malformation characterized by a nodule, dent or dimple located anywhere adjacent to the external ear.[4] 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.[5]

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


Preauricular sinuses and cysts result from developmental defects of the first and second pharyngeal arches.[6] This and other congenital ear malformations are sometimes associated with renal anomalies.[7] 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[8].[citation needed]


Occasionally a preauricular sinus or cyst can become infected.[9]

Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often.[10] Preauricular sinuses can be excised surgically, but often present a high risk of recurrence.[11]


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

  • 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[edit]


  1. ^ 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.
  2. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  3. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0. 
  4. ^ Noah S Scheinfeld; Valerie Nozad (Mar 18, 2008). "Preauricular Sinuses". Retrieved 24 Feb 2009. 
  5. ^ 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. 
  6. ^ From Stedman's Medical Spellchecker cited in (2006). "Preauricular Sinus". Retrieved 24 Feb 2009. 
  7. ^ Raymond Y. Wang; Dawn L. Earl; Robert O. Ruder; John M. Graham Jr. "Syndromic Ear Anomalies and Renal Ultrasounds". Archived from the original on 2012-07-01. 
  8. ^
  9. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  10. ^ 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
  11. ^ Leopardi G, Chiarella G, Conti S, Cassandro E. (2008). "Surgical treatment of recurring preauricular sinus: supra-auricular approach". Acta Otorhinolaryngol Ital. 28 (6): 302–5. PMC 2689545Freely accessible. PMID 19205595. 


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