Preauricular sinus and cyst

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Template:Infobox medical condition (new) Preauricular sinuses and preauricular cysts are two common congenital malformations. Each involves the external ear. The difference between them is that a cyst does not connect with the skin, but a sinus does. [1] 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.[2]

Preauricular sinuses are inherited features, and frequently appear next to both ears.[3] Preauricular sinuses can be associated with other defects that are not visible, one example being branchio-oto-renal syndrome.[4]

Presentation

Complications

Occasionally a preauricular sinus or cyst can become infected.[5] Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often.[6] Preauricular sinuses can be excised surgically, but often present a high risk of recurrence.[7]

Causes

Preauricular sinuses and cysts result from developmental defects of the first and second pharyngeal arches.[8] This and other ear malformations are sometimes associated with renal anomalies.[9] 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.[10]

Treatment

Courses of treatment typically include the following:[11]

  • Surgical excision is indicated with recurrent fistular infections,[12] 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

References

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  1. Thatcher, A.L. (2022). Congenital and inflammatory neck masses in children. In M. Lesperance (Ed.), Cummings Pediatric Otolaryngology, 23, 308-321.
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  3. Moore, K.L., Persaud, T.V.N., & Torchia, M.G. (2010). Development of eyes and ears. Before we are born, 17, 257-268.e1.
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  12. Dellinger, M.B., & Waldhausen, J.H.T. (2020). Head and neck sinuses and masses. In Holcomb and Ashcraft's Pediatric Surgery, 72, 1171-1185.

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Bibliography

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Further reading

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External links

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