Preauricular pits - A hole in the ear

In certain cases of preauricular sinus, more severe infections can occur, which are typically characterised by symptoms such as localised swelling accompanied by redness, the development of abscesses, varying degrees of pain and discomfort, and the presence of fluid discharge.

Typically, the diagnosis of preauricular sinus is determined through a physical examination conducted by a physician or otolaryngologist. The doctor examines the area surrounding the ear to identify any abnormal lump or cavity in the skin. In some instances, further tests or diagnostic investigations may be necessary to confirm the presence of preauricular sinus and evaluate its extent. These additional examinations can include ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT). These imaging tests provide more detailed images of the region surrounding the preauricular sinus and help rule out other potential conditions. In rare cases, a biopsy may be required to confirm the diagnosis or exclude other disorders.

If the preauricular pit is prone to infection, the recommended treatment involves administering antibiotics and draining any pus to clean the affected area. In cases where infections persist or symptoms worsen, it is best to consult a surgeon who specialises in otolaryngology. Since the preauricular sinus is in close proximity to the facial nerve, specialised intervention by a qualified physician is necessary to ensure targeted and appropriate care.

Surgical removal is another option for treating a preauricular sinus. This procedure involves removing the core and subcutaneous tract of the sinus, especially when there is a history of recurrent infections. Surgical removal of preauricular sinus fistulas is typically carried out under local anesthesia. The procedure involves making a skin incision in front of the auricle to remove the fistula. It is important to excise the fistula along with a small section of surrounding skin. To aid in the healing process and prevent complications such as hematoma, a small silicone tube, known as a drain, may be inserted into the surgical cavity for a few days to remove serum secretion.

Complications associated with the removal of preauricular cysts should be considered. While the duration of the surgical procedure is typically short, there are potential risks involved. These include:

• Pain during chewing for a few days.
• Discomfort when moving the neck.
• Postoperative bleeding, although it is usually well controlled.
• Occurrence of a hematoma after surgery, which is possible but not usually a cause for concern.
• Infection at the surgical site, which can typically be managed effectively with antibiotics and, if necessary, further surgical intervention.
• Painful or excessive scarring of the skin, known as keloid formation.
• Possibility of recurrence, even after a properly performed surgery, indicated by the reappearance of swelling or a fistulous opening.

The occurrence of this malformation during embryogenesis cannot be prevented. However, if symptoms worsen, it is advisable to seek medical attention to prevent any further complications or deterioration.