Preauricular sinus and cyst
| Preauricular sinus and cyst | |
|---|---|
 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, 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 on race, 0.1-9% in the US, 0.9% in the UK, and 4-10% in Asia and parts of Africa. Frequency is known to be higher in Africans and Asians compared to caucasians.[4]
They are inherited features and usually appear on one side, but may be present on both sides in 25 to 50% of cases.
Causes
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] In rare cases they may be associated with branchio-oto-renal syndrome.
Complications
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 cysts are treated with surgery which, because of their close proximity to the facial nerve, is performed by an experienced surgeon, such as an otolaryngologist (a head and neck specialist).[9]
Treatment
- Antibiotics when infection occur e.g. Co - Amoxiclav 7 days course. Topical anti-staphylococci ointment may be applied if necessary.
- Surgical excision: indicated in recurrent fistular infections. Preferably done after relatively healing the infection. In case of persisting infection, infection drainage is performed during the excision operation. Operation performed by otolaryngologist surgeon and NOT by general surgeon.
- The fistula can be excised as a cosmetic operation even though no infection appeared. The procedure considered a selective operation when there is no associated complications.
See also
References
- ↑ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
- ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
- ↑ Noah S Scheinfeld; Valerie Nozad (Mar 18, 2008). "Preauricular Sinuses". Retrieved 24 Feb 2009.
- ↑ Hong Jun Kim; Jae Heon Lee; Hyun Sang Cho; In Seok Moon (Sep 20, 2012). "A Case of Bilateral Postauricular Sinuses". Retrieved 4 Jan 2015.
- ↑ From Stedman's Medical Spellchecker cited in WrongDiagnosis.com (2006). "Preauricular Sinus". Retrieved 24 Feb 2009.
- ↑ Raymond Y. Wang, Dawn L. Earl, Robert O. Ruder, John M. Graham Jr. "Syndromic Ear Anomalies and Renal Ultrasounds".
- ↑ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
- ↑ 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
- ↑ Michael Hawke Ear Disease Published by PMPH-USA, 2003; page 5. ISBN 1-55009-241-3
External links[2]
- The preauricular sinus: A review of its aetiology, clinical presentation and management International Journal of Pediatric Otorhinolaryngology (2005) 69, 1469—1474
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- ↑ Leopardi G1, Chiarella G, Conti S, Cassandro E. (2008). "Surgical treatment of recurring preauricular sinus: supra-auricular approach.". Acta Otorhinolaryngol Ital. (6):302-5.
- ↑ Kim JR1, Kim do H1, Kong SK2, Gu PM1, Hong TU1, Kim BJ1, Heo KW3. (2014). "Congenital periauricular fistulas: possible variants of the preauricular sinus.". Int J Pediatr Otorhinolaryngol. (11):1843-8.