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Pre-auricular Sinus with Post-auricular Extension: An Uncommon Variant

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Abstract

Pre-auricular sinus usually presents in front of the auricle without any diagnostic dilemma. But confusion arises when it presents with post-auricular swelling, abscess or discharging sinus. Here we describe series of pre-auricular sinus with post-auricular extension, a “variant type” of pre-auricular sinus and their management. A prospective study was done in the department of ENT in a tertiary care hospital of West Bengal from April 2015 to March 2018. After control of infection and proper pre-operative investigations patients, sinus was excised using bi-directional approach. The sinus tract along with a thin rim of conchal cartilage and pre and post-auricular cuff of skin was excised in toto. Among 76 cases of pre-auricular sinus, seven had “variant type”. There were five males and two females in the variant group. Five patients were in the first decade of life and two patients were in the second decade of life. Four patients presented with post-auricular scar, two patients presented with post-auricular discharging sinus and one patient presented with post-auricular abscess. Wound healing was perfectly normal in all patients. None had recurrence till 1 year follow up. Pre-auricular sinus may present as “variant type” with post-auricular abscess or discharging sinus. So when a patient presents with post-auricular abscess or discharging sinus, pre-auricular region and pinna should be examined carefully. This helps to avoid unnecessary investigations and interventions which only complicate future management of these patients.

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References

  1. Heusinger CF (1864) Hais-Kiemen-Fisteln von noch nicht beobachteter Form. Virchows Arch 29:358

    Article  Google Scholar 

  2. Malipatil SR (2014) Preauricular sinus as recurrent postaural abscess: a rare presentation. Otorhinolaryngol Clin Int J 6(2):84–86

    Article  Google Scholar 

  3. Choi SJ, Choung YH, Park K, Bae J, Park HY (2007) The variant type of preauricular sinus: postauricular sinus. Laryngoscope 117(10):1798–1802

    Article  Google Scholar 

  4. Dunham B, Guttenberg M, Morrison W et al (2009) The histologic relationship of preauricular sinuses to auricular cartilage. Arch Otolaryngol Head Neck Surg. 135(12):1262–1265

    Article  Google Scholar 

  5. Moore KL (1988) The developing human: clinically oriented embryology, 4th edn. WB Saunders Co., Philadelphia, pp 417–418

    Google Scholar 

  6. Lam HC, Soo G, Wormald PJ, Van Hasselt CA (2001) Excision of the preauricular sinus: a comparison of two surgical techniques. Laryngoscope 111(2):317–319

    Article  CAS  Google Scholar 

  7. O’Mara W, Guarisco L (1999) Management of the preauricular sinus. J La State Med Soc 151:447–450

    PubMed  Google Scholar 

  8. Zou F, Peng Y, Wang X et al (2003) A locus for congenital preauricular fistula maps to chromosome 8q11.1-q13.3. J Hum Genet 48(3):155–158

    Article  CAS  Google Scholar 

  9. Minkowitz S, Minkowitz F (1964) Congenital aural sinuses. Surg Gynecol Obstet 118:801–806

    CAS  PubMed  Google Scholar 

  10. Lampert FM, Koulaxouzidis G, Stark GB (2013) The preauricular sinus: a novel approach for complete bilateral excision via a modified face-lift incision. Mod Plast Surg 3:76–79

    Article  Google Scholar 

  11. Nair S, James E, Chugh R (2011) An unusual case of recurrent post aural abscess. Indian J Otolaryngol Head Neck Surg 63:58–60

    Article  Google Scholar 

  12. Hassan ME, Samir A (2009) Pre-auricular sinus: comparative study of two surgical techniques. Ann Pediatr Surg 3:139–143

    Google Scholar 

  13. Prasad S, Grundfast K, Milmoe G (1990) Management of congenital preauricular pit and sinus tract in children. Laryngoscope 100:320–321

    Article  CAS  Google Scholar 

  14. Baatenburg de Jong RJ (2005) A new surgical technique for treatment of preauricular sinus. Surgery 137:567–570

    Article  Google Scholar 

  15. Wright T, Valentine P (2008) The anatomy and embryology of the external and middle ear. In: Gleeson M, George GB, Burton MJ, Clarke R, Hibbert J, Jones NS et al (eds) Scott-Brown′s otorhinolaryngology, head and neck surgery, vol 3, 7th edn. Hodder Arnold, London, pp 3105–3106

    Chapter  Google Scholar 

  16. Lampert FM, Koulaxouzidis G, Stark GB (2013) The preauricular sinus: a novel approach for complete bilateral excision via a modified face-lift incision. Mod Plast Surg 3:76–79

    Article  Google Scholar 

  17. Sanji RR, Channegowda C, Patil SB, Anand B (2015) Pre- and post-auricular sinus. Indian J Otol 21:225–228

    Article  Google Scholar 

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Correspondence to Ajoy Khaowas.

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Das, C., Khaowas, A. Pre-auricular Sinus with Post-auricular Extension: An Uncommon Variant. Indian J Otolaryngol Head Neck Surg 71 (Suppl 2), 1511–1514 (2019). https://doi.org/10.1007/s12070-019-01605-1

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  • DOI: https://doi.org/10.1007/s12070-019-01605-1

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