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, 0.1-0.9% in the US, 0.9% in the UK, and 4-10% in Asia and parts of Africa. Comparative frequency is known to be higher in Africans and Asians than in Caucasians.[4]
Preauricular sinus are inherited features and usually appear just on one side. They are present on both sides, however, 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] They are associated with Beckwith–Wiedemann syndrome, and 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 a plastic surgeon or an otolaryngologist (a head and neck specialist).[9]
Treatment
Courses of treatment typically include the following:
- Antibiotics when infection occur (e.g., Co - Amoxiclav 7 days course). Topical anti-staphylococci ointment may be applied if necessary.
- 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 otolaryngologist specialist surgeon, and NOT by a general surgeon.
- The fistula can be excised as a cosmetic operation even though no infection appeared. The procedure is considered a selective operation in the absence of any 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 (2012-09-20). "A Case of Bilateral Postauricular Sinuses". PMC 3936561
. - ↑ 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
Bibliography
- Leopardi G1, Chiarella G, Conti S, Cassandro E. (2008). "Surgical treatment of recurring preauricular sinus: supra-auricular approach". Acta Otorhinolaryngol Ital. 28 (6): 302–5. PMC 2689545. PMID 19205595.
- 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. 78 (11): 1843–8. doi:10.1016/j.ijporl.2014.08.005. PMID 25190621.
External links
- The preauricular sinus: A review of its aetiology, clinical presentation and management International Journal of Pediatric Otorhinolaryngology (2005) 69, 1469—1474