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. 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.
Preauricular sinuses are inherited features, and frequently appear next to both ears. Preauricular sinuses can be associated with other defects that are not visible, one example being
branchio-oto-renal syndrome
Branchio-oto-renal syndrome (BOR) is an autosomal dominant genetic disorder involving the kidneys, ears, and neck. It often has also been described as Melnick-Fraser syndrome.
Signs and symptoms
The signs and symptoms of branchio-oto-renal syndrom ...
.
Presentation
Complications
Occasionally a preauricular sinus or
cyst
A cyst is a closed sac, having a distinct envelope and cell division, division compared with the nearby Biological tissue, tissue. Hence, it is a cluster of Cell (biology), cells that have grouped together to form a sac (like the manner in which ...
can become
infected.
Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often. Preauricular sinuses can be excised surgically, but often present a high risk of recurrence.
Causes
Preauricular sinuses and cysts result from developmental defects of the first and second
pharyngeal arches
The pharyngeal arches, also known as visceral arches'','' are structures seen in the embryonic development of vertebrates that are recognisable precursors for many structures. In fish, the arches are known as the branchial arches, or gill arch ...
. This and other ear malformations are sometimes associated with renal anomalies. In rare circumstances these pits may be seen in genetic conditions such as
branchio-oto-renal syndrome
Branchio-oto-renal syndrome (BOR) is an autosomal dominant genetic disorder involving the kidneys, ears, and neck. It often has also been described as Melnick-Fraser syndrome.
Signs and symptoms
The signs and symptoms of branchio-oto-renal syndrom ...
; however these conditions are always concurrent with other health concerns.
Treatment
Courses of treatment typically include the following:
* Surgical excision is indicated with recurrent fistular infections,
[Dellinger, M.B., & Waldhausen, J.H.T. (2020). Head and neck sinuses and masses. In ''Holcomb and Ashcraft's Pediatric Surgery, 72'', 1171-1185.] 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
Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical a ...
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
*
Branchial cleft cyst
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Thyroglossal cyst
A thyroglossal cyst is a fibrous cyst that forms from a persistent thyroglossal duct. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland dur ...
*
Lachiewicz Sibley syndrome
*
List of cutaneous conditions
Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the body and composed of skin, hair, nails, and related muscle and glands. The major function of this system is as a barrier against t ...
References
Bibliography
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Further reading
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External links
{{Congenital malformations and deformations of face and neck
Cutaneous congenital anomalies
Congenital disorders of ears
Cysts