Preauricular sinuses are common congenital malformations. They affect men and women with equal frequency and they can be unilateral or bilateral. A preauricular sinus appears as a very small pit just in front of the external ear (see figure 1). Most people with preauricular sinuses are completely asymptomatic. However, these sinuses can drain a foul smelling discharge, and when this happens, they are prone to chronic infection. Once infected, preauricular sinuses rarely remain asymptomatic, giving rise to recurrent infections, cellulitis, or even abscess formation, a collection of pus that needs to be lanced.
When a preauricular sinus becomes infected, it is an indication for surgery to remove the entire sinus tract. However, the surgery should be delayed until antibiotics are given to treat the infection and allow the associated inflammation to subside. Some surgeons recommend removing preauricular sinuses even before they get infected because the surgery is more difficult when dealing with the scarring that is associated with recurrent infection. This, however, is more controversial.
Removal of a preauricular sinus is usually done under generally anesthesia, and patients are discharged home the same day. Sutures will be removed one week later, and the scar is usually cosmetically very favorable. Your doctor at Suburban Ear, Nose, and Throat is trained in the surgical management of preauricular sinuses.