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, a Geswein hole,[1] an ear pit,[2]:782 or a preauricular cyst[3]) is a common congenital malformation characterized by a nodule, dent or dimple located anywhere adjacent to the external ear.[4] 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. Comparative frequency is known to be higher in Africans and Asians than in Caucasians.[5]
Preauricular sinuses are inherited features, and most often appear unilaterally. They are present bilaterally in 25-50% of cases.
Causes
Preauricular sinuses and cysts result from developmental defects of the first and second pharyngeal arches.[6] This and other congenital ear malformations are sometimes associated with renal anomalies.[7] They may be present in 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.[8]
Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often.[9] Preauricular sinuses can be excised with surgery which, because of their close proximity to the facial nerve, is performed by an appropriately trained, experienced surgeon (e.g. a specialist General Surgeon, a Plastic Surgeon, an otolaryngologist (Ear, Nose, Throat surgeon) or a Head and Neck specialist).[10]
Treatment
Courses of treatment typically include the following:
- Antibiotics when infection occurs.
- 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 appropriately trained specialist surgeon e.g. an otolaryngologist 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
References
- ↑ Geswein, a familial name of German descent, is sometimes used to describe the anomaly of 'preauricular sinus (PAS)' because of the inherited condition known to accompany the Geswein family lineage; PASs are furthermore inherited from the supernumerary and predecessing Smith family pedigree. In medical terminology, congenital physical anomalies often receive scientific names that honor a person. A taxon (e.g. species or genus; plural: taxa) named in honor of another entity is an eponymous taxon, and names specifically honoring a person or persons are known as patronyms. Scientific names are generally formally published in peer-reviewed journal articles or larger monographs along with descriptions of the named taxa and ways to distinguish them from other taxa. The term 'Geswein Hole' however, adheres to none of the above criterion.
- ↑ 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". Korean J Audiol. 16 (2): 99–101. PMC 3936561
. PMID 24653881. doi:10.7874/kja.2012.16.2.99. - ↑ 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. PMID 25190621. doi:10.1016/j.ijporl.2014.08.005.
External links
- The preauricular sinus: A review of its aetiology, clinical presentation and management International Journal of Pediatric Otorhinolaryngology (2005) 69, 1469—1474