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Introduction: Preauricular fistulas are not uncommon congenital disorders in children. They are associated with imperfect auricle formation as a consequence of incomplete fusion of the auditory hillocks of the first and second branchial arches., Aim: The aim of this study was to present diagnostic methods with evaluation of treatment results of preauricular fistulas in children., Materials and Methods: We analysed retrospectively clinical and epidemiological features, diagnostic methods and treatment results of the patients with preauricular fistula attended in the Otolaryngology Department of Medical University in Gdańsk., Results: Between 1995 and 2009 in the Department of Otolaryngology MGUed 23 children (13 girls and 10 boys) were treated for preauricular fistulas. The age of the children ranged between 2 to 16 years (median 7.7). The fistula was recognized on the left side in 14 children, in 6 on the right and bilaterally in 3 children. The diagnosis was based on the presence of a cutaneous fistula in the region of the helix's anterior crus with inflamed surrounding and purulent discharged in physical examination and in radiological imaging (MRI). Patients were treated surgically in the classical way and using Prasada's method including resection of the cutaneous fistula and cyst with a part of the helix. Squamous epithelium in the resected fistulas was found in 91.3% of the children. No recurrence was observed, good cosmetic outcome was achieved in all children., Conclusions: Each patient with bilateral preauricular fistula needs to be diagnosed for congenital disorders of the middle ear and kidneys. MRI may be useful in establishing the location of the fistula. Surgical treatment is not necessary in preauricular, blind-ended sinuses. In the postoperative material of the sinus squamous epithelium is found.

Objective: After excision of a preauricular sinus, a head bandage compressive dressing is usually used to reduce dead space and to decrease the risk of recurrence. However, such use of a head bandage may cause various problems. We assessed a new method of compressive dressing, using suture transfixion of silicone sheets to the former sinus tract, following preauricular sinus excision., Methods: This retrospective study reviewed the medical records of patients undergoing preauricular sinus excision in a tertiary referral centre over a five-year period. After excision of the preauricular sinus, patients underwent suture transfixion of silicone sheets. Post-operative outcomes were analysed., Results: The new dressing method was performed on 50 ears of 37 patients. The post-operative incidence of recurrence and haematoma formation was 4 and 2 per cent, respectively. Other problems possibly caused by head bandaging, such as headache, facial flushing, and nausea and/or vomiting, were not observed., Conclusion: Compressive dressing by suture transfixion of silicone sheets is safe and effective following preauricular sinus excision.

Objectives: To evaluate the clinical course of congenital preauricular sinus (PAS) up until adulthood and to determine its association with congenital ear and renal abnormalities., Design: Cohort survey., Setting: Medical screening facility at a military base., Participants: All individuals in a cohort of male subjects who were medically assessed for conscription into the army between September 1, 2003, and March 31, 2004., Interventions: Subjects identified as having PAS were further evaluated with pure-tone audiometry and renal ultrasonography., Main Outcome Measures: Presence of PAS and associated hearing and renal abnormalities., Results: Of 10 734 male subjects (median age, 19 years; range, 16-26 years) screened, 121 (1.13%) were found to have PAS, all of which were isolated. The point prevalence of PAS in Chinese, Malay, and Indian subjects was 1.36%, 0.69%, and 0.17%, respectively. Of the 29 subjects (24.0%) who developed symptoms (mainly sinus discharge), most had recurrent symptoms, and 7 (24.1%) of the 29 had onset of symptoms after age 16 years. Only 1.7% and 2.6% of the subjects had associated hearing loss (sensorineural) and renal deformity (minor in nature), respectively., Conclusions: In a study of young adult males with PAS, associations with ear and renal abnormalities were found to be rare, although PAS had widely been acknowledged to be associated with these congenital defects. Up until adulthood, about one quarter of all lesions became symptomatic. Of those who developed symptoms, almost one third did so after age 16 years. The most common symptom was sinus discharge, which tended to be recurrent.

Preauricular sinus and fistulas are minor developmental anomalies. They are bilateral in 35% to 50% of cases. We describe the application of a combined technique in a rare case of bilateral congenital preauricular fistulas. Initial fistula probing serves as a surgical guide, and further methylene blue infection helps to avoid leaving viable squamous epithelial remnants.

A 30-year-old male presented with multiple, yellowish to skin-colored, firm to soft nodules on the forehead, temple, postauricular area and neck for the previous seven years. Examination of the scalp revealed a single, soft, cystic swelling on the occiput and the patient complained of occasional discharge from two, 0.1 x 0.1 cm, openings in front of both ears. Histopathology of the facial lesion was suggestive of steatocystoma multiplex, while that of the scalp revealed a pilar cyst. An otorhinolaryngeal evaluation confirmed the presence of bilateral pre-auricular sinus. We present this previously unreported pilosebaceous hamartoma, constituting facial steatocystomas and pilar cyst, associated with bilateral preauricular sinus.

The preauricular sinus is a relatively common physical finding especially in the pediatric population. It is defined as a congenital lesion in which a small skin opening located in front of the external ear communicates with a subcutaneous network of cysts. The vast majority are benign in nature and require no intervention. Draining sinus tracts are prone to infection and should be excised. Complete excision of the pit and sinus tract provides the only definitive cure. To prevent problematic recurrence, we recommend wide exposure of the lesion by the technique described.

Purpose: The retrospective investigation evaluated the clinical data on patients with a preauricular fistula with respect to demographic factors, symptoms, preoperative diagnosis, and surgical therapy. Follow-up studies served to critically assess the outcome of the operations., Patients and Methods: The records of 62 patients were studied. Patients were divided into two groups: those operated on for the first time for a preauricular fistula and those operated on for a recurrence. Controlled follow-up was performed by means of a standardized questionnaire filled out by both the patients' physicians and the patients themselves., Results: The mean age of patients operated on for the first time was 16 years, and that of patients operated on for a recurrence was 22 years. Although the overall rate of recurrence was 21%, it differed widely between groups (14% in first operations and 42% in patients operated on for the first time for a recurrence). These figures are within the lower range of the recurrence rates previously reported. Serious side effects, such as persistent damage to the facial nerve, were not observed., Conclusions: Operative management of a preauricular fistula is a treatment with few side effects that should be offered to each patient with such a malformation. Because the first operation is decisive for the further course of the condition, surgery should be performed under optimum conditions to avoid recurrence.