Radiofrequency thermal ablation versus 'cold steel' for supra-auricular excision of preauricular sinus: comparative study.

Objective: To compare the results of radiofrequency thermal ablation versus 'cold steel' excision, for supra-auricular excision of preauricular sinus.
Study Design: Prospective study. Observations included recurrence, intra-operative bleeding, operation time and ease of dissection.
Setting: Tertiary referral hospital.
Subjects and Methods: Sixty cases of preauricular sinus were assigned randomly to two groups (30 cases each). Group one patients underwent cold steel sinus excision, whereas group two patients underwent radiofrequency-assisted sinus excision.
Results: Fifty patients were operated upon, with a mean age of 12.26 years. Most patients were aged between zero and five years (40 per cent). The average patient follow-up time was 15 months (range, six to 24 months). Recurrence rates were 23 per cent in group one and 3 per cent in group two; this difference was statistically significant (p = 0.016). Dissection of the sinus tract was reported to be much easier in the radiofrequency group, compared with the cold steel group (p = 0.023), with minimal bleeding.
Conclusion: From our observations, radiofrequency-assisted, local, wide excision appears to be preferable for treatment of preauricular sinus, compared with cold steel excision, as it allows better peri-operative visualisation, easier dissection, minimal bleeding and a lower subsequent recurrence rate (3.3 per cent).