ABSTRACT

The preauricular sinus is a congenital sinus whose opening is situated on the anterior aspect of the helix of the pinna. It results from ectodermal inclusions that arise during fusion of the six fetal tubercles that form the pinna. The course of the sinus is unpredictable and often consists of multiple branches. It passes anteriorly and inferiorly through the subcutaneous tissue to end in a racemose group of preauricular cysts and, contrary to some reports, frequently extends deep to the subcutaneous tissue to be attached to the cartilage of the pinna. The sinus is often familial, and may be unilateral or bilateral. In many cases, the preauricular sinus is completely asymptomatic and requires no treatment. However, it may present with an intermittent discharge or become infected, or as a preauricular abscess. Total excision of the sinus and the underlying group of preauricular cysts is essential for cure of the symptomatic sinus and this may also require excision of a small amount of underlying cartilage at the point of attachment. Incomplete excision results in a significant recurrence rate.