What is Preauricular Sinus?
Preauricular sinus appears as a tiny skin-lined hole or pit, often just in front of the upper ear where the cartilage of the ear rim meets the face. It may occur on one side (unilateral) or both sides (bilateral) of the ear. Affected people usually do not have any additional symptoms unless it becomes infected.
How common is Preauricular Sinus?
Preauricular sinus is a common birth defect. Please discuss with your doctor for further information.
What are the symptoms of Preauricular Sinus?
Children with a preauricular pit don’t always have the same set of symptoms. Some also have a syndrome associated with their pit. The most common symptoms of a pit by itself and in conjunction with a syndrome include:
- A visible tiny opening in front of one or both ears.
- An opening that appears as more of a dimpling.
- Swelling, pain, fever, redness or pus in and around the pit, signaling an infection, such as cellulitis or an abscess.
- A slow-growing painless lump right next to the opening, signaling a cyst. A cyst also raises the risk of infection.
- Asymmetric earlobes and an abnormally large tongue in addition to pits in front of the ears can be a sign of Beckwith-Wiedemann syndrome. This syndrome is associated with abdominal abnormalities and kidney and liver cancers.
- Holes or pits in the side of the neck, pits and/or tags in front of the ear, hearing loss, and kidney abnormalities can all be a sign of branchio-oto-renal syndrome.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you or your children have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes Preauricular Sinus?
The visible part of the ear is called the auricle. It forms during the sixth week of gestation. When auricular development encounters fusion problems, a preauricular pit forms.
What increases my risk for Preauricular Sinus?
Please discuss with your doctor for further information.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is Preauricular Sinus diagnosed?
A preauricular pit may go unnoticed at birth. Whether you or your primary care provider first notices the tiny hole, the next step is to see an otolaryngologist. An otolaryngologist can perform the proper evaluation of the pit and any associated risks. During the course of the evaluation, the otolaryngologist may:
- Rule out various genetic syndromes that cause abnormalities of the face and head; some syndromes cause more severe abnormalities with the ear, including folded or asymmetrical ears, and hearing loss as well. Sometimes, these additional abnormalities can be very mild and hardly noticeable, but a specialist’s careful eye can recognize them.
- Examine your child’s pits and look for signs of cysts or infection.
- Perform imaging, such as a CT scan or MRI with contrast, in cases where the pit is in an atypical location, such as below the external auditory canal (closer to the lobe); this can be signaled by frequent swelling. Imaging is also generally recommended when pits appear with other outer-ear abnormalities.
- Perform imaging to help the doctor differentiate cysts and abscesses
- Perform an ultrasound of the kidneys if your child has preauricular pits and a branchial cleft cyst, to rule out branchio-oto-renal syndrome
- Perform an audiogram if the pits are associated with other outer-ear deformities. Pits by themselves don’t usually require a hearing test. Confirmation of normal hearing is recommended for children with ear deformities in addition to pits.
- Refer your child to appropriate specialists if he has organ system abnormalities or other syndromic features.
How is Preauricular Sinus treated?
An otolaryngologist is the best type of specialist to recommend and perform treatment for a preauricular pit since treatment can vary according to a complex set of factors. In addition, if the sinus tract ultimately requires surgical removal, the tract might be lengthy and convoluted and best left to the most experienced hands. Possible treatment approaches include:
- Leaving a pit alone if it doesn’t become infected.
- Prescribing your child oral antibiotics if the pit shows the earliest signs of infection, including redness and swelling.
- Performing needle aspiration on a difficult infection known as an abscess, if it fails to respond to antibiotics. The doctor may “culture,” or examine, the bacteria extracted from the pus.
- Performing incision and drainage if the abscess fails to respond to needle aspiration.
- Surgically removing the entire tract if the pit is prone to recurrent infections. The procedure is done under general anesthesia and may take up to an hour; it can be done in an outpatient facility. A surgeon will usually postpone surgery until after an infection and residual inflammation are cleared up. Pits behind the external auditory canal require two incisions to remove the tract completely.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage Preauricular Sinus?
The following lifestyles and home remedies might help you cope with Preauricular Sinus:
If your child does have surgery to remove his pit, he can usually go to an outpatient facility for this procedure and be sent home the same day. The doctor and nurse will recommend wound care for the bandaged area, prescribe antibiotics, and schedule a follow-up appointment. Sutures will dissolve on their own. Your child will need to keep his head elevated at night for about a week and avoid showering until the bandage is removed. He can usually return to school within the week but will have to avoid strenuous activity for several weeks.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Preauricular Pits. https://www.chop.edu/conditions-diseases/preauricular-pits. Accessed July 30, 2018.
Preauricular sinus. https://rarediseases.info.nih.gov/diseases/10507/preauricular-sinus. Accessed July 30, 2018.
Review Date: August 24, 2018 | Last Modified: September 13, 2019