Preauricular Sinus: How To Get Better

Working as a busy ENT specialist means that we see a whole range of conditions affecting the ear, nose and throat. Our patients want to see a top ENT specialist in Singapore who is friendly and good with both children and adults. One interesting example of the many ENT problems we see is the preauricular sinus, an extra hole in front of the ear. This may become infected to form a painful swelling which discharges yellow pus in front of the ear.

WHY DO I GET THESE EAR INFECTIONS FROM THE PREAURICULAR SINUS?

So why do people get these unusual ear infections? The preauricular sinus forms when the ear does not develop entirely in a normal manner. A long track of ear skin lies deep in front of the ear to cause an ear infection. Doctors will prescribe antibiotics to treat any infection of the preauricular sinus. Ultimately, ENT specialists will advise complete surgical removal of the whole track (with the hole included) to prevent further ear infections.

For more information on other causes of ear infections, please see https://www.drannabelle.com/ear-hearing-ent-specialist.html

Sometimes, these extra holes in front of the ears may occur on both sides. In these cases, there may be an underlying genetic reason for bilateral preauricular sinuses. This means that other people in the same family may have this too. Such patients may also have underlying kidney abnormalities so they may need a scan of the kidneys.

DO I NEED SURGERY TO REMOVE THE INFECTED PREAURICULAR SINUS?

If you keep suffering recurrent infections of your preauricular sinus, then yes, you will need surgery to remove the entire infected structure. The preauricular sinus has a long track deeper underneath the skin. This leads to a cyst, a fluid-filled structure which is the root cause of the ear infection.

The surgery has one main aim only. We need to remove the ENTIRE preauricular sinus and cyst to prevent recurrent infection. If we leave a bit of the infected tissue behind, then there is a high chance of infection recurring. We tend to see infected preauricular sinuses in children and young adults. Sometimes, accidental trauma onto the preauricular sinus may cause it to become inflamed and infected.

WHAT IF THERE IS A PREAURICULAR ABSCESS BREWING?

A course of antibiotics sometimes helps. However if there is a painful lump around the area, there is an abscess forming. An abscess is a collection of trapped infected pus which we usually drain via a small incision. In adults, we can do this in clinic. But in young children, we have to do this under general anaesthesia.

Sometimes, a 2-stage surgical plan is needed if there is an abscess brewing. First priority is to drain the pus stuck inside the wound and to leave it open to heal. A few weeks later, we then do the formal excision of the entire preauricular sinus track and cyst. It is very difficult to find the entire preauricular sinus track to remove cleanly in an abscess.

WHAT DO I NEED TO KNOW ABOUT PREAURICULAR SINUS SURGERY?

This surgery is usually done as a day case, meaning you can go home a few hours later. Although we can do this under local anaesthesia with you awake, we prefer doing it under general anaesthesia. This is in case the infected track is very long and deep.

Patients don’t really complain about postop pain. They go home on a week’s course of oral antibiotics with a simple dressing. A week later, they come back for removal of stitches. For children, dissolvable stitches are usually used so no suture removal is needed.

The surgery is low risk. The main risk is that of recurrence of your preauricular sinus or cyst. We usually quote less than 5% risk of recurrent infection after surgery. There will also be a scar but this tends to heal quite nicely in most patients. Some patients report mild numbness of the skin near the incision but this usually improves with time.

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