Preauricular Sinus: What is this?

Do you notice these little “holes” in front of your ears? Many people have them and think they are normal but they aren’t! The “hole” is a leftover sign of your ear development which wasn’t completed when you were still growing in your Mum’s tummy. If they never become infected, then you can just leave them alone. But the problem is a preauricular sinus carries the risk of ear infection which can present with ear pain and swelling.

Sometimes, there is yellow fluid leaking out of the “hole” which originates from a deeper cyst under the skin. Dirt and skin oils tend to build up at the “hole” opening, which then leads to higher risk of infection. There usually is an underlying skin cyst connected to the “hole” on the surface. This skin cyst (preauricular cyst) can become infected or worse, grow to form a large ear abscess!

PREAURICULAR SINUS: WHEN SHOULD I WORRY?

You should watch out for the following signs of ear infection from the preauricular sinus:

1. Yellow liquid leaking from the preauricular sinus opening
2. Swelling or “lump” around the preauricular sinus which may be painful
3. Red inflamed skin surrounding the preauricular sinus

If you see any of the above signs in you or your child, please see an ENT specialist in Singapore quickly. You need to start antibiotics! In more severe cases, drainage of the trapped infected fluid may need to be done (abscess drainage).

PREAURICULAR SINUS: HOW DO I TREAT?

Usually, if the “hole” opening never becomes infected, then you or your child do not need surgery. Just be careful to keep the area clean. Try to avoid trauma to the preauricular area too as that can sometimes cause inflammation.

The treatment of preauricular sinus ear infection is quite clear:

1. Treat with antibiotics first.
2. May need incision and drainage to release any underlying trapped pus and infected fluid (abscess stage).
3. Even after the infection is better, we would still advise complete removal of the preauricular sinus and its underlying cyst to prevent future infections. This is minor surgery (day case).

PREAURICULAR SINUS SURGERY: WHAT DO I NEED TO KNOW?

This is a day surgery procedure under general anesthesia with you asleep. The main risk of this procedure is 5% risk of recurrence of the preauricular abnormal tissue. Recurrence means that some remaining tissue may eventually grow back to cause future infections. So it is very important that we remove the underlying cyst, track and the piece of ear cartilage that the preauricular cyst is growing from. Pretty straightforward in both children and adults actually!

The scar usually heals quite nicely afterward. Some patients feel a slightly numb or altered sensation around the scar area but this usually recovers with time. Most patients are so happy to get rid of their preauricular sinus ear infections that this minor effect doesn’t bother them!

PREAURICULAR SINUS: HOW DO I LOOK AFTER MY WOUND AFTER SURGERY?

Wound care postop after preauricular sinus surgery is quite straightforward!

You don’t really need to do very much frankly. Your wound is already dressed with a waterproof plaster to keep the area dry.

Some helpful things to take note of:

1. Keep the wound area dry eg during shower, for a week. Wash hair only after at least 72 hours after surgery.
2. Please remember to complete your course of antibiotics given to you after surgery.
3. Come for your clinic appointment a week later for removal of your stitches! In children, we use dissolvable stitches so no need to get stressed over stitch removal, parents!

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