Preauricular sinus: A comparative study between different surgical approaches

Ahmed Shaker ElAassar, Mohammad Abd-El Hady, Sherif M Askar, Hazem Said Amer, Mohammad Waheed El-Anwar

Indian Journal of Otology 2017 23(3):193-196

Background: The preauricular sinus is a congenital abnormality of the external ear that is usually asymptomatic. However, if recurrent infection, persistent discharge or abscess formation occurs, complete surgical excision of the sinus is required. Objective: The objective of the study is to compare the long-term results of the preauricular sinus excision by simple sinectomy, microscopic-assisted sinectomy, and supra-auricular approach. Patients and Methods: Patients who had symptomatic preauricular sinus scheduled for surgical excision were randomly categorized into three groups: Group A (sinectomy) for whom preauricular sinus was excised by simple sinectomy using methylene blue; Group B (microscopic-assisted sinectomy) treated by simple sinectomy using the microscopic to follow, dissect out and excise the sinus tract(s); and Group C (supra-auricular approach) treated by the supra-auricular approach. Results: Excisions of 68 preauricular sinuses were carried out in 58 patients. The mean follow-up period was 19.7 months with a range of 9–30 months. The overall recurrence rate was 13.4% (9 cases). The timing of recurrence ranged from 3 to 6 months (3–12 months). The simple sinectomy technique had the highest recurrence rate (28%). The recurrence rate of the microscopic-assisted technique was 15% while the supra-auricular approach had the lowest recurrence rate (3.4%). Conclusion: The supra-auricular approach offers the most favorable outcome for the management of the preauricular sinus.

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