Preauricular sinus

Preauricular sinus is a common congenital condition particularly in the Orientals. There is no need for any treatment unless it becomes infected (Fig. 20.1). It may then present with pain, swelling and discharge. If seen at an early stage,

Figure 20.1. An infected preauricular sinus.

infected preauricular sinus may be controlled with antibiotic. If a patient presents with a preauricular abscess, I&D together with antibiotic become necessary. The site of incision should be through the sinus opening so as to minimize branching of the sinus tract. This is particularly important with recurrent preauricular abscess. Abscess formation or recurrent infections are indications that the sinus tract should be excised. It is important that all sinus tracts should be excised to prevent recurrence. If in doubt, any soft tissue adherent to the tract should be excised as deep as the tem-poralis fascia. The supra-aural approach is a suitable choice with good results.

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