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A Surgical Technique for Congenital Preauricular Sinus
Heon Yoo1, Dong Ha Park1, Il Jae Lee1
1Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
Insights
Surgical excision of preauricular sinuses using dye instillation and probe insertion achieved zero recurrence. This technique offers a promising prognosis for congenital ear anomalies.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Congenital Abnormalities
Background:
- Preauricular sinuses are common congenital abnormalities in children.
- Surgical treatment of preauricular sinuses is challenging due to high recurrence rates.
- This study reviews outcomes and presents a surgical technique for preauricular sinus excision.
Purpose of the Study:
- To review the outcomes of preauricular sinus treatment.
- To introduce a specific surgical technique for preauricular sinus excision.
- To evaluate the prognosis of the presented surgical method.
Main Methods:
- Retrospective review of 44 patients (57 sinus tracts) undergoing excision between 2007-2014.
- Preoperative dye instillation and intraoperative probe insertion for sinus tract visualization.
- Elliptical skin incision followed by medial and posterior dissection to the ascending helix cartilage.
Main Results:
- The study included 44 patients with 57 preauricular sinus tracts.
- No postoperative wound complications or infections were reported.
- A recurrence-free rate was achieved in all patients following the surgical procedure.
Conclusions:
- A combination of dye instillation, probe insertion, and modified dissection resulted in recurrence-free preauricular sinus tract excision.
- The technique demonstrated successful outcomes in a diverse patient group.
- Further studies with larger patient cohorts are recommended to validate these findings.
Background:
Preauricular sinuses represent a common congenital abnormality in children. Classically, a preauricular sinus manifests as a small opening, usually near the anterior limb of ascending helix. The difficulty in the surgical treatment of preauricular sinus is the high recurrence rate. The aim of this article is to review the outcomes of preauricular sinus and to introduce our surgical technique and its prognosis.
Methods:
A single-institutional retrospective review was performed for all patients who had undergone excision of congenital periauricular sinus between October 2007 and April 2014. Medical records were reviewed for demographic information, wound complication, and recurrence rate. The sinus tract was visualized with the aid of preoperative dye instillation and intraoperative probe insertion. The skin next to the sinus opening was incised elliptically, and the tract itself was dissected medially to the end of the sinus tract and posteriorly to the cartilage of the ascending helix.
Results:
The review identified 44 patients for a total of 57 preauricular sinus tracts. The mean age at time of operation was 16.3 years with a range from 9 months to 65 years. Unilateral preauricular sinus tract was present in 31 patients (11 right and 20 left preauricular tract), and 13 patients had bilateral sinus tract. None of the patients had experienced wound issues postoperative, and there were no recurrent sinus tract formation or infection.
Conclusion:
Using a combination of dye instillation, probe insertion, and modified dissection, we were able to achieve a recurrence free series of preauricular sinus tract excision among a heterogenous group of patients. A large patient series is necessary to replicate the results of this study.
