Surgical deroofing in the treatment of patients with auricular pseudocyst

An auricular pseudocyst is a fluid filled cavity, characterized by a lack of epithelium, in the intra-cartilaginous space. Clinically, it presents as a painless lump on the upper anterior surface of the ear. Various treatment methods have been discussed in the literature, including aspiration, incision and drainage, or steroid injection. However, these approaches are associated with a high rate of recurrence and results are often esthetically unsatisfactory; therefore, a need for improved treatment approaches remains.

From March, 2015, to June, 2017, 15 patients with auricular pseudocyst were treated with surgical deroofing followed by local contour pressure dressing with a simple bolster. In addition, the structure of the auricular pseudocyst was assessed at a microscopic level.

Patients were followed up for a mean period of 12 months, during which time there were no reports of postoperative complications or recurrence. The results were cosmetically excellent in all patients and no cartilage deformity was seen. Considering the composition of pseudocysts seen on microscopic evaluation, deroofing to remove the anterior leaflet and removal of debris from the posterior leaflet is an appropriate treatment modality.

This reliable and simple approach may be recommended as first line treatment for auricular pseudocysts to avoid recurrence and complications associated with other treatment modalities, such as cartilage deformity, skin depigmentation, and scarring.