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Causes and prevention of revision surgery for preauricular sinus: A histopathological analysis

Woo Jin Kim1, Yeo Myeong Lee1, Do Hun Kim1

  • 1Department of Otorhinolaryngology-Head &Neck Surgery, Inje University Busan Paik Hospital, Busan, South Korea.

International Journal of Pediatric Otorhinolaryngology
|December 18, 2018
PubMed
Abstract

Insights

Histopathological analysis of revision surgery for preauricular sinus (PAS) revealed residual epithelial-lined lumens and associated cartilage in most cases. Wide local excision of soft tissue and adjacent cartilage is recommended to prevent PAS recurrence.

Area of Science:

  • Otolaryngology
  • Surgical Pathology

Background:

  • Preauricular sinus (PAS) surgery recurrence rates vary.
  • Few studies have histopathologically investigated PAS recurrence after primary surgery.

Purpose of the Study:

  • To perform a histopathological analysis of revision surgery for PAS.
  • To identify causes of recurrence and reduce future recurrence rates after primary surgery.

Main Methods:

  • Retrospective review of medical records for patients undergoing revision PAS surgery (2002-2017).
  • Histopathological review of surgical specimens from revision surgeries.

Main Results:

  • 19 revision surgeries were analyzed; 73.7% showed residual epithelial-lined lumens.
  • 82.4% of lumens had attached cartilage, and 100% showed inflammation.
  • Granulation tissue was present in 52.6% of revision specimens.

Conclusions:

  • Recurrence is often due to residual epithelial tracts and associated cartilage.
  • Recommend wide local excision including inflammatory soft tissue.
  • Concomitant partial removal of adjacent ascending helix cartilage is advised to prevent PAS recurrence.
Keywords:
Congenital preauricular fistulaPathologyReoperation

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