A Case of Bilateral Postauricular Sinuses

Abstract

Preauricular sinuses are common congenital malformations that usually occur at the anterior margin of the ascending limb of the helix. There are rare cases in which the location of the preauricular sinus is posterior to the tragus, and the direction of the sinus tract is toward the posterior. This variant type of preauricular sinus is called, 'postauricular sinus'. Postauricular sinus is uncommon. Thus, diagnosis and treatment may be delayed due to its location of its opening and atypical clinical symptoms. Typical treatment is a single stage operation through bidirectional skin incision. However, we found out that according to the length and invasion depth of the sinus tract, there was an option between unidirectional and bidirectional skin incisions that we may choose from.

Ectopic Preauricular Sinus in a Facial Cleft and Microtia Patient

“…Chromosome locus 8q11.1–q13.3 has been reported as possible culprit [ 5 8 10 11 ]. Bearing in mind that the external ear originates from fusion of 6 hillocks of His: 3 caudal borders of the first brachial arch (gives rise to tragus and the anterior crus of helix) and 3 caudal border of the second branchial arch (gives rise to rest of the auricle) [ 1 3 5 6 8 9 10 11 ], it is no surprise the disease manifests in various types of syndromes and these include Branchio-Oto-Renal Syndrome, Branchio-Oto-Ureteral Syndrome, Branchi-Otic Syndrome, Branchio-Oto Costal Syndrome, Tetralogy of Fallot, and clinodactyly, Steatocytoma multiplex, rare syndrome of bilateral defects, deafness, preauricular sinus, external ear anomaly and comissural lip pit syndrome, Cat Eye syndrome, Wartenburg's Syndrome, Floating-Harbour Syndrome of unusual phenotype, Trisomy 22 mosaicisim, and Full Trisomy 22 [ 5 8 ]. Concomitant congenital anomalies related to hearing loss accounts for 1.7% of preauricular sinus, while renal problems are associated with 2.6% of the disease.…”

“…Preauricular sinus was first introduced in the literature in 1864 by Heusinger [ 1 2 3 4 5 6 ]. Similar terminologies that was used interchangeably in the literature are: preauricular pits, fistulas, tracts, and cysts [ 3 5 ].…”

“…Although asymptomatic disease can be left untreated, once infected however, surgical intervention is the mainstay treatment of choice [ 4 7 ]. Its incidence and prevalence are far higher among Africans followed by Asians and least common among Caucasians (African up to 10%, Koreans 5%, Taiwan 1.6%, and less than 1% in the United States and England) [ 1 2 4 5 6 8 9 10 11 ]. A retrospective study provides an imaginary tragal vertically extended line that demarcates and categorizes sinus into classical type (preauricular sinus) and variant type (postauricular type) [ 1 2 ].…”

Preauricular sinus: Incidence and inheritance

“…Rarely, however, similar structures can be located in other areas of the auricle such as the tragus, pinna, etc. due to the complexity of auricular formation (13)(14)(15).…”

Dual-incision approach for excision of postauricular sinus

“…1 ). This latter type of preauricular sinus is called postauricular sinus [ 2 – 4 ]. Surgery for typical preauricular sinus is usually not complicated because there is minimal involvement of the auricular cartilage.…”