Pre-auricular sinuses are small holes or cysts that develop above the ear canal, in front of the ear. They are also known as pre-auricular pits, cysts or fissures.
The small hole is indicative of a sinus tract under the skin that has developed as a result of failure of fusion of the parts which give rise to ear auricle development as a fetus.
Pre-auricular sinuses are congenital (ie; present at birth) but they are not associated with hearing loss, and rarely its associated with genetic syndromes such as Branchio-otorenal syndrome where there are other associated abnormalities.
The main problem with preauricular sinuses is they can get infected resulting in:
- Smelly or purulent fluid discharge from the sinus
- Pus and abscess formation around the pre-auricular area
If there is pus formation, it may require drainage of the pus before it gets better. A child or adult with repeated infections of their preauricular sinus will be recommended to excise the sinus. If the sinus does not pose chronic problems, it can be safely left alone and observed.
Pre-auricular sinuses can be confused with 2 other conditions:
- Pre-auricular ta g: these are skin tags at the front of the ear canal without any sinus tract. They do not cause infections like pre-auricular sinuses do.
- Branchial cleft cyst: this is a congenital condition whereby there is failed fusion of parts of the branchial arches during development.