Preauricular Cysts, Pits, and Fissures Workup
- Author: Samuel T Ostrower, MD; Chief Editor: Arlen D Meyers, MD, MBA more...
Culture samples may be obtained during drainage procedures.
Imaging is not indicated for routine preauricular cysts and sinuses.
Imaging is indicated in patients who present with pits or fistulas located in atypical regions, those with cartilage duplication around the external auditory canal that extends into the parotid, or those with recurrent parotid swelling. Sedation may be necessary in uncooperative or frightened children.
CT scans with contrast offer better bone definition, while MRI with contrast shows superior soft tissue delineation.
Ultrasound imaging may help the physician differentiate cysts, abscesses, and solid masses in this region, but it may not allow for complete analysis of the finer detail in small tracts and deeper fistulae.
Patients who have preauricular cysts or pits and a branchial cleft cyst should undergo a renal ultrasound to rule out branchio-oto-renal syndrome.
Audiogram is not indicated in isolated preauricular cysts, pits or tags.
Needle aspiration may be performed in patients with infected lesions that have not responded to oral antibiotic therapy.
Findings associated with ear pits include diffuse interstitial dermatitis, abundant foreign body reaction, and ruptured follicular cyst, epidermal cyst, and epidermal sinus tract.
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