Overview
What are preauricular cysts, pits, and fissures?
How are preauricular tags characterized?
How can simple preauricular cysts differentiated from branchial cleft cysts?
What is the workup approach to preauricular cysts, pits, and fissures?
What is the treatment approach to preauricular cysts, pits, and fissures?
What is the incidence of preauricular cysts, pits, and fissures?
What is the role of genetics in the etiology of preauricular cysts, pits, and fissures?
In which syndromes are preauricular cysts, pits, and fissures characteristic?
What is the role of medication in the etiology of preauricular cysts, pits, and fissures?
What is the pathophysiology of preauricular cysts, pits, and fissures?
What is the presentation of noninfected preauricular pits?
What is the presentation of infected preauricular pits?
What is the presentation of preauricular cysts?
What is the presentation of preauricular tags?
What are the indications for treatment of preauricular cysts, pits, and fissures?
What is the relevant anatomy of preauricular cysts, pits, and fissures?
What are the contraindications to excision of preauricular cysts, pits, and fissures?
Workup
What is the role of lab studies in the evaluation of preauricular cysts, pits, and fissures?
What is the role of imaging studies in the evaluation of preauricular cysts, pits, and fissures?
What is the role of audiogram in the evaluation of preauricular cysts, pits, and fissures?
What is the role of needle aspiration in the evaluation of preauricular cysts, pits, and fissures?
What are the histologic findings characteristic of preauricular cysts, pits, and fissures?
Treatment
What consultations may be beneficial in the management of preauricular cysts, pits, and fissures?
What is the surgical treatment for abscessed preauricular cysts?
What anatomical boundaries help ensure complete excision of preauricular cysts?
What is the recurrence rate following preauricular cyst excision?
How are preauricular tags excised?
What should be done preoperatively to excision of preauricular cysts, pits, and fissures?
What is the standard approach to excision of preauricular cysts, pits, and fissures?
What is included in postoperative care following excision of preauricular cysts, pits, and fissures?
When should would evaluation occur following excision of preauricular cysts, pits, and fissures?
What are common complications of preauricular cysts, pits, and fissures excision?
What are less common complications of preauricular cysts, pits, and fissures excision?
What is the prognosis following excision of preauricular cysts, pits, and fissures?
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Preauricular ear tag. Image courtesy of Jack Yu, MD.
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Multiple tags in a child with oculoauriculovertebral dysplasia. Note the hemifacial atrophy, retrognathia, and lower set ear. Image courtesy of Jack Yu, MD.
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Uninfected preauricular pit. Image courtesy of Ed Porubsky, MD.
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Close-up image of preauricular pit. Image courtesy of Ed Porubsky, MD.
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Infected preauricular cyst with swelling and erythema toward the cartilage of the ear.
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A preauricular sinus tract is probed with a blunt needle, and methylene blue dye is injected. Note the region in front of the pit, where previous abscess formation, spontaneous drainage, and residual scarring and granulation have occurred. This circumstance requires a more complex procedure. Removal of the entire sinus tract and the granulation disease is essential. Image courtesy of Ed Porubsky, MD.
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Preauricular sinus tract, cyst, and granulation removed. The skin was closed with slight undermining and no tension. Sutures are removed 7-10 days later.
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Keloid scar formed several months after removal of preauricular sinus tract. Intralesional steroids and close observation are indicated.