Operačné riešenie a recidíva u pacientov s preaurikulárnym sínusom v 15-ročnom súbore Detskej otorinolaryngologickej kliniky LF UK a NÚDCH v Bratislave

Abstract

Summary Introduction: Preauricular sinus (PAS) is a congenital defect of soft tissue located in the preauricular region. Its manifestation usually occurs when the sinus is infected but there is a possibility that preauricular sinus will not manifest at all. Surgical drainage is indicated in case of abscess formation. Complete extirpation is the method of choice in case of acute infection or long-lasting secernation from sinus. Failure to completely excise preauricular sinus is a common complication of the surgical intervention. The aim of this article is to get familiar with PAS, analyze group of observed patients and evaluate risk factors leading to recurrence of PAS. Material and methods: We evaluated a group of 55 patients with the PAS diagnosis (55 surgical extirpations PASS, N = 55) who underwent surgery at the Department of children otorhinolaryngology of MFCU and NICD during 15-years long period. It is retrospective analysis that is focused on surgical intervention and PAS recurrence. Results: In the observed group of patients (N = 55), 49 patients (89.09%) fully healed without any recurrence and 6 patients (10.91%) had a PAS recurrence. Conclusion: The most of PAS recurrences are results of an incomplete extirpation. The main reason for this is problematic identification of the PAS in its entirety. There are factors which lead to lower prevalence of PAS recurrence. They are precise dissection of PAS, an experienced surgeon, surgical procedure in general anaesthesia, identification of PAS in its entirety with all its branches using instillation of methylene blue, using a sondage and microscope, using an extended supra-auricular approach to identify temporal fascia, total removal of all epithelial components of the PAS with extraction of auricular cartilage that adheres to the sinus, prevention of rupture and leaking of a content of the PAS during surgery and reduction of a dead space in the wound using precise suture without drainage. Key words preauricular sinus – abscess – drainage – extirpation – recurrence