S255 – Treatment of Complicated and Uncomplicated Preauricular Pits

Abstract

Objectives 1) To review our experience with complicated and uncomplicated preauricular pits requiring surgical excision. 2) To review relevant embryology, anatomy, and surgical technique. Methods A retrospective chart review from 2002 to 2007 was conducted at a tertiary care university hospital to identify patients less than 18 years old undergoing surgical excision of a preauricular pit. Charts were reviewed for patient age, presentation, complications, treatment algorithm, and outcome. Results 13 patients underwent surgical excision of a preauricular pit. The indication for excision was either recurrent infection or recurrent drainage in all cases. 3 of 13 patients had a pre-surgical complication of the infection, including localized cellulitis of the preauricular skin or infection of the helical cartilage. These patients were treated with a prolonged course of antibiotics prior to surgical excision. All 13 patients were treated with wide surgical excision; in the 3 patients with pre-excision complications, careful attention was paid to meticulous surgical excision of all involved tissue. There were no postoperative complications. No recurrences were noted at up to 3-year follow-up. Parents were satisfied with the cosmetic outcome in all cases. Conclusions Preauricular pits are an important entity due to their potential for significant infectious morbidity. Appropriate diagnosis and management with wide local excision, especially in the context of a complicated presentation, can result in excellent cosmesis with minimal risk of recurrence. Relevant embryology, anatomy, and surgical technique will be reviewed.