Abstract
Preauricular sinus is a common congenital malformation. Unusual presentations can be subtle with some difficulty in obtaining diagnosis. A 27-year-old woman with 6 months history of recurrent right postauricular swelling which was initially thought to be a recurrent mastoid abscess presented. She had repeated incision and drainage with recurrent post auricular abscess. An incidental extravasation of fluid from an asymptomatic preauricular sinus during postauricular abscess cavity irrigation and a positive fistulogram revealed the diagnosis. Combined excision of the preauricular sinus tract and postauricular abscess cavity achieved a good outcome with patient been asymptomatic over a period of one-year follow-up. There should be a high index of suspicion of recurrent abscesses in close proximity with an ipsilateral preauricular sinus in the head and neck region.
Highlights
Preauricular sinus is a common congenital malformation characterised by a nodule, dent or dimple located anywhere adjacent to the external auditory canal [1]
Combined excision of the preauricular sinus tract and postauricular abscess cavity achieved a good outcome with patient been asymptomatic over a period of one-year follow-up
There was no opening in the ear canal and the course of the tract was oblique to the ear canal, which strongly suggest a preauricular sinus abscess rather than a branchial cleft type I anomaly [5]
Summary
Preauricular sinus is a common congenital malformation characterised by a nodule, dent or dimple located anywhere adjacent to the external auditory canal [1] They are not rare anomalies of the ear, though not frequently diagnosed in routine ear examinations. When it is infected results to erythema, discharge, oedema, pain and if the sinus ostium is blocked pus accumulates leading to abscess formation It may be complicated by infections spreading to contiguous structures such as pinna, external auditory canal and temporomandibular joint. Differentials of postauricular abscess are inflamed adenopathy, infected epidermoid cyst, mastoiditis, subperiosteal abscesses, the latter two cases mostly coexist with auditory and vestibular symptoms [4] [5] This communication documents a preauricular sinus with unusual presentation while highlighting the features which culminated in its diagnosis and appropriate management
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