Preauricular pits - A hole in the ear

If you just started noticing changes in your hearing, Amplifon is here for you.

What are preauricular pits, sinuses or cysts?

Preauricular sinus is an uncommon occurrence in the human body, characterised as a harmless genetic anomaly. It manifests itself as a small hole near the ear's cartilage and is typically present from the early stages of fetal development. Surgical intervention may be necessary to remove this small hole. It is common for the preauricular sinus to appear on only one ear, while the occurrence of two holes on both ears is rare.

Causes of preauricular pits

Preauricular pit is the result of a benign genetic anomaly that is not present in all individuals. It develops during fetal development and has a hereditary component. This malformation occurs when the longitudinal gills (residual gill cysts) fail to fully absorb during embryonic life. In most cases, it does not cause any issues and remains asymptomatic. However, there are instances where it can lead to infections with varying degrees of severity and associated symptoms.

Genetic factors and hereditary predisposition

Hereditary predisposition is believed to be a contributing factor in the development of preauricular sinus, as it is a genetic malformation. This malformation is thought to occur due to abnormalities in the formation of the branchial ridges during fetal development. Normally, these ridges develop into various structures, including the ears. However, in the case of preauricular sinus, the branchial ridges may remain separate from the rest of the system and form the sinus.

Beckwith-Wiedemann syndrome

Beckwith-Wiedemann Syndrome (BWS) is a rare genetic disorder that is present from birth and can impact various organs and tissues in the body. It arises from abnormalities in genes, primarily on chromosome 11. One of the possible associated features of BWS is the presence of a preauricular sinus, also known as a congenital ear fistula, and can be linked to serious conditions involving kidney dysfuntion. Although the precise relationship between BWS and preauricular malformation is not fully understood yet, research has revealed that the condition affects the regulation of genes that play a crucial role in growth and development during embryogenesis.

Branchiootorenal Syndrome

Branchio-Oto-Renal Syndrome (BOR) is a rare genetic disorder characterised by abnormal development of the gills, ears, and kidneys. This syndrome can occur with various manifestations, but common symptoms include neck and facial structure abnormalities, hearing loss, outer ear abnormalities, and kidney problems. BOR has multiple genetic forms, and in some cases, a correlation between Branchio-Oto-Renal Syndrome and preauricular sinus has been observed. This association can be explained by the fact that both conditions stem from abnormalities during the embryonic development of neck and ear structures. Specifically, alterations in the branchial ridges during fetal development can cause the formation of the preauricular sinus and the manifestation of the defects associated with BOR.

Mandibulofacial Dysostosis

Mandibulo-Facial Dysostosis (MFD), commonly referred to as Treacher Collins Syndrome, is a rare genetic disorder characterised by abnormal skull and facial development. While no direct link has been established between Mandibulo-Facial Dysostosis and preauricular sinus, both conditions stem from disruptions in the embryonic development of the face and nearby structures.

We're here to help.

We take the time to understand your hearing health and the impact it’s having on your life and the people closest to you. With approximately 200 Amplifon clinics in the UK, we can ensure that we can support you when you need us most. Whether you need a FREE hearing test, or a hearing aid adjustment, our audiologists will provide you with expert, professional advice.

Symptoms of preauricular pits

In certain cases of preauricular sinus, more severe infections can occur, which are typically characterised by symptoms such as localised swelling accompanied by redness, the development of abscesses, varying degrees of pain and discomfort, and the presence of fluid discharge.

Testing and diagnosis

Typically, the diagnosis of preauricular sinus is determined through a physical examination conducted by a physician or otolaryngologist. The doctor examines the area surrounding the ear to identify any abnormal lump or cavity in the skin. In some instances, further tests or diagnostic investigations may be necessary to confirm the presence of preauricular sinus and evaluate its extent. These additional examinations can include ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT). These imaging tests provide more detailed images of the region surrounding the preauricular sinus and help rule out other potential conditions. In rare cases, a biopsy may be required to confirm the diagnosis or exclude other disorders.

How are preauricular pits treated?

If the preauricular pit is prone to infection, the recommended treatment involves administering antibiotics and draining any pus to clean the affected area. In cases where infections persist or symptoms worsen, it is best to consult a surgeon who specialises in otolaryngology. Since the preauricular sinus is in close proximity to the facial nerve, specialised intervention by a qualified physician is necessary to ensure targeted and appropriate care.

How is an preauricular pit removed?

Surgical removal is another option for treating a preauricular sinus. This procedure involves removing the core and subcutaneous tract of the sinus, especially when there is a history of recurrent infections. Surgical removal of preauricular sinus fistulas is typically carried out under local anesthesia. The procedure involves making a skin incision in front of the auricle to remove the fistula. It is important to excise the fistula along with a small section of surrounding skin. To aid in the healing process and prevent complications such as hematoma, a small silicone tube, known as a drain, may be inserted into the surgical cavity for a few days to remove serum secretion.

Is there a link between tinnitus and headache?

Find out more about the relationship between tinnitus and migraine.

Learn more

Complications with preauricular pits

Complications associated with the removal of preauricular cysts should be considered. While the duration of the surgical procedure is typically short, there are potential risks involved. These include:

  • Pain during chewing for a few days.
  • Discomfort when moving the neck.
  • Postoperative bleeding, although it is usually well controlled.
  • Occurrence of a hematoma after surgery, which is possible but not usually a cause for concern.
  • Infection at the surgical site, which can typically be managed effectively with antibiotics and, if necessary, further surgical intervention.
  • Painful or excessive scarring of the skin, known as keloid formation.
  • Possibility of recurrence, even after a properly performed surgery, indicated by the reappearance of swelling or a fistulous opening.

Are preauricular pits dangerous?

Typically, the presence of a preauricular pit is not deemed harmful and does not need treatment unless it leads to symptoms or complications. However, there are instances where the malformation can become infected or develop an abscess. In such cases, individuals may experience pain, swelling, and redness in the surrounding region. If an infection arises, it is advisable to consult a doctor for evaluation. The doctor may prescribe antibiotics or perform an abscess drainage procedure if deemed necessary.

Is preauricular pit surgery dangerous?

Surgery is frequently required when the preauricular pit becomes infected. As with any surgical procedure, there are potential risks involved. However, these risks are typically well managed through the use of anti-inflammatories and antibiotics.

What happens if preauricular pit is not treated?

While it is extremely rare for an infected preauricular sinus to directly cause hearing loss, there are potential risks if the infection is left untreated. If not properly treated, the infection in the preauricular sinus can spread to the outer ear or external ear canal, leading to ear problems like otitis externa. It is crucial to take infections in the preauricular sinus seriously and seek appropriate treatment to prevent complications.

How long does it take to heal?

The length of time it takes to heal depends on the size and complexity of the sinus. Following the procedure, it is common to experience some discomfort or uneasiness in the treated area. However, pain can usually be managed by taking the pain relievers prescribed by the doctor. The healing process can vary from person to person and may take around two weeks, depending on the specific type of surgery performed.

Is preauricular pit surgery painful?

Preauricular sinus excision surgery is not painful because it is performed under local anesthesia. However, you may experience some discomfort a few days after the operation.

Inflamed preauricular pit: what to do?

If an individual experiences an inflammation in the preauricular sinus, it is best to promptly seek medical assistance. A healthcare professional will assess the situation and provide appropriate guidance, which may involve prescribing anti-inflammatory medication and/or antibiotics. In more complex cases, drainage of the infected area may be necessary. This procedure should be carried out by a physician in a sterile environment to ensure safety and effectiveness.
Find your nearest clinic in one click

Preauricular pits prevention

The occurrence of this malformation during embryogenesis cannot be prevented. However, if symptoms worsen, it is advisable to seek medical attention to prevent any further complications or deterioration.

Try our online hearing test

Take a quick, easy test to find out how you're hearing.

Have a look at out related contents

Learn more on how your hearing works, thanks to our experts contents. You can also have a look at our blog, with our latest news. 

Get support and advice

Book a free hearing test

Book now

Test your hearing online

Take the test

Find your nearest store

Find a store