A preauricular pit is a small skin-lined blind-ending pit just in front of the ear. It forms during the embryological development of the ear. The pits usually affect one but can affect both ears. They usually occur in isolation and are rarely associated with developmental syndromes. They do not affect hearing but can get infected and form an abscess.
If they are asymptomatic, preauricular sinuses can be left alone and no intervention is required. If they get infected, antibiotic treatment may be prescribed and the sinus should be surgically removed once the infection has resolved.
Preauricular tags are fleshy knobs of skin in front of the ear that are not attached to a pit. Like preauricular pits, they are also developmental abnormalities of the ear and do not affect hearing. But unlike pits, they are not at risk of infection and are of cosmetic concern only.
Your child cannot eat for 6 hours before the procedure. In breast fed babies this time may be reduced by the anaesthetist. Your child can drink water for up to 2 hours before the operation. The Day Surgery Unit will instruct you the day before surgery to confirm fasting times. It is useful to bring your child’s favourite toy along on the day.
The anaesthetist will meet you and your child prior to the procedure. They will discuss the anaesthetic with you and take you through to the operating theatre. Your child will be anaesthetised using a face mask and then you will be taken to a waiting area. Once your child is asleep a drip is inserted often in the hand or arm, but occasionally it may need to be sited in the leg.
An elliptical incision is marked around the sinus or tag. For preauricular sinuses, a probe is inserted into sinus to determine its length and depth and then it is completely removed down to the cartilage of the ear. For preauricular tags the tag and its cartilaginous core is completely excised down to its base. Local anaesthetic is injected to numb the area. The wound is closed with absorbable sutures which are under the skin. Tissue glue is applied as a dressing. It is lilac in colour and takes 2 weeks to fall away. The whole operation takes around 30 minutes.
On completion of the operation your child will be taken to the recovery area. Children often initially appear distressed and a little confused upon waking up but will quickly settle down once you are with them and if offered a drink or something to eat. Full recovery usually takes about 2-3 hours after which you can go home.
Children’s paracetamol should be given for pain relief for 24 hours. After that use paracetamol only if needed. Some children need additional medication such as ibuprofen or celecoxib. Opiate (morphine-type) medications are not usually required. Paracetamol and ibuprofen can be given at the same time and work well together. Follow the dosages recommended on the packaging or by the anaesthetist. Never give more than has been prescribed.
It is quite normal for there to be some bruising in front of the ear. This usually resolves in week or so.
In general, your child may eat a normal diet after surgery. Vomiting is common on the day of surgery. It is temporary, and usually due to the anaesthetic and pain-relief medications that are used. If vomiting occurs, start with clear liquids and add solids slowly for the first day.
I will review your child 4-6 weeks after the surgery to ensure healing of the wound. For patients from rural areas this may be deferred to your local General Practitioner or Paediatrician. Please ring soon after the operation to arrange a convenient time.
This is a common operation with a low complication rate. The vast majority of children who have this operation recover well and have no serious complications of surgery. However, complications can occur. Some of the recognised ones include:
Preauricular tags do not recur. The chance of recurrence of a preauricular sinus is <5%. The risk is increased if there have been repeated episodes of infection or if the sinus was incompletely excised.
Infection & Bleeding
There is a 1-2% risk of bleeding or wound infection after surgery. The wound will appear red, be tender to touch and may discharge pus or blood. If this occurs, a course of antibiotics may be required, and you should contact me or present to your General Practitioner or Local Hospital as soon as possible.
Please refer to the following resource for more information:
This page is intended to provide you with information and does not contain all known facts about preauricular pits and sinuses. Treatment may have uncommon risks not discussed here. Please do not hesitate to ask any questions you may have.