Surgical technique for complicated preauricular sinus: Pilot study of double elliptical excision with coaptation suture

• Published in: International journal of pediatric otorhinolaryngology Vol. 177; p. 111858
• Main Authors: Lee, Jae Woo, Seo, Kwang Sik, Oh, Se-Joon, Kong, Soo-Keun, Kim, Seok Hyun, Lee, Il Woo, Lee, Hyun Min
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.02.2024
• Subjects: Child; Child, Preschool; Complicated case; Congenital; Craniofacial Abnormalities; Double elliptical excision; Female; Humans; Male; Operative; Pilot Projects; Postoperative Complications - epidemiology; Preauricular fistulae; Retrospective Studies; Surgical procedures; Suture Techniques; Sutures; Treatment Outcome; Preauricular fistulae; Operative; Congenital; Surgical procedures; Complicated case; Double elliptical excision
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2024.111858

Preauricular sinus (PAS) is a congenital anomaly that can progress to complicated cases with granulation tissue around the PAS area due to skin inflammation. Treatment involves incision and drainage or continuous dressing; however, surgical treatment may be necessary. We evaluated a surgical method for the effective treatment of complicated PAS. We retrospectively reviewed the medical records of 152 patients with PAS who were treated at a tertiary medical institution between September 2015 and June 2022. Data regarding age, sex, preoperative history related to PAS, a joint operation with a plastic surgeon, operation time, admission duration, follow-up duration, and postoperative complications were collected. The study population was divided into single-excision and double-excision with coaptation suture groups. The clinical characteristics were analyzed and compared between the two groups. Surgical treatment for PAS was performed in 131 patients (166 ears) in the single-excision group and 21 patients (27 ears) in the double-excision group. The average age was 6.22 ± 4.06 years old, and the male-to-female ratio was similar in the single-excision group (M:F = 68:63) but higher for females in the double-excision group (M:F = 5:16) (p = 0.017). Joint surgeries with a plastic surgeon were more frequent in the double-excision group, and the operation time and admission duration were significantly longer. The preoperative history and postoperative complications (seven cases, 4.6 %) did not differ significantly between the two groups, although there was a higher percentage of complications in the double elliptical excision group. Double excision with one or more coaptation sutures is an effective one-step method for complicated PAS with an acceptable aesthetic appearance of the scar, although it requires a longer operation time and admission duration for wound care. Further studies with larger and more diverse patient populations are needed to validate these findings. •We retrospectively evaluated 152 patients with preauricular sinus (PAS).•The population was divided into single and double excision groups.•Preoperative history or postoperative complications were similar between groups.•Double-elliptical excision with coaptation suture is effective for complicated PAS.