Robert J Baatenburg de Jong1. 1. Department of Otolaryngology and Head and Neck Surgery, Leiden University Medical Center, The Netherlands. r.j.baatenburg_de_jong@lumc.nl
Abstract
BACKGROUND: The objectives of this paper are to describe the shortcomings of current techniques for treatment of preauricular sinus (PAS) and to introduce a new surgical technique. PAS is a common congenital abnormality. Usually these lesions are asymptomatic. However, some patients complain of discharge and/or (recurrent) infections, and require excision. Surgical treatment of PAS is characterized by high recurrence rates. This paper describes a single institution's experience with the operative management of PAS and introduces a new technique. METHODS: Data on PAS procedures were collected from a retrospective review of patients' charts and interviews by questionnaire of all patients treated operatively for PAS in the Leiden University Medical Centre from 1984 to 2003. RESULTS: Thirty-nine patients (21 male, 18 female) with PAS underwent 40 procedures for PAS. These procedures included 17 classic operations (in 16 patients) and the "inside-out technique" in 23 patients. In the patient group treated "classically," 2 patients developed a recurrence; one underwent successful reoperation; the other patient has been lost to follow-up. Another patient developed wound breakdown postoperatively, resulting in an ugly scar. Two patients had postoperative infections requiring treatment. Neither recurrences nor complications requiring treatment occurred in the group who underwent the inside-out technique. CONCLUSIONS: The inside-out technique provides an easy solution for patients with PAS. However, further study on a larger patient group is necessary.
BACKGROUND: The objectives of this paper are to describe the shortcomings of current techniques for treatment of preauricular sinus (PAS) and to introduce a new surgical technique. PAS is a common congenital abnormality. Usually these lesions are asymptomatic. However, some patients complain of discharge and/or (recurrent) infections, and require excision. Surgical treatment of PAS is characterized by high recurrence rates. This paper describes a single institution's experience with the operative management of PAS and introduces a new technique. METHODS: Data on PAS procedures were collected from a retrospective review of patients' charts and interviews by questionnaire of all patients treated operatively for PAS in the Leiden University Medical Centre from 1984 to 2003. RESULTS: Thirty-nine patients (21 male, 18 female) with PAS underwent 40 procedures for PAS. These procedures included 17 classic operations (in 16 patients) and the "inside-out technique" in 23 patients. In the patient group treated "classically," 2 patients developed a recurrence; one underwent successful reoperation; the other patient has been lost to follow-up. Another patient developed wound breakdown postoperatively, resulting in an ugly scar. Two patients had postoperative infections requiring treatment. Neither recurrences nor complications requiring treatment occurred in the group who underwent the inside-out technique. CONCLUSIONS: The inside-out technique provides an easy solution for patients with PAS. However, further study on a larger patient group is necessary.