Preauricular sinuses in the pediatric population: techniques and recurrence rates

Abstract

Aim: To review the outcomes of two surgical techniques in the management of preauricular sinus in the pediatric population.

Methods: The clinical records of pediatric patients who underwent surgical excision of preauricular sinus in the Department of Otolaryngology of KK Children's and Women's Hospital between January 1997 and March 2009 were retrospectively reviewed. Patients were categorized into two groups, based on the method used for sinus tract visualization or delineation: (1) Microscope group and (2) methylene blue dye and probe group. The latest information on recurrence of preauricular sinus and complications after surgery were updated by phone interview.

Results: 208 out of 305 preauricular sinuses were included in this study (n=114 in microscope group; n=94 in methylene blue dye and probe group). 97 cases were excluded as these patients were not contactable by phone or had inadequate data from the clinical records. The mean age of the patients is 6.5 years old. The overall recurrence rate was 2.4% (95% confidence interval (CI) 0.010-0.055) and the overall complication rate was 6.3% (CI 0.037-0.104). Surgical excision with microscope guidance had significantly lower recurrence rate (0.9%) compared to surgical excision with methylene blue dye and probe guidance (4.3%), with an odds ratio of 28.4 (CI 1.22-659.99, P=0.037). The complication rates were not statistically significant between the two groups. The recurrence and complication rates were not significantly affected by race, gender, sex, location of sinus, indication for surgery, history of previous sinus excision, presence of infection during surgery and duration of surgery.

Conclusion: Surgical excision of preauricular sinus under microscope guidance and under methylene blue and probe guidance in our series had very low overall recurrence and complication rates compared to that reported in the literature. The microscope group had a lower recurrence rate in comparison to that of the methylene blue and probe group.