What are Pre-Auricular Cysts?

Pre-Auricular cyst

Some people are born with a small dimple right in front of the ear, where the arch of the ear lobe inserts into the face. Simply put, this is a remnant of a cyst that used to exist in front of our ears before we were born. In the majority of the people, this cyst completely obliterates before birth. In select people, the cyst never goes away and the sac as well as the connecting duct to the outside of the skin persists.

The portion of the cyst that is underneath the skin is also lined with normal skin tissues. As such, it does produce new skin on a regular basis, and the old skin is shed off. However, since the old skin cannot be washed away during regular showering, some of this accumulates within the sac. Occasionally the sac may become bigger or even get infected.

Most patients with preauricular cysts may never experience symptoms, or at least not manifest those symptoms until later in life. Conversely, some children exhibit issues with recurrent infections right away. Some other people complain of occasional drainage from the pit. During periods of infection, patients usually experience rapid swelling as well as redness and pain in the area. The drainage may increase and become more pus like.

It was previously recommended to remove all these preauricular cysts preventively before any symptoms develop. Newer thinking recommends such procedures only in symptomatic patients. During an active infection episode, the treatment is to be given oral antibiotics. If there is a large collection underneath, the patient may also need to have drainage of abscess done in the emergency setting. The patients with frequent infections could benefit from having the entire sac removed during surgery. This is typically done in the operating room under general anesthesia, as the deeper portion of the sac runs to the cartilage of the ear which might also need to be removed at the same time.

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Posted in: Ears

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