Unveiling Preauricular Sinus: A Case Report of Misinterpreted Postauricular Cyst

Preauricular sinus (PAS) is a congenital malformation of preauricular soft tissue, with an incidence of 0.1%–0.9%. Sinuses appear as little dells in front of the external ear, at the anterior margin of the ascending limb of the helix. . The majority of PAS are asymptomatic and require no therapy. However, surgical treatment is required for inflammation, persistent discharge, redness, and increasing symptoms, such as abscesses. Postauricular extensions are uncommon in PAS, and they may manifest as cysts or abscesses. The formation of PAS can be explained by defective fusion, incomplete closure, or isolated ectodermal folding. The postauricular sinus has a varied course, with the “postauricular sinus” variant showing sinus opening posterior to the tragus and in close proximity to the helix crus. In rare cases, postauricular sinus should be considered if recurrence occurs even after appropriate antibiotic therapy, incision and drainage, and excision of mass like lesions in the retro auricular region. Surgical excision is the definitive treatment for infected PASs and cysts. We discuss the case of a 4 year old female child who presented with chronic discharge and edema in the right postauricular area for 2 years. The discharge was purulent, malodorous, and sometimes sanguineous. The edema was accompanied by erythema and discomfort. She received antibiotics and analgesics, followed by complete excision of the sinus tract. The injury healed without a noticeable scar. The patient was monitored for 6 months, and no recurrence was seen. A preauricular abscess may appear when the PAS is symptomatic, despite the fact that it is frequently asymptomatic. A postauricular abscess is an uncommon manifestation of a kind of PAS. This brings us to the conclusion that, in order to prevent recurrences, the sinus tract should be completely resected after it has been opened and carefully monitored using a variety of methods.