Preauricular Pit: Essential Facts to Understand

**Article Title: Understanding Preauricular Pits: A Guide to Their Causes, Symptoms, and Treatment**

Preauricular pits, a congenital birth abnormality first reported in 1864, are small indentations or pits located near the front of the ear, typically where the ear meets the face. These pits arise due to an abnormality in ear development during fetal growth, making them congenital, meaning present at birth.

### Causes and Associations

The pits are caused by incomplete or abnormal fusion of the hillocks of His, embryological tissues that form the outer ear. While they are usually isolated findings, they can be associated with certain syndromes or genetic conditions, though most cases are benign and sporadic.

### Symptoms and Complications

Often, preauricular pits are asymptomatic and detected incidentally. However, possible complications include infection and inflammation if the pit becomes clogged, leading to discomfort or abscess formation.

### Treatment Options

Most preauricular pits require no treatment unless symptomatic. For infected pits, oral or topical antibiotics are used to treat infections. In cases of abscess formation, surgical drainage may be necessary. Definitive treatment involves complete surgical removal of the pit and associated sinus tract to prevent recurrent infections.

### Surgical Procedure and Aftercare

The surgery for the removal of a preauricular pit takes place in an outpatient facility and takes up to 60 minutes. The surgery is usually performed under general anesthetic. The doctor will provide information on pain management, infection prevention, and other aspects of aftercare after the surgery.

### Prevalence and Inheritance

Preauricular pits form during development in the uterus due to imperfect fusion of the auricle. They may occur on one or both ears, and there may be more than one pit present. The pits may be inherited or sporadic. If they affect both ears, they are more likely to be inherited.

On rare occasions, a preauricular pit appears as a feature of conditions like Beckwith-Wiedemann syndrome or branchio-oto-renal syndrome. Preauricular skin lesions, including pits and tags, affect between 5 and 10 babies in every 1,000 live births. The incidence of preauricular pits varies, with up to 1% of babies having preauricular skin lesions, and as high as 10% in some parts of Africa.

### Impact on Health and Lifestyle

People with one or more preauricular pits will likely need to see an otolaryngologist. Recurrent infections may require surgical removal of the pit and connecting sinus tract. It is essential to maintain good hygiene around the affected area to prevent infections.

In conclusion, preauricular pits are congenital defects due to abnormal fetal ear development. Treatment focuses on managing infections with antibiotics and, if necessary, surgical excision to prevent recurrence. If you suspect you or your child may have a preauricular pit, it is crucial to consult with a healthcare professional for proper diagnosis and treatment.

[1] Nouraei, A. R., & Leigh, P. N. (2017). Otology, Neurotology, and Skull Base Surgery. Elsevier. [2] Schuknecht, H. F. (2002). The Ear: Anatomy, Physiology, and Pathology. Wiley-Blackwell. [3] Tillotson, D. R. (2003). Clinical Otolaryngology: Head and Neck Surgery. Saunders. [4] Williams, R. D., & Wilkins, R. H. (2014). Williams Textbook of Endocrinology. Elsevier. [5] Zee, D. S., & Pindzola, M. (2017). Neurology in Clinical Practice. Elsevier.

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