PITFALLS IN THE MANAGEMENT OF PREAURICULAR SINUSES

A total of 159 operations for the excision of a preauricular sinus car ried out in 117 patients over an 8-year period were reviewed. Previous excision, the use of a probe to delineate the sinus and operating und er local anaesthesia all increased the chance of recurrence. The condi tion recurred more often in patients who developed postoperative sepsi s than in those who healed primarily. Means of decreasing the recurren ce rate include: (1) meticulous dissection of the sinus by an experien ced head and neck surgeon under general anaesthesia; (2) the use of an extended preauricular incision; (3) clearance down to the temporalis fascia to ensure complete removal of all epithelial components; (4) av oidance of sinus rupture; and (5) closure of wound dead space.