Section 9


What is the diagnosis?

Preauricular pit / sinus

What is the embryological origin of this condition?

Incomplete fusion of Hillocks of his

Name a differential diagnosis for this.

First branchial cleft cyst

What syndrome might this be associated with?

Branchio-oto-renal syndrome

Name two techniques to help ensure the whole tract intraoperatively?

  • Use of methylene blue to stain tract
  • Use of lacrimal probe

Supporting Information

Preauricular pit/sinus- incomplete fusion of the Hillock of His (one of 6, derived from branchial arch 1 and 2).

  • Associated with branchio-oto-renal syndrome with neck sinus, hearing loss and kidney dysfunction. 
  • Conservative if asymptomatic
  • Abx if infected then surgery
  • Surgery- elliptical incision followed by dissection down to temporalis fascia and cartilage at root of helix which is resected. May use methylene blue. Risks, infection, bleeding, scar, recurrence.
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