title: The preauricular sinus: factors contributing to recurrence after surgery.
abstract: OBJECTIVE
  The objective of this study was to summarize clinical presentation, treatment, and recurrence of preauricular sinuses.
  
  
  METHODS
  This retrospective, institutional review board-approved study reviewed the medical records of patients who underwent preauricular fistulectomy between January 1995 and June 2005 at university-based hospitals in South Korea. Only patients who underwent classic preauricular fistulectomy (not incision and drainage) and could be followed up for at least 3 months were included in the study.
  
  
  RESULTS
  A total of 191 patients (206 ears) were enrolled. The right and left ears were involved in 79 and 97 patients, respectively. The most common location of the preauricular pit was the anterior margin of the ascending limb of the helix (93.2%). The most common indication for surgery was the recurrent exacerbation of acute infection (58.3%). The recurrence rate after surgery was 4.9%. Surgery under local anesthesia contributed to recurrence after the procedure (P = .009) and the cases that featured local infiltrative anesthesia had a higher rate of recurrence than the cases that had general anesthesia with an odds ratio of 6.875.
  
  
  CONCLUSIONS
  Although this study showed that surgery under local anesthesia contributed to recurrence, it did not mean that it was only the anesthesia technique that influenced the recurrence. Surgeons should bear in mind that complete removal of the epithelial lining provides a lower recurrence rate, especially under local anesthesia. The main limitation of this study was that recurrent cases were too few to allow a statistical analysis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Yeo
authors.forename: Beom-Cho
authors.initials: BC
authors.lastname: Jun
authors.forename: Si-Nae
authors.initials: SN
authors.lastname: Park
authors.forename: Jung-Hak
authors.initials: JH
authors.lastname: Lee
authors.forename: Chang-Eun
authors.initials: CE
authors.lastname: Song
authors.forename: Ki-Hong
authors.initials: KH
authors.lastname: Chang
authors.forename: Dong-Hee
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000175:diagnosis* / Q000601:surgery*; D004322:Drainage; D004427:Ear Diseases / Q000175:diagnosis* / Q000601:surgery*; D004431:Ear, External / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome