The histologic relationship of preauricular sinuses to auricular cartilage.
OBJECTIVE
To determine the histologic relationship and distance between excised preauricular epithelial sinus tract and the adjacent auricular cartilage (sinocartilaginous distance) in a series of patients. The excision of preauricular sinuses is a common surgical procedure. Recurrences are frequent and can be technically challenging. While advocated by several authors, the surgical removal of adjacent auricular cartilage is not universally performed.


METHODS
Retrospective case series.


METHODS
Children's Hospital of Philadelphia.


METHODS
Fifty-two pediatric patients who underwent surgical excision of preauricular sinus tracts and adjacent auricular cartilage.


METHODS
Between September 1, 2005, and July 31, 2007, the preauricular sinus tracts and adjacent auricular cartilage were excised from 52 pediatric patients. A pathologist reviewed a total of 58 specimens to determine the relationship between epithelial tract and cartilage.


METHODS
The sinocartilaginous distance in microns.


RESULTS
Patient ages ranged from 8 months to 17 years (mean age, 4 years). In all but 1 case, the tracts were in close proximity to the cartilage. The average sinocartilaginous distance was 472 mum (median distance, 400 mum); the 25th percentile was 250 mum. In over 50% of the specimens, the sinocartilaginous distance was less than 0.5 mm, and in nearly all of the these, the epithelial tract was in continuity with stromal tissue histologically indistinguishable from perichondrium.


CONCLUSIONS
The observed sinocartilaginous distances suggest that it may be difficult to dissect most sinus tracts from the cartilage. The routine removal of a small portion of auricular cartilage along with the sinus tract may yield a more thorough excision and help to prevent recurrence.
Dunham
Brian
B
Division of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. dunhamb@email.chop.edu
Guttenberg
Martha
M
Morrison
Wynne
W
Tom
Lawrence
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000473:pathology / Q000601:surgery*; D004425:Ear Cartilage / Q000473:pathology / Q000601:surgery*; D004431:Ear, External / Q000002:abnormalities* / Q000196:embryology; D005260:Female; D005402:Fistula / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies