title: Decision making in the choice of surgical management for preauricular sinuses with different severities.
abstract: OBJECTIVE
  The preauricular sinus is a common congenital abnormality of the preauricular soft tissues. Here, we demonstrate the decision making in the choice of surgical management of preauricular sinuses based on disease severity. In addition, a method termed figure 8 incision with extended fistulectomy is introduced.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Between January 2003 and February 2010, a total of 90 patients (109 ears) underwent surgery for preauricular sinuses in our hospital.
  
  
  METHODS
  After controlling the infection, the patients received definite surgery. They were classified into 3 groups according to the operative methods. We recorded the clinical conditions and any recurrences during the follow-up period.
  
  
  RESULTS
  Group I patients (48 ears) had a trace inflammatory condition and underwent a simple sinusectomy. The recurrence rate was 2.08%. Group II (31 ears) and group III (30 ears) patients had more highly inflamed tissue and underwent a local wide excision and a figure 8 incision with extended fistulectomy, respectively. The recurrence rate in group II was 22.58%. Meanwhile, none of the group III cases showed a recurrence. In our study, there were 8 recurrent cases in 109 ears, yielding a recurrence rate of 7.34%.
  
  
  CONCLUSIONS
  Simple sinusectomy is an adequate surgical technique for preauricular sinuses with a mild inflammatory condition. For more severe cases, the figure 8 incision with extended fistulectomy can achieve adequate wound exposure for radical excision of the inflamed tissue and a satisfactory surgical outcome.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Wan-Ju
authors.initials: WJ
authors.lastname: Huang
authors.forename: Chia-Huei
authors.initials: CH
authors.lastname: Chu
authors.forename: Mao-Che
authors.initials: MC
authors.lastname: Wang
authors.forename: Chin-Lung
authors.initials: CL
authors.lastname: Kuo
authors.forename: An-Suey
authors.initials: AS
authors.lastname: Shiao
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000601:surgery; D003657:Decision Making; D054644:Ear Auricle / Q000002:abnormalities / Q000601:surgery*; D004424:Ear Canal / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D012852:Sinusitis / Q000151:congenital / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D013624:Taiwan; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: incision method; preauricular excision; preauricular sinus; surgical procedure