title: Association of Recurrence of Infected Congenital Preauricular Cysts Following Incision and Drainage vs Fine-Needle Aspiration or Antibiotic Treatment: A Retrospective Review of Treatment Options.
abstract: Treatment modalities for preauricular sinus tract infections vary.  Effort should be taken to decrease methods that lead to increased recurrence after surgical excision.
  
  
  
  To determine whether incision and drainage (I & D) of infected congenital preauricular cysts is associated with increased rate of recurrence when compared with fine-needle aspiration or antibiotic treatment.
  
  
  
  This was a 9-year (2006-2014) retrospective cohort study undertaken at a tertiary care pediatric hospital. Children treated for preauricular sinus tract infections were identified using the procedure code for excision of preauricular pit, cyst, or sinus tract.
  
  
  
  Postexcision recurrence.
  
  
  
  Sixty-nine children ranging in age from 4 months to 17 years (mean age, 5.9 years) underwent excision of a preauricular cyst. Thirty-seven of 69 patients (54%) were female. Fifty-seven of 69 (83%) had a preoperative history of infection; the remainder had chronic drainage. Of children with preoperative infection, 27 were initially treated with incision and drainage (I & D), 12 were treated with fine-needle aspiration only, and 18 received antibiotic therapy alone. Overall, the recurrence rate was 8 in 69 (11.6%). Among the 27 patients with a preoperative history of infection treated with I & D, 5 lesions (18.5%) recurred, and among those who only received preoperative antibiotic therapy or fine-needle aspiration 1 in 30 lesions (3.3%) recurred (absolute difference of 15.2%; 95% CI, -1.7% to 33.6%).
  
  
  
  Among infants and children undergoing excision of preauricular cysts, a history of infection was not associated with a higher recurrence rate. There was, however, evidence to suggest that a higher rate of recurrence exists among children who had a preoperative history of infection treated with I & D. Our results suggest a more conservative treatment of infected preauricular pit and/or sinus.
authors: Department of Otolaryngology, Walter Reed National Military Medical Center, National Capital Consortium, Washington, DC.
authors: Holly
authors: H
authors: Rataiczak
authors: Division of Otolaryngology, Children's National Medical Center; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC.
authors: Jennifer
authors: J
authors: Lavin
authors: Division of Otolaryngology, Children's National Medical Center; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC.
authors: Michelle
authors: M
authors: Levy
authors: Division of Otolaryngology, Children's National Medical Center; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC.
authors: Joshua
authors: J
authors: Bedwell
authors: Division of Otolaryngology, Children's National Medical Center; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC.
authors: Diego
authors: D
authors: Preciado
authors: Division of Otolaryngology, Children's National Medical Center; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, DC.
authors: Brian K
authors: BK
authors: Reilly
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle; D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents