title: Is routine audiometric testing necessary for children with isolated preauricular lesions?
abstract: BACKGROUND
  Preauricular lesions, including tags, pits, sinuses, and cysts are commonly seen. Some studies have shown increased incidence of hearing loss in these patients but other studies have failed to corroborate this finding. The purpose of this study is to evaluate the incidence of hearing loss in patients with isolated preauricular lesions.
  
  
  METHODS
  Retrospective chart review of all pediatric otolaryngology patients seen at a tertiary academic center between 2008 and 2014. All patients with the diagnosis code of 744.1 or 701.9 (preauricular skin tag) or 744.46, 744.47, or 744.89 (preauricular pit/fistula/cyst) were included in this study. Medical records were reviewed for clinical, demographic, and audiologic data.
  
  
  RESULTS
  Ninety-nine patients, 46 males, 53 females, with preauricular lesions were identified. Twelve were found to have abnormal hearing. Five patients had conductive hearing loss due to underlying Eustachian tube dysfunction. Four patients had sensorineural hearing loss; three of these patients had an enlarged vestibular aqueduct and one patient did not have an identified cause. Three patients had sound field testing or abnormal otoacoustic emissions that suggested hearing loss with no further follow up.
  
  
  CONCLUSIONS
  Children with isolated preauricular lesions with no history of otologic surgery or risk factors for hearing loss may not need audiologic evaluation outside of regular hearing screening. However, there does appear to be a higher association with Eustachian tube dysfunction in these children. Further studies will need to be done to determine whether or not there is an embryological correlation for this finding.
authors.affiliation: Head and Neck Institute, Department of Otolaryngology - Head and Neck Surgery, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH, USA. Electronic address: wugr@upstate.edu.
authors.forename: Grace T
authors.initials: GT
authors.lastname: Wu
authors.affiliation: Head and Neck Institute, Department of Otolaryngology - Head and Neck Surgery, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH, USA. Electronic address: devinec@ccf.org.
authors.forename: Conor
authors.initials: C
authors.lastname: Devine
authors.affiliation: Head and Neck Institute, Department of Otolaryngology - Head and Neck Surgery, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH, USA. Electronic address: xua@ccf.org.
authors.forename: Allen
authors.initials: A
authors.lastname: Xu
authors.affiliation: Head and Neck Institute, Department of Otolaryngology - Head and Neck Surgery, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH, USA. Electronic address: geelank@ccf.org.
authors.forename: Katie
authors.initials: K
authors.lastname: Geelan-Hansen
authors.affiliation: Head and Neck Institute, Department of Otolaryngology - Head and Neck Surgery, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH, USA. Electronic address: annes@ccf.org.
authors.forename: Samantha
authors.initials: S
authors.lastname: Anne
mesh_terms: D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000150:complications*; D004427:Ear Diseases / Q000150:complications*; D004431:Ear, External / Q000002:abnormalities*; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Fistula; Hearing loss; Preauricular pit; Tag