Causes and prevention of revision surgery for preauricular sinus: A histopathological analysis

Publication date: Available online 9 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Woo Jin Kim, Yeo Myeong Lee, Do Hun Kim, Sihong Choe, Donghoo Lee, Sung Yool Park, MiSeon Kang, Hwa Jin Cho, Kyung Wook Heo

Abstract

Objective

Recurrence rates following preauricular sinus (PAS) surgery vary. Few studies have investigated recurrence after primary PAS surgery in histopathological terms. We performed a histopathological analysis of the causes of revision surgery for PAS, with a view to reducing the recurrence rate after primary surgery.

Methods

We reviewed the medical records of patients who underwent revision surgery after primary excision of a PAS between 2002 and 2017. A pathologist reviewed the histopathology slides.

Results

In total, 24 patients underwent revision surgery; of those, histopathology slides were available for 18 patients (19 revisions). The mean interval between primary and revision surgery was 50.4 months. We detected lumen with stratified squamous epithelium in 14 of the 19(73.7%) revisions. Cartilage tissue was attached to the epithelial lining of the lumen in 14 of the 17(82.4%) slides containing lumen. Inflammatory changes were found in all slides, and granulation tissue was detected in 10 of 19 revision surgery slides.

Conclusions

To prevent PAS recurrence after primary surgery, we recommend a wide local excision including the inflammatory soft tissue, with concomitant partial removal of the cartilage of the ascending helix adjacent to the PAS.

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