August 18, 2020 4 min read
One thing that alarms all mothers is when something unusual appears to their child’s physical attributes. This extra tiny hole next to the ear, for instance, can be seen only to a few individuals who were naturally born with it.
The extra tiny hole next to your child’s ear is called “preauricular pits” and has many other terms such as ear pits, preauricular cysts, preauricular fissures, and preauricular sinuses. It is a condition that is caused by a congenital defect. It most likely occurs during the formation of the auricle (the outer part of the ear) during the first two months of gestation. The hole formed is an opening of connected sinus tracts that can either be short or branching out in different directions zigzagging throughout the ear tissue.
Experts think the pits develop when two parts of the auricle, known as the hillocks of His, don’t properly join together. No one’s sure why the hillocks of His don’t always join together, but it may be related to a genetic mutation.
Though it’s an inborn abnormality, experts have proved that it is something not to worry about as it is often a benign condition. Although it does have chances to get infected. That being said, it may rarely be associated with certain genetic syndromes like Branchio-oto-renal (BOR) syndrome, Beckwith-Wiedemann syndrome, or Mandibulofacial dysostosis.
When you (or your pediatrician) notices a preauricular pit, a specialist called an otolaryngologist or an Ear, Nose, and Throat (ENT) doctor is the most recommended doctor to go to for your baby to make sure the pit is not a marker of something more serious.
Your ENT doctor will first want to rule out genetic syndromes sometimes associated with preauricular pits. The doctor will have a close look at your child’s ear, head, and neck as these pits can as well be caused by other syndromes which often result in other ear malformations that lead to hearing loss.
Your doctor will also check if the preauricular pit is present in one or both ears of your child. If both ears are affected, it's more likely that the cause is a family history of congenital malformation.
A computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan with contrast is sometimes ordered by your doctor to be performed to better examine the pit. This also helps the doctor identify underlying complications like an infection or cyst.
Some other tests that your doctor may perform also include an audiogram or a hearing test if some other abnormalities are found other than that extra tiny hole next to the ear of your child. The doctor may also order a kidney ultrasound if the ear pits are suspected to be of the branchio-oto-renal syndromes.
Ultimately, if a genetic syndrome is suspected, you will be referred to other specialists who can help you manage organ-specific problems for your child.
Preauricular sinus is lined with skin cells and can get blocked and infected at any time. It may be Infected that can lead to the formation of abscess and cellulitis.
Look out for the signs of an infected preauricular pit which includes pain, fever, redness, and/or a foul-smelling yellowish discharge that requires treatment from a physician. The doctor will often prescribe antibiotics and may perform incision and drainage of the pus-filled collection around the infected area.
A preauricular pit can also accumulate material and become a cyst—a painless lump near the pit.
On instances that the preauricular pits are persistently infected, the doctor would advise having it removed surgically. Otherwise, if no serious infections occur then the preauricular pits could remain open as it is as they will not as well close on their own.
Did you know that some studies claim that having this extra tiny hole next to the ear is a sign that the person born with it is an extraordinary being?
Preauricular sinuses are more common in people with African and Asian heritage, with up to 10 percent of the population of Asia and parts of Africa having them.
In cultures where they’re more prevalent, there are some superstitions about them. For like associating the condition to attracting wealth or a higher IQ.
It’s also believed that the holes form as a result of a slight defect in the pharynx, and some theorize that they might actually be an ancient remnant of gills.
Leave us a comment if you like this post, request a topic, or ask a question and we will gladly share what we know about our precious children.
Gupta R, Agrawal A, Poorey VK. Preauricular sinus: a clinicopathological study. Int J Res Med Sci. 2015;3:3274-7. doi:10.18203/2320-6012.ijrms20151175
Deshpande SA, Watson H. Renal ultrasonography not required in babies with isolated minor ear anomalies. Arch Dis Child Fetal Neonatal Ed. 2006;91(1):F29–F30. doi:10.1136/adc.2005.083329
Adegbiji WA, Alabi BS, Olajuyin OA, Nwawolo CC. Presentation of preauricular sinus and preauricular sinus abscess in southwest Nigeria. Int J Biomed Sci. 2013;9(4):260–263.
Kumar Chowdary KV, Sateesh Chandra N, Karthik Madesh R. Preauricular sinus: a novel approach. Indian J Otolaryngol Head Neck Surg. 2013;65(3):234–236. doi:10.1007/s12070-012-0520-y
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