Abstract Preauricular sinus is a congenital malformation often prone to high recurrence rates following standard excision techniques due to complex ramifications. This study aimed to evaluate the effectiveness of the supra-auricular approach in the excision of complicated preauricular sinuses, specifically addressing the challenges of recurrence and incomplete resection. A retrospective case series was conducted involving 15 patients diagnosed with congenital preauricular sinuses, including variant types, who underwent surgical excision between December 2021 and January 2024. The surgical technique involved an elliptical incision extended superiorly to the supra-auricular region, deepening dissection to the temporalis fascia to ensure en bloc resection of the sinus tract and compromised cartilage. Postoperative outcomes were monitored over a minimum follow-up period of 6 months. The study population consisted of 9 males and 6 females with a median age of 28 years. The supra-auricular approach was successfully implemented in all cases, achieving a 100% success rate. The technique provided clear surgical access, allowing for the complete removal of the sinus tract and adherent tissues without injury to the superficial temporal vessels. Significantly, no recurrences or major postoperative complications were observed during the follow-up period, and patients reported satisfactory cosmetic results. The supra-auricular approach proves to be a highly versatile and effective method for managing complicated preauricular sinuses. By utilizing the temporalis fascia as a medial landmark, this technique facilitates complete excision and significantly minimizes recurrence risks, suggesting it should be considered a preferred surgical option for these congenital anomalies.
Joseph et al. (Wed,) studied this question.