What causes a preauricular cysts and fistulas, and when is excision indicated?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Answer

A preauricular cyst or fistula may form as the result of abnormal development of the first and second branchial arch and may manifest as persistent discharge or recurrent infection. A draining sinus may be present anterior to the tragus; when infected, the cyst distends with pus, and the overlying skin is erythematous. Complete excision is indicated if these lesions become repeatedly infected. The facial nerve is at risk for injury during excision because of the close relation of the cyst or fistula to the superior branches of the nerve within the parotid gland.


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