Preauricular Pits: Causes and Treatment

It’s often mistaken for a dimple or piercing hole, but preauricular pits are usually benign malformations that appear above or in front of the ear canal.“In most cases, children with a preauricular pit are perfectly healthy and can live a typical life,” said Audiology & Hearing Services of Charlotte audiologist Melissa Karp.

What is a Preauricular Pit?

The auricle is the outer portion of your ear, and preauricular refers to the front of the auricle. Preauricular pits form in the sinus tracts underneath the skin around your ears and are only noticeable as a tiny opening.A pit can be short or long, with multiple branches in the sinus tract. Openings usually only form on one ear, but preauricular pits have been known to show up on both ears. It’s uncommon, but a pit may also appear below the ear canal, closer to the earlobe.

What Causes a Preauricular Pit?

These malformations form in the womb around the sixth week of pregnancy when the outer ear takes shape. There is often a problem with the fusion of the tissue, causing the pit.The exact cause is unknown, but genetic factors may contribute to the preauricular pits, especially if they’re present on both ears.

Symptoms and Diagnosis

Because preauricular pits are visible at birth, children receive a physical exam of their ears, head and neck for signs of other malformations and to rule out genetic syndromes.Pits can become infected, so symptoms like skin redness and swelling, pain, pus and fever usually indicate the presence of a cyst or other irritant. A CT scan or MRI is taken to verify the cause.

How are Preauricular Pits Treated?

Since they don’t affect hearing or physical health, preauricular pits are often left alone unless they cause frequent infections.“Infected preauricular pits need to be treated by a healthcare provider with antibiotics and sometimes an incision to drain the pus,” said Dr. Karp. “If other ear abnormalities are found, your healthcare provider may order a hearing test.”The pit will require surgical removal if there are cysts or infections. The procedure requires general anesthesia and can be completed in a few hours. At-home wound care is necessary to keep the incision clean.It may also be necessary to visit an otolaryngologist, a doctor specializing in ear, nose and throat health. They will be able to determine if a genetic syndrome is contributing to the preauricular pit and recommend further testing and treatment.

Possible Comorbidities

Branchio-oto-renal (BOR) syndrome: The presence of preauricular pits and other lumps in the ear and throat suggest BOR syndrome, which is associated with hearing loss and kidney problems.‍

Beckwith-Wiedemann syndrome: Symptoms include asymmetric earlobes, an enlarged tongue, and preauricular pits. Abdominal problems and kidney and liver cancers may be caused by Beckwith-Wiedemann syndrome.

‍Mandibulofacial dysostosis: Also known as Treacher Collins syndrome, this condition causes abnormalities in the head and face. The head is often small and doesn’t grow in proportion to the rest of the body. Developmental, speech, language and intellectual delays are common, too.

The expert team at Audiology & Hearing Services of Charlotte will address your child’s preauricular pit management and care and make recommendations for other specialists if necessary. Call 704-412-7975 or contact us online to schedule your appointment.