Objectives: This study was performed to propose the proper surgical timing of infected preauricular sinus (PAS) by comparing surgical results of active infection PAS group (AIPASG) to infection-controlled/or non-infected PAS group (IC/NIPASG).
Methods: Two hundred and twelve patients with PAS who underwent surgical excision using minimal supra-auricular approach by one surgeon (S.N.P) in a tertiary referral center between Apr 1999 and Dec 2016 were enrolled in this study. Medical records of 36 patients of AIPASG at surgical time point and 176 patients of IC/NIPASG were collected and their surgical results were compared. Postoperative wound infection, recurrence, need of drain insertion or external compression dressing and other clinical parameters including age, sex, follow up duration and previous incision & drainage (I&D) history were investigated and statistically compared between two groups.
Results: There were no significant differences of various clinical parameters between two groups, except previous I&D history (24 among 36 patients of AIPASG and 12 among 176 patients of NI/ICPASG, P < 0.05). Post-operative immediate but mild wound erythema was observed in 11 among 212 patients with no statistical difference between two groups (4 among 48 ears of AIPASG and 7 among 219 NI/ICPASG, P = 0.105) and was controlled by short-term antibiotics and conservative management. Only 1 patient of NI/ICPASG needed a revision surgery of wound exploration and curettage. No more recurrence of infection during their long-term follow-up period was observed in both groups.
Conclusion: There was no significant difference in the surgical results of minimal supra-auricular approach of PAS excision between AIPASG and NI/ICPASG. Therefore, we suggest that this surgical technique can be performed even in the infected PAS which does not quickly respond to the conservative treatment.
Keywords: Infected preauricular sinus; Minimal supra-auricular approach; Surgical technique; Timing of surgery.
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