Clinical features and surgical outcomes of congenital preauricular sinuses in children

Relevance. Congenital preauricular sinuses (PAS) account for approximately 5% of all congenital anomalies of the maxillofacial region. Previous studies have reported delayed diagnosis and postoperative recurrence following surgical treatment of preauricular sinuses. Objective. To investigate the clinical presentation and surgical outcomes in children treated for congenital preauricular sinuses. Materials and methods. A retrospective review was conducted of pediatric patients admitted for congenital preauricular sinuses to the Department of Oral and Maxillofacial Surgery at City Clinical Hospital No. 1 (Volgograd, Russian Federation) between 2019 and 2025. Results. Among 149 patients hospitalized for congenital preauricular sinuses, children accounted for 12.7% of cases. In 94.7% of patients, a unilateral sinus tract opening was observed near the superior pole of the helix. In some cases, atypical anatomical variants were identified, including atypical location, the presence of two sinus tract openings, or bilateral preauricular sinuses located at the typical anatomical site. Most children (73.7%) presented with inflammatory changes, whereas 26.3% were admitted for elective surgical treatment. Preoperative ultrasonography combined with intraoperative dye injection significantly improved visualization of the sinus tract. Conclusion. Children with congenital preauricular sinuses typically seek medical care only after the development of inflammatory complications. During clinical assessment, possible atypical location of the sinus tract should be considered, as this may result in technical difficulties during surgical treatment.