PREAURICULAR SINUS: A Guide to Identifying and Managing PAS

Preauricular Sinus




Names like Shah Rukh Khan, Brad Pitt, Deepika Padukone, Rosie Huntington, Katrina Kaif, Jennifer Garner, Ariana Grande, and the list goes on.

Right from all these famous media personalities to the girl next door, we all know a number of people who come under having one of the most prominent facial features— which is “A Dimple.”

And most of us are also aware of the fact that these dimples are a result of certain genetic deformations or genetic mistakes that is not common in all which is why not all of us have dimples. But nevertheless, the wider you simple, the deeper the dimple.

By now, I’m sure that all of us would have pictured the image of a dimple on one’s cheeks.

But, have you ever seen a dimple on the ear?

Well, you might have seen it, but you probably wouldn’t have given a thought to it.

Here’s what exactly I’m talking about— It is the PREAURICULAR SINUS (PAS).

Preauricular sinus is basically a small hole or a dimple or an invagination or a depression that is mostly present on the pinna (also called auricle) of the ear. It can be one too many in number which either affects one or both ears. They are mostly found in the periphery of the ear.

And it is called the preauricular sinus because it is formed due to the presence of a sinus tract that connects from a region of infection to the outer skin where it opens out to the atmosphere as the pinna fails to close it. And this opening is what appears as a hole or dimple. The sinus tract formation is an abnormality as it is generally absent in most people.

This hole is usually small and they also occur in very few people most importantly, it causes no harm to anybody.

Having said that, they also turn out to be pathetically irritating at times, when they are infected.



This pit on the outer skin is attached to a sinus tract on the inside that halts at a region that is prone to infections. Here, in this case, the region is— sinus chambers.

So, when a sinus chamber gets infected, the bedding bacteria and viruses dwell in the sinus tract which pours out the infected pus on the outside of the skin through the opening. This causes infection of the sinus tract as well as the Preauricular pits.


  • The bacterial infection causes swelling of the sinus tract and the skin around the pit.
  • Solidified pus is poured out of the sinus tract.
  • Pain
  • Redness
  • The pain and long-term infection can cause fever as well.


This kind of sinus tract network is not found in all humans and thus, it comes under a condition of abnormality. Various scientists and their studies have stapled the fact that such a pit is formed mostly in the sixth week of the embryo development of a fetus in the mother’s womb.

If otherwise, studies have also proved that, such openings could be formed due to the hillocks of His (a part of the pinna) that failed to seal, and the reason for it is yet to be known.

Though the genetic mutation causing the Preauricular sinus is not harmful, they tend to indicate a fore coming syndrome that might possibly exist in you.

Some of such syndromes are:-

  • Branchio-oto-renal syndrome– It is mostly related to kidneys and hearing issues.
  • Beckwith-Wiedemann syndrome– It also affects our liver, and kidneys, and causes the unusually large tongue and folded ear lobes.

Thus, on seeing these preauricular sinus pits in a newborn baby, your doctor might recommend you to go for various diagnostics methods which test for the possible syndromes that might occur.


Diagnosis is mostly recommended in two situations, one is when you are born, your doctor will suggest for diagnosis of the above-mentioned syndromes and more.

Two is when you have no threat of any syndrome and you continue to lead a normal life, but at some point when your sinus tract gets infected due to bacteria, viruses, and other microorganisms that pour out on the skin in the form of a puss.

Such an infection usually suppresses on its own, but if it fails to do so and the infection prolongs for a long time, then, the pus is taken out using a sterile needle and is examined to study the bacteria responsible for such an infection. This shall help your doctor to give medicines that would target that specific bacteria and this will make treatment more efficient.


Any sort of treatment first starts from home,

A few such homely remedies you can follow alongside your doctor’s medication are:

  • Since the infection, in the long run, causes pain and swelling, you can take regular and safe pain killers for instant relief
  • You can use a hot water bag and press it against your ear, this will help in reducing swelling and itchy irritation that is caused due to the breeding bacteria
  • Regularly wipe the area of infection with a cotton swab dipped in Dettol. This will keep the surrounding skin clean and sterile, and will also prevent the spread of infection from one place to another.
  •  Also, avoid touching your wound now and then as this might exaggerate the irritation.

Later on, the most obvious mode of treatment recommended by your doctor is:

  • Firstly, they would prescribe some basic antibiotics concerning the bacteria that is causing the infection. The type of bacteria is anyway identified by the aforementioned diagnostic method. Thus, the prescribed antibiotics will help to combat the infection up to a certain extent.
  • If this method fails to improve your condition, then the doctor will try to take out the maximum portion of the pus manually with the help of a needle. This will drain out most of the content inside the sinus tract and will lead to the drying of the wound.
  • The last and the PERMANENT TREATMENT is SURGERY (Preauricular sinus excision). When the above medications help you to suppress the condition only for a while, and it tends to show up over and over again like a chronic infection, that is when your doctor would ask you to get the surgery done.

This surgery is proceeded by injecting anesthesia into your ear followed by which the sinus tract is ultimately removed. By this, the infection can be cured permanently.


It is always better to be aware of the various basic health issues that we may or may not face in our day-to-day life. This will help us acknowledge our health and well-being.



This blog including information, content, references, and opinions is for informational purposes only.

The Author does not provide any medical advice on this platform.

Viewing, accessing, or reading this blog does not establish any doctor-patient relationship.

The information provided in this blog does not replace the services and opinions of a qualified medical professional who examines you and then prescribes medicines.

And if you have any questions of medical nature, please refer to your doctor or the qualified medical personnel for evaluation and management at a clinic/hospital near you.

The content provided in this blog represents the Author’s own interpretation of research articles.

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