A preauricular pit is a small hole in front of your ear that you are born with. Most of the time it is harmless and doesn’t cause any health problems.
Preauricular Pit
A preauricular pit is a small hole or cyst just in front of your ear above your ear canal. This hole marks a sinus tract under the skin that’s in the wrong place.
These tracts can vary in size. Some people have a short tract while others have a longer one with lots of branches. There’s usually only one pit and it’s commonly on the right side. Most people don’t realize they have a pit until they have a routine ear, nose, and throat examination or some kind of infection.
Preauricular pits are congenital. This means you’re born with one when your ear doesn’t fully develop before birth. It’s a common condition and is considered harmless. Your doctor might look for other irregularities if they notice your newborn baby has a pit.
Causes of Preauricular Pit
Genetics. It’s not clear why you get a preauricular pit. Sometimes it happens sporadically during development. Sometimes it's a genetic condition.
The visible part of your ear is called the auricle. A baby typically grows it during the sixth week of pregnancy. A preauricular pit forms when the auricle doesn’t fuse all the way.
Other syndromes. Preauricular pits can also happen in other congenital syndromes. These are not common and include:
- Beckwith-Wiedemann syndrome
- Mandibulofacial dysostosis
- Branchiootorenal syndrome
- Oculoauriculovertebral dysplasia
- Wolf-Hirschhorn syndrome
- Chromosome 5p deletion syndrome
- Chromosome arm 11q duplication syndrome
Taking propylthiouracil medication during early pregnancy might also cause preauricular pits in your baby. This medication is used to treat hyperthyroidism, or an overactive thyroid.
Symptoms of Preauricular Pits
Preauricular pits look like a pinhole or dimple in front of your ear. Other people might mistake it for a piercing.
Most people who have a preauricular pit don’t have any symptoms or hearing problems. Sometimes you can get an infection when the opening seals bacteria inside. its symptoms include:
- Redness
- Swelling
- Pain
- Fluid discharge
- Fever
Some people might have lots of infections. These could be from an abscess or cellulitis. An abscess is a collection of pus that builds up in the area. Cellulitis is a potentially serious skin infection.
Some people might also get cysts. These are bumps that grow under the skin. Symptoms include a bump that is:
- Near the pit
- Slowly growing
- Not tender
- Red and swollen, if infected
Some people also get auricular tags. These are fleshy bumps of skin near the pit that:
- Don’t grow fast
- Are attached to your skin
- Are the same color as your skin
- Don’t hurt
- Don’t leak fluids
Preauricular Pit and Kidneys
Sometimes people with preauricular pits also have kidney or other problems. One syndrome called branchiootorenal syndrome can cause hearing loss, pits in the side of your neck, ear tags, preauricular pits, and kidney problems.
Your doctor might do a kidney ultrasound if you have hearing problems, a preauricular pit, and one or more of the following:
- A family history of deafness
- A family history of kidney deformity
- Another malformation
- History of diabetes during pregnancy in the mother
Treatment for Preauricular Pits
Experts have different opinions about treatment. Some say you shouldn’t have treatment unless you have symptoms. Others say a preauricular pit should be removed regardless. Most people never have symptoms that require treatment.
Antibiotics. Your doctor will give you antibiotics to treat an infection if your preauricular pit has a smelly discharge or other symptoms of infection. Make sure to take the pills until your prescription is finished.
Home treatment. There are things you can do at home to manage a preauricular pit infection along with taking your antibiotics. Examples of home treatment include:
- Pain relievers
- Warm compresses on your ear
- Keeping the area clean of any discharge
- Avoid touching it
Needle aspiration. If you get an abscess, your doctor might insert a needle into it to collect fluid. They will test the fluid to find the type of bacteria. This will help them prescribe the right kind of antibiotic.
Drainage. Your doctor might use a sterile needle to drain the fluid and pus if your abscess doesn’t get better with antibiotics.
Surgery. Some people get cysts and lots of infections. Your doctor might recommend surgery to take out the entire sinus tract. This procedure is done under general anesthetic but can often be done in an outpatient clinic. You will have to wait until the infection clears up before you can have surgery.
You can also have tags removed. This is usually for cosmetic reasons.
Considerations for Preauricular Pits
The outlook for you or your baby is good. Most people with this condition don’t have problems. Infections can be easily treated with antibiotics.
Make sure to talk to your doctor for treatment if your ear is bothering you or you have signs of an infection.
