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Preauricular abscess

For 2 weeks I have been dealing with a very painful abscess on my ear, where after alot of research and several trips to a local medical clinic and ER, I have found that what I have is an abscess in the Preauricular pit/sinus.

I have been given 3 rounds of antibiotics, one of which I am still taking (Clindamyacin). I have yet to see any improvement from taking the antibiotics, so I went to the ER yesterday where they attempted to do and Incision and Drainage procedure. Some of the abscess was soft, but a large part of it in the middle was still hard... ??? With making an incision, the doctor was able to squeeze a good portion of the abscess out... but there is still a fairly large sized lump there. There has been no drainage coming from the incision since she did this.
I still have some tenderness down the side of my cheek, as well as some puffiness up into my scalp area as well.

I can say that by doing what she did, it did relieve alot of pressure and pain that I was having, but I still am having to take pain relievers to reduce the swelling and continued discomfort.
She instructed me to continue finishing out the anitbiotic I am now taking, and that it should dry up anything left in the abscess, as she said that at the point it was beforehand that no antibiotic would be able to get rid of it alone without I&D procedure being performed.

I am still very concerned, and am thinking of contacting an Ear, Nose and Throat physician about this bc I just feel like a regular physician does not know much about preauricular pits/sinuses, as I have had to educate every physician I have seen thusfar for treatment bc they had no idea what those little holes in the tops of my ears were. I get the feeling that they do not know the complications that can arise from the condition, and that has me worried that if the swelling continues that more serious problems are going to develop.

Has anyone else had this problem?

21 Responses
Avatar universal
These are fairly common.  If they repeated get infected, they can be surgically removed.  See an ENT MD.  It is likely that the infection would need to be treated with antibiotics prior to any surgery.
242516 tn?1368227505
OtoHNS_MD has good advice, an ENT can take care of it if it's not getting better.
Avatar universal
Reply to post by Kimmy72-

I have been dealing with pain and swelling of my right ear over the past week, and after alot of research and several trips to a number of medical centres, I also realised the small hole present on my right external ear is a preauricular sinus/pit.

Upon my first visit to the GP(where my ear was not yet swollen but was very itchy, with alot of discharge and peculiar smell present), I was prescribed antibiotics(Ibilex) to treat my ear. I also had a sore throat which I thought was associated with my ear itching/swelling but the doctor said to just take the antibiotics to clear up my nose and throat. However, due to my skepticism with the GP's evaluation of my condition, I decided not to buy the prescribed antibiotics with the script I was given. I persisted with the sore throat and swollen ear(constantly applying Dettol antiseptic liquid) until the pain(especially my ear) reached the point that I needed better medicine to relieve my discomfort in my ear and throat. I purchased the antibiotics(Ibilex) 2 days after the initial visit to the GP and started taking them immediately, along with betadine gargle and strepsils to relieve my sore throat.

After 2 days taking Ibilex, my ear did not improve, with pain and swelling increasing. I managed to research some articles on the management of my condition(infected preauricular sinus) on the internet and discovered that my ear swelling was in fact an abscess forming, therefore needing an I&D(incision and drainage) procedure to be undertaken. I attempted to visit another GP this time(one which was open late at night) to undertake this procedure(as the pain in my ear and head was very severe) but it took me 2 GP appointments(through constant persistence that I needed the I&D procedure undertaken) to finally have my ear incised and drained. Once the surgical procedure with local anaesthesia was performed, the pressure and pain on the right side of my head was relieved. If anyone undergoes this I&D procedure, please make sure your doctor/nurse gives you some pain killers(Panadeine or panadeine forte depending on severity of pain) to control the pain after the local anaesthetic has worn off. I have currently changed my course of antibiotics from Ibilex to Flucloxacillin and am resting at home while my ear wound heals. My sore throat is still present but is much more bearable than the pain I experienced from my infected preauricular sinus/pit. I am currently gargling salt water and taking strepsils lozenges to relieve my sore throat.

Here is a good article I discovered while researching my condition-

Avatar universal
Thanks for your replies :)

After all was said and done, I had an I&D. I think this was the worst experience that I have ever had! But was relieved from alot of discomfort in the end. There was still alot of stuff left that the dr couldnt get out, but was told that it would drain out on its own. The following day after I had the I&D, I applied a hot rag to the area and within 15 minutes it began draining constantly. By the end of the day, it was almost all completely drained out.
Sweet relief! ;)

I havent had any problems with it since then, except I notice that I now have developed a small bump down below the preauricular sinus.. which I think they call a tag or something.

I hope that you are doing better now, sime_on :)
Avatar universal
i went to the ENT doc today for mine. He simply stuck a needle into the infected/swollen area and drew out the infection. it was not a pleasant experience, but at least it didnt take too long. under a minute i would say. he then bandaged me and prescribed some antibiotic(pills) to take and one pain killer med.
he suggested surgery to close the hole up. he described it as skin that was suppose to grow as a straight line at birth but instead folded in.
i havent decided as yet.

hope this helps out
Avatar universal
so the aspiration didnt work....
i switch docs and this one did an I&D.........
unfortunately i had to go back a few days later to get another I&D
now most has drained out but i can feel a hard lump.......
Avatar universal
I just wanted to let you know that I understand what you are going through. I had 3 surgeries on my preauricular pit between the ages of 5-10 (I'm 26 now), and I've dealt with 2 infections (1 when I was 23, another infection at 25). I'm actually dealing with one at the present time, which is why I started googling information/forums on this particular area.

What happened to the hard lump that you had? Did it ever go away? How are you doing now? With my past 2 infections, I took antibiotics (Augmentin) and my abcess (underneath the incision site from my previous surgeries) popped on its own. This process took about a 1 week.

Right now, my GP is prescribing me something else and we're going to see how the week goes. I'm keeping a hot towel on it when I can -- this is what helped the abcess to burst on its own last time. I also have an appointment with an ENT next week . . . though I know, he's just going to tell me they have to do an I&D, which I would like to avoid.  
Avatar universal
Hi, i had to add my comments, i have one preauricular pit either side of my ears and had terrible abcess in my right one which ment i had to go into hospital in Feb 09 have it drained then went back into hospital in the May to have them closed up. 12 months later i had abcess again in right one and had antibiotics which helped it to poped where the stitches had been.I had to go back to ENT who told me they might never  hea lproperly  and i would be best to have more surgery. my appointment is on 26th of this month and i have just delt with another bout of infection in my right one again. but the ENT said it could happen again even with the surgery.. so i wouldnt bother to have surgery if you dont have any trouble with them leave well alone.
Avatar universal
I am 21 and have had the worse year of my life. I had a lump on my chest between my breast for about six years, never thought nothing of it because the doctor told me it was just fatty tissue.... one morning i woke up and the lump spread to my breast and became extremely painful. I went to the hospital, was put on antibiotics and still the pain got worse and the hardening increased almost all the way up to my neck, two days after going to the er and being on antibiotics, i went to my doctor and she put me on another anitbiotic and said there was nothing she could do because it wasnt to the surface yet, but she said she could try.... I just wanted it gone so i said ok,,, she put a needle in me and said crap im not getting anything... at that point she sent me home and told me to put warm compresses on my chest. She said THERE IS NOTHING THAT I CAN DO to prevent it and i had to deal with it.... I THINK NOT!!!!  I would like to know, what in the body do we have to much of or not enough of that causes an abcess to occur. is there anything that i eat that can help or make it worse, anything i drink.... does the amount of water intake make a difference?????????? please help me
Avatar universal
Several years ago, I had a severe infection in one of my preauricular pits.  It was swollen and spreading to my face and neck.  Touching it was extremely painful.  At first it was red, then turned a gradual purple.  I was on antibiotics, none of which worked.  I had to rush to the ENT, who at age 80, had to take cultures to determine the best treatment. Because of the pressure from the infection, there was concern that it may cause blindness, so he had to excise it.  I guess it is called the I&D procedure.  Extremely painful, the process definitely relieved the pressure and took a few days to drain through this tiny rubber tube.  Fortunately, it healed and caused no problems until NOW, 4 years later.  It has grown in size. I went to another ENT who said we have to excise it. I was concerned because it continues to swell yet is not painful to the touch, yet.  The ENT, whom I am seeing on a fairly regular basis for another issue, keeps insisting on removing it.  What is the cost for this procedure?  What is the success rate of it not recurring? What is the likelihood of scarring or nerve damage?  Any comments would be appreciated.  Currently, I am on cefprozil, and while I thought it was working the first few days, the cyst/abscess continues to grow.
Avatar universal
Wel, i also ones had an i&d at d back of my ear bt afta abt 6 months anoda pop up, wich d doc. said it wil b best 2 hav surgery wich i had, nd up til nw i'm stil havin recurrent pre auricular abscesses. I'm scared 2 go 2 d dr. Because of anoda i&d or surgery. What shld i do plz?
Avatar universal
i am also experiencing the same thing as yours..at the moment the pain is life hell..it caused me stiff neck and burning pain makes me feel sooo uncomfortable.i went to see a EENT doctor 2 days ago and prescribed Proxco med and advised me to have warm compress.i did not buy the prescribed meds because before i came to see her i am already taking antibiotics so i decided not to buy the meds she prescribed and continue taking the antibiotic i started taking..until now it is still panful and it feels like its getting worst..i already had a lot of research in the internets and almost all of the articles iv read is to have a I&D which i am sooooo scared to do..huhuhuhu what am i gonna do now?
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