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Recurring Preauricular Pit/Discharge

My son is 5 yrs old and has had 3 operations on a preauricular pit.  His last operation was when he was 1.5 yrs old.  Now 5 and the scar, which never healed properly and had post-op infections resistant to antibiotics has now started discharging small amounts of pus and irritating him, going red and hurting him when I massage the area to try and get any discharge out.

Discharge is coming from the original pit site as well as the 2 tiny holes left by the stitches from the operations, discharge can vary from quite solidified and white to runny with some colour to it.

We are now booked in for a 4th and final operation (hopefully) this time the paeditrician will remove the underlying cartilage and use methylene blue (not sure if this will work considering the pit has been operated on already).  I suppose I want an ENT opinion or other persons experience.  Will this 4th op work considering cartilage is being removed, what else can we do?  This is a very traumatic issue for us and so very terribly painful to my son.  I live in Australia and hope this site can provide some info to me, I just don't know where else to go for assistance.
52 Responses
Avatar universal
I have had an infected ear pit for 27yrs. It's quite embarassing at times but I've learned to deal with it. I thought about getting it treated but have not gone yet. I have read a couple of articles somewhere that once repeat surgical treament is generally not effective but I can't back that up, since I haven't had treatment myself. Have they tried needle aspiration, I here that is another alternative.
Avatar universal
Here is a link to an article I found very informational, it actually provides instructions on how to remove the sinus tract and possible complications of surgery. I hope this provides a little insight into your situation.

http://www.****
Avatar universal
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-

http://www.****
Avatar universal
My daughter, now 4, has preauricular pits on both ears. She suffered with constant infections for about 6 months. She went through several rounds of various antibiotics, including three that she had allergic reactions to.  Her ENT wanted to operate on her, but my husband and I weren't comfortable with the idea. After reading so many postings where the operations didn't seem to work, I'm even more grateful that we chose not to go that route.
We have an awesome pediatrician who utilizes both traditional and homeopathic remedies. My daughter started taking 3 tiny homeopathic pills of Apis Mel twice daily. Now she takes them once daily. Since taking the pills she has never gotten another infection and it's been over 1 1/2 years.
1061534 tn?1276705661
If the ENTIRE tract is not removed, the pits and the symptoms will persist.  Therein lies the difficulty and the failure rate.  There are techniques that the surgeon can use to help him or her be more sure that all has been removed.  But yes, the failure rate in certain hands can be frustratingly high.  I would recommend finding a surgeon with experience with these and one who is well-aware of their potential to track deeply.
Avatar universal
My 3 year old daughter has had bilateral pits since birth. One deeper one discharges white/yellow sebum every couple of days if i push near the hole. More appears during humid/hot weather which i assume is caused by more sweat/skin cells etc. She is never bothered by it and it is painless. I only 'pop' it when it appears a bit raised as though it is full. I believe this is normal and not necessarily pus due to an infection? It does not smell. Is that correct, or does she actually have a never-ending infection that should be treated with antibiotics?!

Also, could i be making it worse by releasing the sebum? Should i let it simply drain out on its own? I feel i am doing the right thing as i have an opportunity to clear it with clean hands and dettol disinfectant?
The surgery seems quite difficult, and given it doesn't trouble her, I have assumed it is uneccessary at this point.

  
I'd dearly appreciate any advice.
1061534 tn?1276705661
I agree, probably not infected; you are expressing material from glands inside the pit.

My guess is that this will need to be treated at some point, however.  One of two things will likely happen -- either it will become infected and/or, as she ages, she will become embarrassed and self-conscious by it.  If it does become infected, the resultant scarring may make excision a little trickier.

I would suggest starting to find an Otolaryngologist whom you would trust to remove this, as I would think it's only a matter of time.
Avatar universal
I'm twenty three i have two ear pits. I've been to some drs that have stated that extracting this white discharge is ok as long as there is no pain. I had one of the pits completely removed due to a bug bite in the same area and THERES NOTHING TO WORRY ABOUT IF THIS HAPPENS :) I've never had any problems after the procedure and no pain or drainage either. (My surgery was twelve years ago.)
Avatar universal
a cousin of mine and me both have this condition, both of us have had this since birth. when I was very young my mother would clean it out now I do it myself. I'm 37 now and I dont find it embarrassing at all, and I have never had an infection in it. If it doesnt cause you or your children any sort of issue I would not recommend any type of surgery (if its not broke dont fix it!) I'm VERY active, I went through the army, as did my cousin, with it and I work out 12-15 hours a week. dont take anyone at there word when they say that eventually this is certain to be a problem, my personal experience would suggest otherwise.
Avatar universal
I have a 2 year old girl and 2 1/2 month baby. They were born with this pits in both ears. I just started to look for  some info today and found many articles about it.
I clean them like 3 times a week, but sometimes when I do it it just doesn't seem to stop comming out, specially in my girl. (this means is infected or normal function of the body )Should I just keep on doing it. If yes, could I just  alcohol or desinfectant. The pediatrician told me just to take what comes out and not push anymore, but sometimes it comes out a lot . I live in FL , so the whether makes it worse because of the sweat.
thanks./
Avatar universal
I agree with you Jclyde. I am 35 years old and have ear pits on both ears. The one on my left ear is the active one especially when I was growing up. Once in a while it would feel itchy (not painful) and would release a yellowish fluid that's got bad odour. When I was a teenager I was a bit embarassed about it but as you grow older - it doesn't matter much at all. Luckily I noticed they have been less irritated (itchy) and when they do - I just extract what I could with the use of alcohol (to disinfect and to mask the odor)
The right ear pit is inactive. Does not get eachy but since it is a whole, once in a while I would mildy press on it and white discharge which is not fould smelling would come out.

When I gave birth to my daughter 4 yrs ago (she had one ear pit) the first thing I checked was if she had one. Luckily its just one and not two. Also hers was the inactive one. Praying it does not get infected or anything.

I never thought ear pits would be a problem. I have had two cousins, an aunt who has got these, and I never heard of them getting infected to consider surgery.

Avatar universal
My daughter is 14 months old and had a pit on her left ear that we have removed 2 months ago. At first is healed great except the the "dissolvable" stitches didn't dissolve all the way. One kinda pokes  out of the skin a little. Then yesterday it looked swollen and white under the skin. This morning it was worse. I pushed on the area a little bit to see if anything would come out, and there was a bunch of puss and a little blood. Is this something I need to be worried about? Should I take her to the ER?

Thanks,
Melissa
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