Pemicu 6

Motor root &sensory root of n facialis →

internal acusticus internus → geniculate
ganglion
Sinus Preauricular
 Definisi, Etiologi, Patofisiologi
Van Heusinger in 1864 (the
preauricular sinus is a benign congenital
malformation of the preauricular soft tissues)
aka preauricular pit, preauricular fistula,
preaurikular tract and preauricular cyst
Minggu ke-6
6 auricular hillocks → Penyatuan → Aurikula
Sinus preauricular
- The exact embryologic basis of
preauricular sinuses
is uncertain.
- Incomplete fusion of the first arch
hillocks, an entrapment of ectodermal
folds during auricular formation
- Defective closure of the dorsal portion of
the first branchial cleft
Sadler, T. W., and Jan Langman.
Langman's Medical Embryology.
12th ed. Philadelphia: Wolters
Kluwer Health/Lippincott Williams
& Wilkins, 2012.
Tan, T., Constantinides, H., &
Mitchell, T. E. (2005). The
preauricular sinus: A review of its
aetiology, clinical presentation and
management. International
Journal of Pediatric
Otorhinolaryngology, 69(11),
1469–1474.
doi:10.1016/j.ijporl.2005.07.0
 Tanda Gejala, PF
● A small pit → external ear → anterior
margin of the ascending limb of the helix
○ posterosuperior margin of the helix,
○ tragus
○ lobule
● Cyst subkutan
● Discharge from sinus ← Desquamating
ephitelial sinus or infection
○ taphylococcal species
○ and, less commonly, Proteus, Streptococcus
and
○ Peptococcus species

Tan, T., Constantinides, H., & Mitchell, T. E. (2005). The preauricular sinus: A review of its aetiology, clinical presentation and management. International Journal
of Pediatric Otorhinolaryngology, 69(11), 1469–1474. doi:10.1016/j.ijporl.2005.07.0
 Tatalaksana umum

The majority of patients with preauricular sinus are asymptomatic

Strong association between preauricular pits and renal defects

Wang et al. 2001 Suggested renal USG, one or more of the following:

1. Another malformation or dysmorphic feature.

2. A family history of deafness.
3. An auricular and/or renal malformation.
4. A maternal history of gestational diabetes.

Tan, T., Constantinides, H., & Mitchell, T. E. (2005). The preauricular sinus: A review of its aetiology, clinical presentation and management. International Journal
of Pediatric Otorhinolaryngology, 69(11), 1469–1474. doi:10.1016/j.ijporl.2005.07.0
 Tatalaksana dengan infeksi
● Oral antibiotics
● Needle aspiration
● Incision and drainage
● Resection

Isaacson, G. (2019). Comprehensive

management of infected preauricular
sinuses/cysts. International Journal of Pediatric
Otorhinolaryngology, 109682.
doi:10.1016/j.ijporl.2019.1096
Isaacson, G. (2019). Comprehensive
management of infected preauricular
sinuses/cysts. International Journal of Pediatric
Otorhinolaryngology, 109682.
doi:10.1016/j.ijporl.2019.1096
 Rekonstruksi kosmetik

Reconstruction techniques for

tissue defects formed after
preauricular sinus excision.
Myung Joon Lee, Ho Jik Yang
et al.
Archives of Plastic Surgery,
41, 1, 1 2014
Foreign Bodies
 Foreign Bodies
● Terjebaknya suatu benda pada kanal auditori eksterna
● Classification:
○ Animate: insects, worms, ants, cockroach
○ Inanimate: beans, buttons, toys, rice grains

Scott Brown's Otorhinolaryngology Head and Neck Surgery 8th Ed

Maqbool's Textbook of ENT Diseases 9th Ed
 Clinical Features
● Clinical Features
● Pain in the affected ear
● Deafness
● Aural fullness
● Bleeding
● Discharge
● Itchiness

Scott Brown's Otorhinolaryngology Head and Neck Surgery 8th Ed

https://www.ncbi.nlm.nih.gov/books/NBK459136/
 Evaluation
● Otoscopy:
○ Identification of foreign body
○ Location
○ Determine method of extraction
● Audiometry or tuning fork test
○ Test the extent of hearing loss

Scott Brown's Otorhinolaryngology Head and Neck Surgery 8th Ed

https://www.ncbi.nlm.nih.gov/books/NBK459136/
 Treatment

● Animate
○ Kill the living foreign body
■ Oil-based: mineral oil, cerumol, otocerol
○ Extraction using irrigation or alligator forceps
● Inanimate
○ Syringing
○ Irrigation
○ Wax hook
○ Microsuction
○ Postaural incision
● Use sedation or anesthetics if patient isn’t cooperative

Scott Brown's Otorhinolaryngology Head and Neck Surgery 8th Ed

Maqbool's Textbook of ENT Diseases 9th Ed
 Foreign Bodies
● Prognosis
○ 47% sustain trauma (laceration, tympanic membrane perforation)
○ All methods of extraction are safe
○ Minimal complications
● Complication
○ Excoriation
○ Laceration
○ Perforation
○ Inflammation
○ Otitis external/media

Scott Brown's Otorhinolaryngology Head and Neck Surgery 8th Ed

https://www.ncbi.nlm.nih.gov/books/NBK459136/