The congenital preauricular sinus is usually asymptomatic. However, if recurrent infection and abscess formation occurs, complete surgical excision of the sinus is required. If the sinus tracts are not entirely removed, recurrence is likely to follow. Sometimes the disease is not recognized and diagnosed as a sebaceous cyst or a furunculus.
Incision and drainage in acute abscess, but recurrence rate will be very high.
Means of decreasing the recurrence rate include: (1) meticulous dissection of the sinus by an experienced head and neck surgeon under general anesthesia; (2) the use of an extended preauricular incision; (3) clearance down to the temporalis fascia to ensure complete removal of all epithelial components; (4) avoidance of sinus rupture; and (5) closure of wound dead space.