Objectives

This study was performed to propose the proper surgical timing of infected preauricular sinus (PAS) by comparing surgical results of active infection PAS group (AIPASG) to infection-controlled/or non-infected PAS group (IC/NIPASG).

Methods

Two hundred and twelve patients with PAS who underwent surgical excision using minimal supra-auricular approach by one surgeon (S.N.P) in a tertiary referral center between Apr 1999 and Dec 2016 were enrolled in this study. Medical records of 36 patients of AIPASG at surgical time point and 176 patients of IC/NIPASG were collected and their surgical results were compared. Postoperative wound infection, recurrence, need of drain insertion or external compression dressing and other clinical parameters including age, sex, follow up duration and previous incision & drainage (I&D) history were investigated and statistically compared between two groups.

Results

There were no significant differences of various clinical parameters between two groups, except previous I&D history (24 among 36 patients of AIPASG and 12 among 176 patients of NI/ICPASG, P < 0.05). Post-operative immediate but mild wound erythema was observed in 11 among 212 patients with no statistical difference between two groups (4 among 48 ears of AIPASG and 7 among 219 NI/ICPASG, P = 0.105) and was controlled by short-term antibiotics and conservative management. Only 1 patient of NI/ICPASG needed a revision surgery of wound exploration and curettage. No more recurrence of infection during their long-term follow-up period was observed in both groups.

Conclusion

There was no significant difference in the surgical results of minimal supra-auricular approach of PAS excision between AIPASG and NI/ICPASG. Therefore, we suggest that this surgical technique can be performed even in the infected PAS which does not quickly respond to the conservative treatment.

中文翻译：

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耳前鼻窦感染的手术结果：无需延迟。

目标

通过比较活动感染PAS组（AIPASG）与感染控制/或未感染PAS组（IC / NIPASG）的手术结果，提出了感染前耳窦（PAS）的正确手术时机。

方法

该研究纳入了1999年4月至2016年12月之间由三名转诊中心的一名外科医生（SNP）使用极少的上耳入路手术切除的112例PAS患者。收集手术时间点的36例AIPASG患者和176例IC / NIPASG患者的病历，并比较其手术结果。对两组患者进行术后伤口感染，复发，引流管插入或外部加压敷料的需要以及其他临床参数（包括年龄，性别，随访时间和既往切口和引流（I＆D）史）的调查，并进行统计学比较。

结果

除先前的I＆D病史（36例AIPASG患者中有24例，176例NI / ICPASG患者中有12例，P <0.05）外，两组之间的各项临床参数均无显着差异。212例患者中有11例出现术后即刻但轻度的伤口红斑，两组之间无统计学差异（AIPASG的48耳中有4例，219 NI / ICPASG的7例中有7例，P = 0.105），并由短期抗生素和保守管理。NI / ICPASG仅1例患者需要进行伤口探查和刮除术的翻修手术。两组在长期随访期间均未发现感染复发。

结论

AIPASG与NI / ICPASG在最小耳上PAS切除术中的手术结果无显着差异。因此，我们建议即使在感染后的PAS不能快速响应保守治疗的情况下，也可以执行这种手术技术。