• Advances in pediatric surgery
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• v.9 no.1
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• pp.1-5
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• 2003

Preauricular sinus and preauricular skin tag are common childhood congenital anomalies. It is important for the pediatric surgeon to be familiar with the embryology and differentiation of head and neck structure to accurately diagnose and treat these lesions. Seventy eight patients with preauricular sinus and twenty-eight with preauricular skin tag treated in the Department of Pediatric Surgery at Hanyang University Hospital from January 1981 to May 2002 were reviewed to determine relative frequency, clinical classification and appropriate treatment. The male to female ratio of preauricular sinus was 1:1.2, and preauricular skin tag was 1:1. The most commonly presenting age of sinus and skin tag was before 5 year (62.8%) and before 1 year (53.6%). Twenty nine of 78 cases of preauricular sinuses were on the left, 25 on the right and 24 bilateral. Signs of infection were seen in 73.0% of patients with preauricular sinus at operation. Only 31.3% of lesions were infected in patients less than one year of age, but 89.5% between 3-5 years and 100% between 5-8 years. Cartilage was present in five patients with preauricular skin tag. Although re-operation due to wound infection was necessary in four cases, no recurrences were found. The preauricular sinus is a common anomaly in childhood, and has had a relatively high recurrence rate. But most of the recurrences were due to incomplete resection because of combined infection. Initial proper diagnosis and early operation are very important. Identification of the exact anatomical location of sinus tract is necessary because total excision of the lesions including those tracts is the only way to prevent recurrence.

• Advances in pediatric surgery
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• v.7 no.1
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• pp.7-14
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• 2001

Congenital anomalies of the head and neck region such as preauricular sinus and skin tag, thyroglossal duct cyst, branchial anomaly, cystic hygroma and dermoid cyst are common in pediatric population. It is important for pediatricians and pediatric surgeons to be familiar with the embryology and the anatomical characteristic of these lesions in order to diagnose and treat them properly. Three hundred and nineteen patients with congenital head and neck anomalies treated at Hanyang University Hospital between 1980 and 1999 were reviewed to determine the relative frequency of the anomalies and to analyze the method of management. Eight-four (25.1 %) of 335 lesions were preauricular sinus and skin tag, 81 (24.2 %) were thyroglossal duct cyst, 81 (24.2 %) branchial anomaly, 58 (17.3 %) cystic hygroma and 31 were (9.2 %) dermoid cyst. The male-to-female ratio was 1.4:1. Thyroglossal duct cyst most commonly present at 3-5years, however branchial anomalies commonly are diagnosed in children younger than 1 year. Preauricular sinus showed familial tendency in three patients and was bilateral is 33.8 %. Most head and neck anomalies in children have specific clinical and anatomical characterics. A careful history and physical examination is very useful for diagnosis and proper management. Experienced pediatric surgeons should do the initial surgery since the recurrence rate after incomplete surgical excision can be high.

• Advances in pediatric surgery
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• v.2 no.2
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• pp.119-128
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• 1996

The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients (43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(19) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50(78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.