Ear, Nose & Throat ENT Disorders Print Preauricular Pits and the Hole in Your Child's Ear Medically reviewed by linkedin Medically reviewed by Lyndsey Garbi, MD on October 17, 2019 Lyndsey Garbi, MD, is a pediatrician who is double board-certified in pediatrics and neonatology. Learn about our Medical Review Board Lyndsey Garbi, MD Written by twitter linkedin Written by Melissa Karp, AuD Melissa Karp, AuD, is a board-certified audiologist and the owner of a private audiology clinic in Charlotte, North Carolina. Learn about our editorial policy Melissa Karp, AuD Updated on October 24, 2019 More in Ear, Nose & Throat ENT Disorders Diagnosis Treatment Coping Pediatric ENT Disorders A preauricular pit—also referred to as a preauricular sinus or fistula—is a small hole present in front of the ear that occurs as a result of fusion problems during the sixth week of gestation, when the ear is developing. The pit or opening is the beginning of a sinus tract that weaves itself underneath the skin of the ear. Sometimes the tract is short and other times it can be long with multiple branches coming off and zigzagging throughout the ear tissue. While this sinus tract and pit are not supposed to be there (it's a congenital defect), the good news is that in most instances, the pit is benign, appearing in isolation, and not something to worry about. That being said, it may rarely be associated with certain genetic syndromes like: Branchio-oto-renal (BOR) syndromeBeckwith-Wiedemann syndromeMandibulofacial Dysostosis This is why if you (or your pediatrician) notices a preauricular pit, your baby will be referred to an ear specialist called an otolaryngologist (ear, nose, and throat doctor, or ENT) to make sure the pit is not a marker of something more serious. Get Tips on How to Find the Right Ear, Nose and Throat (ENT) Doctor How a Preauricular Pit Is Evaluated by Your Pediatrician or an Otolaryngologist Your otolaryngologist will first want to rule out genetic syndromes sometimes associated with preauricular pits. To do this, he will take a close look at your child's head, ear, and neck, as some syndromes cause other external ear malformations like asymmetric ears, pits in the neck, or inner ear problems that lead to hearing loss. In addition, your doctor will see if the preauricular pit is present in one or both ears. If both ears are affected, it's more likely there's a family history of this congenital malformation. Sometimes to better examine the pit or other ear abnormalities, your doctor may order imaging tests, like a CT scan or an MRI with contrast. These imaging tests can also help the doctor rule out complications related to a preauricular pit like a cyst or an infection. Other tests your doctor may order include a hearing test called an audiogram, although this is generally ordered only if other ear abnormalities are found in addition to the preauricular pit. In some cases, a kidney ultrasound is recommended, as the constellation of external ear malformations, hearing loss, and kidney impairment can be seen in the branchio-oto-renal syndromes. Ultimately, if a genetic syndrome is suspected, you will be referred to other specialists who can help you manage organ-specific problems for your child. Learn More About Congenital Defects Complications Associated With a Preauricular Pit A preauricular sinus is lined with skin cells and can get blocked and infected at any time. Infection can lead to abscess formation and cellulitis. The signs of an infected preauricular pit are redness, pain, fever, swelling, and/or yellowish, thick discharge. Infected preauricular pits need to be treated by a physician with antibiotics and sometimes incision and drainage of the pus-filled collection. A pit can also accumulate material and become a cyst—a painless lump near the pit. Treatment of a Preauricular Pit Preauricular pits do not typically require removal or closure, although they will not close on their own. However, sometimes a preauricular pit and sinus tract need to be removed surgically if infections are persistent or occurring repeatedly. A Word From Verywell While no one likes to think of their baby having a congenital malformation, it's important to know that ear defects are common. The good news with preauricular pits is that in most instances, they are benign, posing no risk to your precious child. However, it's best to have your child checked out by an ear specialist to be sure. If your child is healthy and not having any problems associated with the preauricular pit, you can leave it alone and get back to enjoying your child's giggles and unique personality. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gupta R, Agrawal A, Poorey VK. Preauricular sinus: a clinicopathological study. Int J Res Med Sci. 2015;3:3274-7. doi:10.18203/2320-6012.ijrms20151175 Deshpande SA, Watson H. Renal ultrasonography not required in babies with isolated minor ear anomalies. Arch Dis Child Fetal Neonatal Ed. 2006;91(1):F29–F30. doi:10.1136/adc.2005.083329 Adegbiji WA, Alabi BS, Olajuyin OA, Nwawolo CC. Presentation of preauricular sinus and preauricular sinus abscess in southwest Nigeria. Int J Biomed Sci. 2013;9(4):260–263. Kumar Chowdary KV, Sateesh Chandra N, Karthik Madesh R. Preauricular sinus: a novel approach. Indian J Otolaryngol Head Neck Surg. 2013;65(3):234–236. doi:10.1007/s12070-012-0520-y Additional Reading Preauricular pits. Children's Hospital of Philadelphia. Chowdary KVSK, Chandra NS, Madesh RK. Preauricular Sinus: A novel approach. Indian J Otolaryngol Head Neck Surg. 2013 Jul;65(3):234-36. Firat Y et al. Isolated preauricular pits and tags: is it necessary to investigate renal abnormalities and hearing impairment? Eur Arch Otorhinolaryngol 2008 Sep;265(9):1057-60. Continue Reading