Fistular Opening below the Intertragric Notch: A Rare Variant of Pre-Auricular Sinus.

A 22-year-old female presented in the Department of Otorhinolaryngology, Institute of Medical Sciences, BHU, Varanasi with complaints of recurrent painful swelling, itching and discharge from left postauricular area for ten years, for which she was operated five year back and the swelling was excised. But her symptoms persisted after surgery. She had history of incision and drainage twice in the left ear after that. On careful examination a sinus opening was found just below the intertragic notch since birth. Scar mark of previous incision and scarring present in postauricular area [Table/Fig-1a,b]. During the surgery, local anaesthesia was given around sinus opening located below intertragic notch and in retroauricular area. Methylene blue dye was injected in the sinus tract. An elliptical incision was made around sinus tract and in retroauricular area and the sinus tract was dissected from surrounding structure under visual guidance. On tracing the sinus tract, the sinus tract was seen to be passing through the conchal cartilage [Table/Fig-2a,b]. Hence, a piece of conchal cartilage was excised along with the tract and the sample was sent for histopathological examination. The sinus tract was not related to parotid tissue and facial nerve. Histopathology confirmed that the excised tissue was a sinus tract lined with squamous epithelium [Table/Fig-3]. The patient was followed up for six months and no any further complains were reported.