Developmentally, the external ear develops from six eminences on the mandibular and hyoid margin of the first external groove. Failure of the tubercles to fuse with each other or failure of some of these tubercles (hillock) to grow normally may produce a variety of external ear malformation such as congenital preauricular sinus.
Preauricular sinus is usually asymptomatic unless it is infected.
Clinical presentations of preauricular sinus abscess are usually recurrent ear discharge, pain, swelling, itching, headache and fever. Other congenital anomalies such as hearing loss or renal problem of 1.7% and 2.6% respectfully are usually associated with preauricular sinus.