A preauricular sinus is noted on exam. This may be associated with which of the following?

• A. Chromosomal anomaly or syndrome
• B. Communication of the sinus with the internal ear or brain
• C. Significant hearing loss
• D. No association

Answer: (B)

A preauricular sinus is a congenital tract near the ear that, while often benign, can extend inward to connect with deeper structures. The important point is that this sinus may communicate with the middle ear or even the intracranial space (brain). That potential connection explains why infections can be more than just a superficial skin issue and why, in some cases, deeper complications need to be considered. Although some syndromes can include preauricular pits (and hearing loss isn’t guaranteed in all cases), the clinically relevant association in this context is the possibility of a tract linking to internal ear or brain structures.