Should You Still Consider Surgery for a Shrinking Preauricular Cyst?

Preauricular cyst

Hello Doctor: Recently, I noticed a lump on the inner side of my left ear, approximately 1 cm in size.
After examination, the doctor diagnosed it as a preauricular cyst and recommended surgery.
However, I have observed that it has decreased in size to less than 0.5 cm over the past few days.
Should I still proceed with the surgery, or is it better to just monitor it for now? Thank you for your advice.

ang, 30~39 year old female. Ask Date: 2013/05/06

Dr. Zheng Jueyi reply Otolaryngology

Hello, the majority of preauricular cysts require surgical treatment for complete resolution.
However, if the cyst has decreased in size and does not become swollen or inflamed again, it can be monitored.
If it continues to enlarge repeatedly, surgery is still recommended.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2013/05/06

More Info

When considering whether to proceed with surgery for a shrinking preauricular cyst, there are several factors to take into account. Preauricular cysts, also known as preauricular sinuses or pits, are congenital anomalies that can sometimes become infected or inflamed, leading to discomfort or complications. Here’s a comprehensive look at the situation:
1. Understanding the Cyst: Preauricular cysts are typically benign and may not require treatment unless they become symptomatic. If your cyst has been diagnosed as non-infected and is currently shrinking, this is a positive sign. The fact that it has decreased in size from 1 cm to less than 0.5 cm suggests that it may not be causing any significant issues.

2. Symptoms and Complications: The primary reasons for surgical intervention include recurrent infections, pain, or cosmetic concerns. If the cyst is asymptomatic (not causing pain, discomfort, or recurrent infections), it may be reasonable to adopt a watchful waiting approach. However, if you experience any symptoms such as redness, swelling, or drainage, it would be prudent to consult your healthcare provider.

3. Surgical Considerations: Surgery for a preauricular cyst typically involves excision of the cyst and surrounding tissue to prevent recurrence. If the cyst is shrinking and not causing any problems, the risks associated with surgery—such as infection, scarring, or complications from anesthesia—may outweigh the benefits. On the other hand, if there is a history of recurrent infections or if the cyst is causing significant cosmetic concerns, surgery might still be warranted.

4. Follow-Up: Regular follow-up with your healthcare provider is essential. They can monitor the cyst's size and any changes in symptoms. If the cyst continues to shrink and remains asymptomatic, it may be reasonable to continue observation. However, if it begins to enlarge again or if you develop symptoms, surgical intervention may be necessary.

5. Personal Preference: Ultimately, the decision to proceed with surgery should also consider your personal preferences and concerns. If the cyst's appearance is bothersome to you, or if you are anxious about the possibility of future complications, discussing surgical options with your doctor may provide peace of mind.

6. Consultation with a Specialist: If you are uncertain about the best course of action, consider seeking a second opinion from an ear, nose, and throat (ENT) specialist or a dermatologist who has experience with preauricular cysts. They can provide additional insights based on their expertise and your specific situation.

In conclusion, if your preauricular cyst is shrinking and asymptomatic, it may be reasonable to monitor it rather than proceed with surgery immediately. However, maintain open communication with your healthcare provider to ensure that any changes in your condition are addressed promptly. If you have any concerns or if the cyst changes in any way, do not hesitate to seek medical advice.

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