case_images: PMC4898253_01
case_images: A pit (arrow) leading to a cystic cavity reaching the post-auricular groove could be seen here, situated in the lower part of the medial surface of right pinna just superior to the lobule
case_images: 1679-4508-eins-12-01-0132-gf01.jpg
case_images: PMC4898253_01_1679-4508-eins-12-01-0132-gf01.jpg
case_images: f1
case_images: On examination, an opening was noted just above the lobule leading to a swelling that reached the post-auricular sulcus (Figure 1).
case_images: (A) The lateral aspect of the right pinna showing another pit in the ascending helix (transparent arrow). In immediate contiguity to the membranous external auditory canal is the pigmented scar (white solid arrow) that corresponds to the sinus cavity on the medial surface. (B) Intra-auricular sinus and its pit can be seen in the ascending helix of the left pinna, in an identical position with the pit in the fellow ear
case_images: 1679-4508-eins-12-01-0132-gf02.jpg
case_images: PMC4898253_01_1679-4508-eins-12-01-0132-gf02.jpg
case_images: f2
case_images: An area of scarring and pigmentation in the lateral surface of the pinna in immediate vicinity to the external auditory canal (EAC) - reminiscent of past inflammations involving the EAC skin, could be seen that corresponded to the sinus tract (Figure 2A). Also, similar pits, which were asymptomatic were noted on the ascending helix of the right (Figure 2A) as well as left pinna (Figure 2B).
case_images: Sinogram showing ballooned sinus tract that ends blindly in front and below the right mastoid process in the soft tissue posterior to the ramus of the mandible and inferior to the external auditory canal, in the region of the anatomic location of the parotid gland
case_images: 1679-4508-eins-12-01-0132-gf03.jpg
case_images: PMC4898253_01_1679-4508-eins-12-01-0132-gf03.jpg
case_images: f3
case_images: After controlling the infection with antibiotics, a sinogram was ordered to assess the post-auricular lesion, which showed a sinus tract that ballooned in to the soft tissue of the neck, just below the mastoid process and EAC, and posterior to the ramus of the mandible (Figure 3).