The small sinus occasionally found just anterior to the upper portion of the auricle or on the helix apparently results from incomplete fusion of three nodules derived from the first branchial arch. The tragus and the helix develop from these nodules.1
A sinus of this type may be shallow and clinically unimportant, but if it is deep enough to retain secretion it may become the seat of repeated infections. The result may be that an extensive region is honeycombed with granulation tissue and epithelized tracts.
If the sinus is well localized it can be dissected out satisfactorily. A sinus which has been the seat of repeated infection, however, cannot be dissected out with assurance that all of its ramifications will be found and removed. For such a one the following method has proved highly satisfactory:
The sinus is first filled with methylthionine chloride in order to stain its lining. For
HAVENS FZ. CONGENITAL BRANCHIOGENIC PREAURICULAR SINUSA Note Regarding Its Treatment. Arch Otolaryngol. 1939;29(6):985–986. doi:10.1001/archotol.1939.00650051065010