Preauricular sinus and preauricular skin tag are common childhood congenital anomalies. It is important for the pediatric surgeon to be familiar with the embryology and differentiation of head and neck structure to accurately diagnose and treat these lesions. Seventy-eight patients with preauricular sinus and twenty-eight with preauricular skin tag treated in the Department of pediatric surgery at Hanyang University Hospital from January 1981 to May 2002 were reviewed to determine relative frequency, clinical classification and appropriate treatment. The male to female ratio of preauricular sinus was 1:1.2, and preauricular skin tag was 1:1. The most commonly presenting age of sinus and skin tag was before 5 year (62.8%) and before 1 year (53.6%). Twenty nine of 78 cases of preauricular sinuses were on the left, 25 on the right and 24 bilateral. Sings of infectio were infection were seen in 73.0% of patients with preauricular sinus at operation. Only 31.3% of lesions were infected in patients less than one year of age, but 89.5% between 3-5 year and 100% between 5-8 year. Cartilage was present in five patients with preauricular skin tag. Although re-operation due to wound infection was necessary in four cases, no recurrences were found. The preauricular sinus is a common anomaly in childhood, and has had a relatively high recurrence rate. But most of the recurrence were due to incomplete resection because of combined infection. Initial proper diagnosis and early operation are very important. Identification of the exact anatomical location of sinus tract is necessary because total excision of the lesions including those tracts is the only way to prevent recurrence.

Congenital anomalies in the head and neck region such as preauricular sinus and skin tag, thyroglossal duct cyst, branchial anomaly, cystic hygroma and dermoid cyst are common in pediatric population. It is important for pediatricians and pediatric surgeons to be familiar with the embryology and the anatomical characterics of these lesions in order to diagnose and treat properly. Three hundred nineteen patients with congenital head and neck anomalies treated at Hanyang University Hospital between 1980 and 1999 were reviewed to determine the relative frequency of the anomalies and to analyze the method of management. Eight-four patients(25.1%) of 335 lesions had preauricular sinus and skin tag, 81 patients(24.2%) had thyroglossal duct cyst, 81 patients(24.2%) had branchial anomaly, 58 patients(17.3%) had cystic hygroma, 31 patients(9.2%) had dermoid cyst. The male-to-female ratio was 1.4:1. The thyroglossal duct cyst was most commonly present at 3-5years, however branchial anomaly was commonly diagnosed in children younger than 1 year. Preauricular sinus shoeed familial tendency in three patients and bilaterality is 33.8%. Most head and neck anomalies in children had clinical and anatomical characterics. A careful history and physical examination were very useful for diagnosis and proper management. The initial surgery should be done by experienced pediatric surgeonsl since the recurrence rate after incomplete surgical excision could be high.