A painful swelling anterior to the ear in a teenaged boy

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Author: Kenneth LeCroy
Date: Dec. 2003
Publisher: Intellisphere, LLC
Document Type: Article
Length: 540 words

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A 15-year-old otherwise healthy male presents with a painful swelling anterior to the right ear of 2 weeks' duration. His parents had noted small openings anterior to both his ears, present since birth (see photos). The openings occasionally drained fluid but had never been infected or painful before. On physical examination, the patient has normal external auditory canals and normal tympanic membranes. He has no pain behind the ear and no cervical lymphadenopathy. The conjunctivae are clear, and there are no eye complaints.

* What is the differential diagnosis?

* What is the diagnosis?

* What is the treatment?

* What caused this anatomic variant?


The differential diagnosis includes an infected preauricular lymph node, parotiditis, malignancy (lymphoma), abscess, epidermal cyst, dermoid cyst, and branchial sinus (also called brachial). This patient has an infected branchial sinus. He was...

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Gale Document Number: GALE|A138991520