The chances are that you know at least one person with a tiny hole somewhere above their ear. In fact, it’s quite a common condition – but the hole isn’t just a leftover scar from a piercing gone wrong. And if you’ve ever wondered why some people have these curious, tiny dimples, it turns out that there may actually be a scientific reason for them.
Indeed, even though the human body is a truly amazing thing, there’s no denying that it throws up all manner of oddities. And there are plenty of such comparatively uncommon conditions that people experience from birth. These may be relatively benign, like a “single transverse palmar crease” or a crease along the palm, or more serious, like congenital heart problems.
Heart problems, for instance, can result in breathing difficulties in newborns and require treatment to ensure that the heart remains functional. However, not all abnormalities are as serious as this. Many are, in fact, harmless.
And if you’ve never seen anyone with a tiny dimple above their ear, then you may never have realized that it was even a thing. In fact, unless close family members, loved ones or you yourself are affected by the condition, then you may have never come across it.
But while these markings are only apparent on a small percentage of the population, they’re more common than you may think. And, as you might have guessed, they’re entirely natural and are present from birth.
The number of people with these holes varies from country to country, however. In the U.S. and U.K., for example, less than one percent of the population is observed to have the condition. In Asia and some African nations, though, this total may be as high as ten percent.
And these mysterious holes are scientifically known as preauricular sinuses or congenital auricular fistulas. They go by many other names, though. For instance, you may have heard them referred to as ear pits or Geswein holes.
Furthermore, these strange birth defects were first noted some 150 years ago. Indeed, the earliest recorded description of the congenital malformation was made in 1864 by a scientist named Van Heusinger.
And while the majority of cases of preauricular sinuses are unilateral – meaning that they’re only present on one ear – there are some cases where people have them on both. In fact, it is thought that between 25 and 50 percent of people with the condition have it on both ears.
It’s also worth noting that having a preauricular sinus is not in itself dangerous. And although there is a chance that the hole may become infected, antibiotics can usually help clear things up.
Sometimes, though, an affected person may wish to have the hole removed. There is disagreement in the medical community, however, as to whether all cases should be repaired or only those that cause issues, such as infections.
If it is removed, then a specialist surgeon must perform the procedure, due to the proximity of the ear pit to the nerves in the face. Typically, a plastic surgeon, a head and neck specialist or an otolaryngologist – a surgeon who specializes in ear, nose and throat medicine – would complete the operation.
Several health issues are associated with a preauricular sinus, however. For instance, it’s one of the indicators of Beckwith-Wiedemann syndrome. This disorder increases the risk of childhood cancer in those affected by it.
And while it’s far rarer, there have also been cases where preauricular sinuses have been linked to branchio-oto-renal syndrome. Inheriting the genetic disorder can lead to children having non-functioning or missing kidneys. What’s more, anomalous openings and skin tags around the ears are a noted symptom of the disease.
As for when the preauricular sinuses first appear, it’s in the embryonic stage of the development of a fetus, when the pharyngeal arches form. In humans and other mammals, these arches will eventually make up the head and neck.
But why are they even a condition in the first place? Well, scientists have come up with some extraordinary theories about why some people are affected by this peculiar malformation. In fish, for instance, the pharyngeal arches not only form the neck and head but also the gills.
Evolutionary biologist Neil Shubin has therefore theorized that preauricular sinuses could in fact be an “evolutionary remnant of fish gills.” For now, however, this remains just a hypothesis – and one that hasn’t been scientifically proven.
Of course, humans still carry around plenty of evolutionary quirks that aren’t actually necessary for our bodies to function. The coccyx and appendix, for instance, are both genetic legacies that we’ve inherited from our ancestors.
It doesn’t seem that much of a stretch of the imagination, then, for the preauricular sinus to be a similar case of nature playing catch up. Until we know for sure, however, the ear pit should be considered just a relatively harmless malformation.
Next time you spot someone with a tiny dimple above their ear, though, you’ll know exactly what it’s all about. And if you sport one yourself, you can now rest easy knowing that, in most cases, it’s absolutely nothing to worry about.