In this video we present a case of a 41-years old patient suffering from a preauricular sinus / pit on the left side. Insertion of a lacrimal probe revealed a deep sinus extending to the temporalis fascia. Therefore the sinus tissue was stained with methylene blue during surgery. As the sinus tract is oftenly adherent or close to the ascending limb of the helix perichondrium / cartilage, a small portion of the cartilage was excised to prevent recurrence of the sinus (recurrence rates are up to 40% in literature). This technique can be performed without any aesthetic deformity. The surgical procedure was recorded with 4k sensor technology. This high-resolution image enables the user to identify and differentiate all important anatomical structures and landmarks. Camera /Technical details VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) consisting of two 4K (4096 x 2160 pixels) sensors displaying a full high definition (HD) (1080p resolution) image. Surgeons: Dr. Christian Jacobi Dr. Katharina Storck Vollständige Operation mit allen OP-Schritten / OP-Techniken einer sog. präaurikulären Fistel bzw. tiefen Sinus mit teilweiser Entfernung des Ohrmuschelknorpels. @ @ Instagram Dr. Christian Jacobi @dr_c_jacobi https://www.instagram.com/dr_c_jacobi/