I use an external tuner because I have a laptop, and it works fine. It's a cheap thing, and I got what I paid for as far as the software, but I'm sure you can get a good external tuner, you just have to know where to look.
On a side note, USB's bandwidth is several times that of PCIs, but I don't know if that makes any difference or not, it may not be worth a hill of beans.
Edit: burnitdown is right, USB 2 has 60MBps of bandwidth but PCI has 133MBps. Dern marketing crap, I knew USB 2 had 480Mbps, but thought PCI was 133Mbps.