Accessory Auricle

Accessory auricle
Specialty	Dermatology
Usual onset	Baby[1]
Treatment	Surgical excision[2]
Frequency	Common, 5 to 10 per 1,000 live births[1]

An accessory auricle is a congenital anomaly typically seen as a skin coloured bump, most frequently just to the front of the ear.^[1][2] It can be classified according to its shape, protruding pattern, and location.^[1] It may be present on both sides, and feel soft or firm.^[2] Most are harmless, though it may be part of Goldenhar syndrome.^[2]

It is generally made up of elastic cartilage with overlying skin.^[2] Diagnosis is by its appearance and biopsy.^[2] Treatment usually involves surgical excision.^[2]

It is common, with an incidence of around 5 to 10 per 1,000 live births.^[1] Males and females are affected equally.^[2]

Signs and symptoms[edit | edit source]

The general presentation is of a skin-covered nodule, papule, or nodule of the skin surface, usually immediately anterior to the auricle.^[2] However, it may be anywhere within the periauricular tissues.^[2] Bilateral presentation can be seen.^[2]

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Genetics[edit | edit source]

A study of a family with 11 affected showed the was inherited in an autosomal dominant manner.^[3]

Diagnosis[edit | edit source]

The lesions presents as a nodule or papule, either sessile or pedunculated. They may be soft or have a cartilaginous structure. By histologic examination, it is a recapitulation of normal external auricle. There will be skin, cartilaginous structures, and cartilage (although the later is not seen in all variants of this disorder).^[4][5] Some investigators believe that the tragus is the only hillock which is derived from the first branchial arch. This is clearly suggestive that true cases of Accessory Auricle represent a true duplication of the hillocks that were part of the second branchial arch.^[6] The second ear appears as a mirror image folded forward and lying on the posterior cheek.^{[citation needed]}

Differential diagnosis[edit | edit source]

These structures are distinctly different from squamous papilloma and benign teratoma.^{[citation needed]}

Classification[edit | edit source]

The several components or degrees of development range from an ear tag, preauricular appendage, preauricular tag, or accessory tragus, to supernumerary ears or polyotia.^[7] It is a relatively common congenital anomaly of the first branchial arch or second branchial arches. Other anomalies may be present concurrently, including cleft palate, cleft lip, or mandibular hypoplasia. There is a known association with Goldenhar syndrome (oculo-auriculo-vertebral syndrome)^[8] and with Wildervanck syndrome.^[9][10][11] There may also be an association with congenital cartilaginous rest of the neck.^{[citation needed]}

Management[edit | edit source]

Simple surgical excision is curative.^[12] The recommended treatment is that the skin is peeled off the extra-auricular tissue and protruding cartilage remnants are trimmed.^[13] Normal appearance is achieved in majority of cases. The reconstruction successful in true cases of accessory auricle, as it also is in individuals with auricular appendages.^[14][15]

Epidemiology[edit | edit source]

These lesions usually present in neonates, although they may not come to clinical attention until adulthood (for cosmetic reasons).^[1] There is no gender predilection.^[1] They are present in approximately 5-10 per 1000 live births.^[1]

References[edit | edit source]

Further reading[edit | edit source]

• Lester D. R. Thompson; Bruce M. Wenig (2011). Diagnostic Pathology: Head and Neck. Hagerstown, MD: Lippincott Williams & Wilkins. pp. 7:2–3. ISBN 978-1-931884-61-7.

External links[edit | edit source]

Classification	ICD-10: Q17.0 ICD-9-CM: 744.1 OMIM: 610420 MeSH: Dimpal