Accessory auricle

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Synonyms and keywords: Ear tag, Preauricular appendage, Preauricular tag, Accessory tragus

Overview[edit | edit source]

An accessory auricle is considered a developmental anomaly resulting from the persistence of a structure which variably recapitulates the normal external ear.

Classification[edit | edit source]

There may be several components or degress of development, ranging from an ear tag, preauricular appendage, preauricular tag, accessory tragus, to supernumerary ears or polyotia.^[1] 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)^[2] and with Wildervanck syndrome.^[3][4][5] There may also be an association with congenital cartilaginous rest of the neck.

Pathophysiology[edit | edit source]

Pathology Findings[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).^[6][7]

Differentiating Accessory Auricle from Other Diseases[edit | edit source]

These structures are distinctly different from squamous papilloma and benign teratoma.

Epidemiology and Demographics[edit | edit source]

These lesions usually present in neonates, although they may not come to clinical attention until adulthood (for cosmetic reasons). There is no gender predilection. They are present in approximately 3-6 per 1000 live births.^[8]

Diagnosis[edit | edit source]

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. However, it may be anywhere within the periauricular tissues. Bilateral presentation can be seen.^{[9][10][6][7][11]}

Physical Examination[edit | edit source]

Skin[edit | edit source]

Ear[edit | edit source]

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  Accessory tragus. Adapted from Dermatology Atlas.^[12]

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  Accessory tragus. Adapted from Dermatology Atlas.^[12]

Treatment[edit | edit source]

Simple surgical excision is curative.^[13]

References[edit | edit source]

Further Reading[edit | edit source]

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