Accessory auricle

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ICD-10 | Q17.0
ICD-9 | 744.1
OMIM | 610420

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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

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

## Classification

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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

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### Pathology Findings

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An intermediate power of a microscopic view of an accessory auricle.

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

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

## Epidemiology and Demographics

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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

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### Signs and Symptoms

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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

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#### Skin

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##### Ear

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

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

## Treatment

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Simple surgical excision is curative.[13]

## References

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1. ↑ PMID 18035991 (PMID 18035991)
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2. ↑ PMID 16877912 (PMID 16877912)
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3. ↑ PMID 8493161 (PMID 8493161)
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4. ↑ PMID 2206506 (PMID 2206506)
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5. ↑ PMID 7204730 (PMID 7204730)
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6. ↑ 6.0 6.1 PMID 11085670 (PMID 11085670)
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7. ↑ 7.0 7.1 PMID 5131708 (PMID 5131708)
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8. ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 894\. ISBN 1-4160-2999-0.CS1 maint: Multiple names: authors list (link)
9. ↑ PMID 8444054 (PMID 8444054)
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10. ↑ "Preauricular sinus and accessory auricle. (Photoclinic)." Consultant Feb. 2002: 256+. Health Reference Center Academic. Web. 2 Nov. 2011.
11. ↑ Hodges FR, Sahouria JJ, Wood AJ (2006). "Accessory tragus: A report of 2 cases". J Dent Child (Chic). 73 (1): 42–4. PMID 16734313.CS1 maint: Multiple names: authors list (link)
12. ↑ 12.0 12.1 "Dermatology Atlas".
13. ↑ PMID 19617017 (PMID 19617017)
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## Further Reading

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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.