Accessory auricle

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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

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

Classification

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

Pathology Findings

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

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

Epidemiology and Demographics

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

Signs and Symptoms

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

Skin

Ear

Treatment

Simple surgical excision is curative.[13]

References

  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.
  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.
  12. 12.0 12.1 "Dermatology Atlas".
  13. PMID 19617017 (PMID 19617017)
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Further Reading

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.