Anaccessory auricle is a congenital anomaly typically seen as a skin coloured nodule, most frequently just to the front of the ear.[1][2]
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.[2] However, it may be anywhere within the periauricular tissues.[2] Bilateral presentation can be seen.[2]
Genetics
A study of a family with 11 affected showed the accessory auricle were inherited in an autosomaldominant manner.[3]
Diagnosis
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]
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
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.[16]
^ abcdCardesa, Antonio (2016). "8. Ear and temporal bone". In Franchi, Alessandro; Slootweg, Pieter J.; Gale, Nina; Ann, Sandison (eds.). Pathology of the Head and Neck. Springer. p. 397. ISBN978-3-662-49670-1.