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An accessory 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 [ edit ]
Well-developed accessory auricle on the side of the neck
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 [ edit ]
A study of a family with 11 affected showed the accessory auricle were inherited in an autosomal dominant manner.[3]
Diagnosis [ edit ]
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).[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 ]
These structures are distinctly different from squamous papilloma and benign teratoma .[citation needed ]
Classification [ edit ]
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 ]
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 ]
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]
References [ edit ]
^ Yang, Y; et al. (2006). "A locus for autosomal dominant accessory auricular anomaly maps to 14q11.2–q12". Human Genetics . 120 (1 ): 144–147. doi :10.1007/s00439-006-0206-1 . PMID 16775710 . S2CID 1196716 .
^ Jansen, T.; Romiti, R.; Altmeyer, P. (2000). "Accessory tragus: Report of two cases and review of the literature". Pediatric Dermatology . 17 (5 ): 391–394. doi :10.1046/j.1525-1470.2000.017005391.x . PMID 11085670 . S2CID 19325370 .
^ Brownstein, M. H.; Wanger, N.; Helwig, E. B. (1971). "Accessory tragi". Archives of Dermatology . 104 (6 ): 625–631. doi :10.1001/archderm.1971.04000240049006 . PMID 5131708 .
^ Stevenson, Roger E.; Hall, Judith G. (2005). Human Malformations and Related Anomalies (2nd ed.). Oxford University Press . pp. 339–340. ISBN 978-0199748082 .
^ Lam, J.; Dohil, M. (2007). "Multiple Accessory Tragi and Hemifacial Microsomia". Pediatric Dermatology . 24 (6 ): 657–658. doi :10.1111/j.1525-1470.2007.00560.x . PMID 18035991 . S2CID 19272462 .
^ Konaş, E.; Canter, H. I.; Mavili, M. E. (2006). "Goldenhar complex with atypical associated anomalies: Is the spectrum still widening?". Journal of Craniofacial Surgery . 17 (4 ): 669–672. doi :10.1097/00001665-200607000-00011 . PMID 16877912 .
^ Tadini, G.; Cambiaghi, S.; Scarabelli, G.; Brusasco, A.; Vigo, P. (1993). "Familial occurrence of isolated accessory tragi". Pediatric Dermatology . 10 (1 ): 26–28. doi :10.1111/j.1525-1470.1993.tb00006.x . PMID 8493161 . S2CID 20872067 .
^ Gao, J. Z.; Chen, Y. M.; Gao, Y. P. (1990). "A survey of accessory auricle anomaly. Pedigree analysis of seven cases". Archives of Otolaryngology–Head & Neck Surgery . 116 (10 ): 1194–1196. doi :10.1001/archotol.1990.01870100088019 . PMID 2206506 .
^ Resnick, K. I.; Soltani, K.; Bernstein, J. E.; Fathizadeh, A. (1981). "Accessory tragi and associated syndromes involving the first branchial arch". The Journal of Dermatologic Surgery and Oncology . 7 (1 ): 39–41. doi :10.1111/j.1524-4725.1981.tb00591.x . PMID 7204730 .
^ Pan, B.; Qie, S.; Zhao, Y.; Tang, X.; Lin, L.; Yang, Q.; Zhuang, H.; Jiang, H. (2010). "Surgical management of polyotia". Journal of Plastic, Reconstructive & Aesthetic Surgery . 63 (8 ): 1283–1288. doi :10.1016/j.bjps.2009.06.037 . PMID 19617017 .
^ Scott-Brown's Otorhinolaryngology (7th ed.). Hodder Arnold. 2016-06-15. p. 969. ISBN 978-0-340-808-931 .
^ Ku, PK; Tong, MC; Yue, V (1998). "Polyotia- a rare external ear anomaly". International Journal of Pediatric Otorhinolaryngology . 46 (1–2): 117–20. doi :10.1016/S0165-5876(98 )00152-9 . PMID 10190712 .
^ Bendor-Samuel, RL; Tung, TC; Chen, YR (1995). "Polyotia". Annals of Plastic Surgery . 34 (6 ): 650–2. doi :10.1097/00000637-199506000-00015 . PMID 7661545 . S2CID 220587660 .
^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set . St. Louis: Mosby . p. 894. ISBN 978-1-4160-2999-1 .
Further reading [ edit ]
External links [ edit ]
R e t r i e v e d f r o m " https://en.wikipedia.org/w/index.php?title=Accessory_auricle&oldid=1224947998 "
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