Accessory auricle: Difference between revisions
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{{CMG}}{{AE}} {{KS}} | |||
{{SK}} 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]]. | An '''accessory auricle''' is considered a developmental anomaly resulting from the persistence of a structure which variably recapitulates the normal [[external ear]]. | ||
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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.<ref name="Lam">{{Cite pmid|18035991}}</ref> It is a relatively common [[Congenital abnormality|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)<ref name="Konas">{{Cite pmid|16877912}}</ref> and with [[Wildervanck syndrome]].<ref name="Tadini">{{Cite pmid|8493161}}</ref><ref name="Gao">{{Cite pmid|2206506}}</ref><ref name="Resnick">{{Cite pmid|7204730}}</ref> There may also be an association with [[congenital cartilaginous rest of the neck]]. | 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.<ref name="Lam">{{Cite pmid|18035991}}</ref> It is a relatively common [[Congenital abnormality|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)<ref name="Konas">{{Cite pmid|16877912}}</ref> and with [[Wildervanck syndrome]].<ref name="Tadini">{{Cite pmid|8493161}}</ref><ref name="Gao">{{Cite pmid|2206506}}</ref><ref name="Resnick">{{Cite pmid|7204730}}</ref> There may also be an association with [[congenital cartilaginous rest of the neck]]. | ||
== | ==Pathophysiology== | ||
== Pathology | === Pathology Findings === | ||
[[File:Ear Accessory Auricle LDRT.tif|thumb|An intermediate power of a microscopic view of an accessory auricle.]] | <div style="float: right;"> | ||
[[File:Ear Accessory Auricle LDRT.tif.jpg|thumb|An intermediate power of a microscopic view of an accessory auricle.]] | |||
</div> | |||
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).<ref name="Jansen">{{Cite pmid|11085670}}</ref><ref name="Brownstein">{{Cite pmid|5131708}}</ref> | 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).<ref name="Jansen">{{Cite pmid|11085670}}</ref><ref name="Brownstein">{{Cite pmid|5131708}}</ref> | ||
== | ==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.<ref name="Bolognia">{{cite book |author=Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |pages= |isbn=1-4160-2999-0 |oclc= |doi= |accessdate=| page=894}}</ref> | 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.<ref name="Bolognia">{{cite book |author=Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |pages= |isbn=1-4160-2999-0 |oclc= |doi= |accessdate=| page=894}}</ref> | ||
== | ==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.<ref name="Cosman">{{Cite pmid|8444054}}</ref><ref>"Preauricular sinus and accessory auricle. (Photoclinic)." Consultant Feb. 2002: 256+. Health Reference Center Academic. Web. 2 Nov. 2011.</ref><ref name="Jansen">{{Cite pmid|11085670}}</ref><ref name="Brownstein">{{Cite pmid|5131708}}</ref><ref name="pmid16734313">{{cite journal |author=Hodges FR, Sahouria JJ, Wood AJ |title=Accessory tragus: A report of 2 cases |journal=J Dent Child (Chic) |volume=73 |issue=1 |pages=42–4 |year=2006 |pmid=16734313 |doi= |url=}}</ref> | |||
===Physical Examination=== | |||
====Skin==== | |||
=====Ear===== | |||
<gallery> | |||
Image:Accessory tragus 01.jpeg|Accessory tragus. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
Image:Accessory tragus 02.jpeg|Accessory tragus. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
</gallery> | |||
== Treatment == | |||
Simple surgical excision is curative.<ref name="Pan">{{Cite pmid|19617017}}</ref> | |||
== References == | == References == | ||
{{reflist}} | {{reflist|2}} | ||
== Further | == Further Reading == | ||
{{cite book |author=Lester D. R. Thompson, Bruce M Wenig |title=Diagnostic Pathology: Head and Neck: Published by Amirsys |publisher=Lippincott Williams & Wilkins |location=Hagerstown, MD |year=2011 |pages=7:2–3 |isbn=1-931884-61-7 |oclc= |doi= |accessdate=}} | {{cite book |author=Lester D. R. Thompson, Bruce M Wenig |title=Diagnostic Pathology: Head and Neck: Published by Amirsys |publisher=Lippincott Williams & Wilkins |location=Hagerstown, MD |year=2011 |pages=7:2–3 |isbn=1-931884-61-7 |oclc= |doi= |accessdate=}} | ||
[[Category:Ear]] | [[Category:Ear]] | ||
Latest revision as of 13:27, 13 August 2014
| Accessory auricle | |
| Classification and external resources | |
| ICD-10 | Q17.0 |
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| ICD-9 | 744.1 |
| OMIM | 610420 |
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WikiDoc Resources for Accessory auricle |
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Most recent articles on Accessory auricle Most cited articles on Accessory auricle |
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Powerpoint slides on Accessory auricle |
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Evidence Based Medicine |
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Cochrane Collaboration on Accessory auricle |
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Clinical Trials |
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Ongoing Trials on Accessory auricle at Clinical Trials.gov Trial results on Accessory auricle Clinical Trials on Accessory auricle at Google
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US National Guidelines Clearinghouse on Accessory auricle NICE Guidance on Accessory auricle
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Commentary |
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Definitions |
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Patient Resources / Community |
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Patient resources on Accessory auricle Discussion groups on Accessory auricle Patient Handouts on Accessory auricle Directions to Hospitals Treating Accessory auricle Risk calculators and risk factors for Accessory auricle
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Healthcare Provider Resources |
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Causes & Risk Factors for Accessory auricle |
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Continuing Medical Education (CME) |
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International |
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Experimental / Informatics |
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
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
-
![Accessory tragus. Adapted from Dermatology Atlas.[12]](/images/c/cb/Accessory_tragus_01.jpeg)
Accessory tragus. Adapted from Dermatology Atlas.[12]
-
![Accessory tragus. Adapted from Dermatology Atlas.[12]](/images/8/8e/Accessory_tragus_02.jpeg)
Accessory tragus. Adapted from Dermatology Atlas.[12]
![Accessory tragus. Adapted from Dermatology Atlas.[12]](/index.php/File:Accessory_tragus_01.jpeg)
![Accessory tragus. Adapted from Dermatology Atlas.[12]](/index.php/File:Accessory_tragus_02.jpeg)
Treatment
Simple surgical excision is curative.[13]
References
- ↑ PMID 18035991 (PMID 18035991)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ PMID 16877912 (PMID 16877912)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ PMID 8493161 (PMID 8493161)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ PMID 2206506 (PMID 2206506)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ PMID 7204730 (PMID 7204730)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ 6.0 6.1 PMID 11085670 (PMID 11085670)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ 7.0 7.1 PMID 5131708 (PMID 5131708)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 894. ISBN 1-4160-2999-0.
- ↑ PMID 8444054 (PMID 8444054)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ "Preauricular sinus and accessory auricle. (Photoclinic)." Consultant Feb. 2002: 256+. Health Reference Center Academic. Web. 2 Nov. 2011.
- ↑ Hodges FR, Sahouria JJ, Wood AJ (2006). "Accessory tragus: A report of 2 cases". J Dent Child (Chic). 73 (1): 42–4. PMID 16734313.
- ↑ 12.0 12.1 "Dermatology Atlas".
- ↑ PMID 19617017 (PMID 19617017)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand
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.