Английская Википедия:Accessory auricle

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Шаблон:Technical Шаблон:Infobox medical condition (new) An accessory auricle is considered a developmental anomaly resulting from the persistence of a structure which variably recapitulates the normal external ear.

Signs and symptoms

Файл:Gould Pyle 104.jpg
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. However, it may be anywhere within the periauricular tissues. Bilateral presentation can be seen.[1][2][3][4][5]

Genetics

A study of a family with 11 affected showed the accessory auricle were inherited in an autosomal dominant manner.[6]

Diagnosis

Файл:Ear Accessory Auricle LDRT.tif
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).[3][4] 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.[7] The second ear appears as a mirror image folded forward and lying on the posterior cheek.Шаблон:Citation needed

Differential diagnosis

These structures are distinctly different from squamous papilloma and benign teratoma.Шаблон:Citation needed

Classification

The several components or degrees of development range from an ear tag, preauricular appendage, preauricular tag, or accessory tragus, to supernumerary ears or polyotia.[8] 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)[9] and with Wildervanck syndrome.[10][11][12] There may also be an association with congenital cartilaginous rest of the neck.Шаблон:Citation needed

Management

Simple surgical excision is curative.[13] The recommended treatment is that the skin is peeled off the extra-auricular tissue and protruding cartilage remnants are trimmed.[14] 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.[15][16]

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.[17]

References

Шаблон:Reflist

Further reading

External links

Шаблон:Medical resources Шаблон:Congenital malformations and deformations of ears