Accessory tragus

1. Accessory Tragus

An **accessory tragus** is a congenital anomaly characterized by the presence of additional skin and cartilage near the tragus of the ear. This condition is typically benign and is often discovered at birth or during early childhood. Accessory tragi are considered a minor malformation and are usually not associated with any significant health issues.

Anatomy and Presentation

The accessory tragus is typically located anterior to the tragus of the ear, along the line from the tragus to the corner of the mouth. It can vary in size from a small, skin-colored papule to a larger, more prominent structure that may contain cartilage. The accessory tragus is often unilateral but can be bilateral in some cases.

Embryology

The development of the accessory tragus is linked to the embryological development of the first and second branchial arches. During normal development, the auricle of the ear forms from six hillocks of tissue that arise from these arches. An accessory tragus results from the persistence of additional hillocks or from incomplete fusion of these structures.

Diagnosis

Diagnosis of an accessory tragus is primarily clinical, based on physical examination. The lesion is typically soft, non-tender, and may have a cartilaginous core. In some cases, imaging studies such as ultrasound or MRI may be used to assess the extent of the lesion or to rule out other conditions.

Treatment

Treatment of an accessory tragus is usually not necessary unless it causes cosmetic concerns or discomfort. Surgical excision is the most common treatment option and is typically performed under local anesthesia. The procedure is straightforward, and complications are rare.

Associated Conditions

While accessory tragi are usually isolated findings, they can occasionally be associated with other congenital anomalies, particularly those affecting the head and neck region. In rare cases, they may be part of a syndrome such as Goldenhar syndrome or branchio-oto-renal syndrome.

Epidemiology

Accessory tragi are relatively common, with an estimated prevalence of 1 in 1,000 to 1 in 2,500 live births. They occur with equal frequency in males and females and across different ethnic groups.

Also see

• Tragus (ear)
• Congenital anomaly
• Goldenhar syndrome
• Branchial arch