Accessory Tragus in an Infant Girl

The left ear of a 1-month-old infant girl shows a congenital papillomatous lesion at the preauricular area. She had no other apparent abnormalities.

Accessory tragi usually are isolated congenital anomalies. They may be single or multiple, unilateral or bilateral, sessile or pedunculated. Generally seen at the preauricular area, they also may occur on the neck, anterior to the sternocleidomastoid muscle, or along the line of the mandible on the cheek.

Consider a more serious associated congenital anomaly before initiating treatment. Like the tragus, accessory tragi are derived from the first branchial arch; thus, they may be associated with first branchial arch syndromes such as cleft lip, cleft palate, and mandibular hypoplasia. Accessory tragi are consistently found in oculoauriculovertebral dysplasia, or Goldenhar's syndrome.

This infant had no associated anomalies. She was given a local anesthetic; the lesion was excised, and its base electrocoagulated.