The accessory tragus is a benign congenital malformation of the external ear. It’s commonly, though incorrectly, referred to as a “skin tag”. It’s actually a small flesh-colored tissue composed of skin, subcutaneous fat, and cartilage. It is typically located anterior to the tragus.
The formation is a result of errors during embryogenesis when the fetus is only about 6 weeks old. The ear is composed from tissue mounds on the embryos (called hillocks) derived from the first and second brachial arch. Any convergence from the normal process can result in an accessory tragus.
In the majority of cases, it is an isolated finding and not associated with other more concerning abnormalities. In rare cases, it can be associated with other abnormalities of brachial arch development, such as Goldenhar syndrome, a type of craniofacial microsomia.
It’s common for patients or parents to seek treatment in childhood. Treatment involves surgical excision with full removal of cartilage stalk below the skin to ensure better cosmetic results. Removal is a low-risk outpatient procedure and it’s uncommon to result in any complications.
If you notice an accessory tragus on your child, please don’t hesitate to contact Wellspring Pediatric Plastics at pediatrics@thewsps.com for a consultation. Our team of specialists are dedicated to addressing your needs, hearing a child’s and parent’s concerns, and crafting effective treatment plans to best fit your family!
