Accessory tragus: a possible sign of Goldenhar syndrome

The accessory tragus is a relatively common benign congenital anomaly. The tragus is a cartilaginous projection that normally occurs anterior to the external auditory meatus. Although aberrancy of the tragus may occur in isolation and is exclusively derived from the first branchial arch, it may occasionally signal a defect in the first or second branchial arches. Thus it may be a sign of other syndromes, such as oculoauricularvertebral dysplasia (Goldenhar syndrome). In fact, accessory tragus is a constant feature of this syndrome and may be associated with other syndromes. Accessory tragi are polypoid and should be distinguished from acrochordon (skin tags), as the shave excision commonly employed for skin tags may expose cartilage and cause slow healing or chondrodermatitis nodularis chronica helicis.