Co-Existing Accessory Tragus and Auriculotemporal Nerve Syndrome-Coincidence or Common Embryogenesis?

Accessory tragi are congenital anomalies arising from the first pharyngeal arch, while auriculotemporal nerve syndrome is a rare condition characterized by prandial unilateral or bilateral facial flushing due to aberrant autonomic signaling. This report describes a 5-month-old female with a right-sided preauricular accessory tragus and recurrent right-sided facial flushing triggered by fruit purees, diagnosed as auriculotemporal nerve syndrome. The case suggests a novel etiology for auriculotemporal nerve syndrome linked to first pharyngeal arch development, as both the accessory tragus and auriculotemporal nerve share this embryologic origin. Recognizing this association may prevent unnecessary food allergy evaluations and highlights the need for further research into connections between dermatologic congenital anomalies and autonomic dysfunction.