Pseudocyst of the auricle. Case report and world literature review

Seroma of Auricle

The pseudocyst of the auricle is an intracartilaginous lesion defined as the accumulation of sterile, straw-coloured fluid in a cyst unlined by epithelium. It is more common in males. The most common site of lesion is the scaphoid fossa and right ear. Though the aetiology remains unclear, it may be associated with mechanical irritation, repeated minor injuries and chronic trauma. If left untreated, it can lead to permanent deformity of the auricle. Pseudocyst of the auricle is a rare and challenging condition. Medical management has unfortunately shown no practical results. Hence, surgical treatment modalities are the best option. The universal aim of treatment is the conservation and restoration of the anatomical structure of the pinna, removal of cystic lesions and prevention of recurrence. Simple aspiration or incision and drainage alone lead to reaccumulation of cystic fluid in most cases. The technique of incision and drainage is the easiest but has a high recurrence rate. Conservative treatment often results in recurrence and unsatisfactory results. Other treatment modalities include incision and drainage with daily irrigation, auricular splinting, aspiration with intralesional steroid injection, aspiration followed by compression dressing, or aspiration with intralesional steroid injection followed by compression dressing and surgical deroofing, surgical deroofing followed by compression with buttons or sheet or sandwich method. Cysts with a diameter less than 1 cm are dealt with through non-surgical treatment modalities, while for cysts having a diameter greater than 1 cm, surgery is considered as first choice therapy. These treatment options have shown promising results. Various modifications in the traditional techniques have reduced the recurrence rate, successfully treated the condition and shown good cosmetic results. This review article aims at providing a holistic collection of various conventional treatment modalities and novel modifications introduced, which can be used in a sequence of definitive treatments of seroma of the auricle.

Auricular pseudocysts: a systematic review of the literature

BACKGROUND

Auricular pseudocysts are benign fluid accumulations of the ear of uncertain etiology. Little is known about the optimal modality to successfully treat these lesions. No systematic review addressing auricular pseudocysts have been published to date.

OBJECTIVES

The aim of this study is to summarize all the published data regarding diagnostic and therapeutic challenges of auricular pseudocysts.

METHODS

On May 28, 2020, a systematic search of Medline, Embase, and Cochrane databases was conducted. All the studies describing treatment of auricular pseudocysts, procedure description, outcome, and follow-up period were included in this review.

RESULTS

After full-text article review, 74 articles were included, representing a total of 1,011 lesions. The commonly used treatments for auricular pseudocysts were deroofing (493 lesions), aspiration (284 lesions), incision and drainage (171 lesions), intralesional steroids (53 lesions), and observation (10 lesions). The highest cure rate was found with the deroofing procedure (97.2%) followed by incision and drainage (95.9%). The mean follow-up period was 6.7 months.

CONCLUSION

Surgical procedures (anterior deroofing or incision and drainage) showed the highest cure rates and should be considered as first-line treatment for auricular pseudocysts. Future adequately designed randomized controlled trials are warranted to compare the efficacy of the techniques described.

Auricular Pseudocyst: Sonographic Appearance in 17 Patients

Auricular pseudocyst (AP) is a rare benign condition that corresponds to an intracartilaginous collection resulting in a noninflammatory cystic swelling of the ear.The objective is to describe ultrasound and clinical presentation of histologically proven AP.An Institutional Review Board (IRB) approved a 6-year retrospective study. Patients with an auricular pseudocyst were selected. Fifty-nine percent of the cases were referred with clinical suspicion of AP. One hundred percent were men, and in 76% of the cases, AP was located in the scaphoid fossa. The mean age was 35 years (76% from 20 to 50 years).Unilateral lesion was present in 94% of the cases. A single lesion was found in 88% and multiple lesions in 12%. On high-resolution ultrasound increased thickness of the cartilage was observed in all patients with a cystic lesion inside the cartilage. Fifty-nine percent of the cases were totally anechoic. The other presented echoes or septa inside the cystic lesion.In conclusion high-resolution ultrasound allows to study the exact anatomic involvement of the cartilage and the surrounding tissues. The auricular pseudocyst presented a characteristic ultrasound finding permitting an adequate early diagnosis and monitoring treatment. Knowledge of this pathology and the sonographic finding is important for a correct diagnosis.

Bilateral pseudocyst of the auricles in a 4-week neonate-case report and world literature review

Pseudocyst of the auricle is a rare, idiopathic disease clinically manifesting as a painless edema of the upper-lateral parts of the auricle. Due to the rarity of the disease, auricular pseudocyst is often misdiagnosed. The confirmation of a diagnosis of auricular pseudocyst is most commonly made on the basis of clinical manifestations. The etiology of the disease remains unknown, and this frequently hinders both proper diagnosis and prevention. We report a case of a 4-week neonate admitted to the Department of Pediatrics, Rheumatology and Environmental Diseases of the Chair of Pediatry, Jagiellonian University, Medical College in Krakow with bilateral pseudocyst with very early presentation that was less prominent after birth and well presented in the second week of life. The surgical treatment was successful. One month after treatment the infant was admitted again to the hospital with hypertension and edema of feet and hands. Treatment with amlodipine was implemented resulting in a normalization of blood pressure. The diagnosis of pseudohypoaldosteronism type I was confirmed.

Clinico-pathological profile and comparative study of conservative versus surgical deroofing as an effective technique in management of pseudocyst of pinna

Background and objectives

An auricular pseudocyst is not uncommon in routine ENT clinical practice, it occurs when fluid accumulates between the intracartilaginous spaces of the auricle. Many treatment modalities have been proposed such as incision and drainage of the cyst, simple needle aspiration, tight bandaging with dental rolls, however recurrence and cosmetic problems are still noted in some cases. The aim of this article was to discuss our experience of surgical treatment of intractable auricular pseudocysts with marsupialisation, deroofing and anterior cartilage leaflet removal along with compression suture therapy.

Materials and methods

Twenty patients were included in the study conducted at ENT department, Sur Ministry of Health Hospital between January 2012 and January 2014 after prior consent and ethical approval. Those following trauma and other pinna conditions like relapsing polychondritis were excluded from our study. The clinical appearances were noted and all patients underwent surgical deroofing with removal of anterior cartilage leaflet and compression suture therapy using buttons for two weeks.

Results and observations

There were 8 males and 12 females out of the 20 and right sided pinna (n = 14) involvement in the region of the scaphoid fossa (n = 12) was more than the triangular fossa (n = 3) or conchal bowl involvement (n = 5). Mostly patients between 30 and 40 years of age were affected (Mean age of 37 years and standard deviation of 8). The overall success rate with deroofing and compression suture therapy was 98%.

Conclusions

Auricular pseudocysts are not an uncommon condition affecting middle aged patients without identifiable etiology. Conservative modalities may be the first choice of treatment for auricular pseudocysts although varied recurrence and failure rates have been published in the literature. However, the deroofing surgical technique with anterior cartilage leaflet removal with compression suture therapy is a reliable and easy procedure which can achieve an acceptable appearance of the pinna without recurrence when conservative management fails or is refused by the patient.

Transwindow Suture Technique for Pseudocyst of Pinna

Pseudocyst or seroma of the pinna is the accumulation of serous fluid between the perichondrium and cartilage of pinna. Though there are several surgical techniques in the treatment of seroma, recurrence is common. The aim and objective of this preliminary study is to present and discuss a novel technique of treating pseudocyst of pinna which is practiced at Karwar Institute of Medical sciences. A prospective study was done with a novel procedure "Transwindow suture technique" for the treatment of pseudocyst of pinna in four patients. Three of the four patients had a very good results without any recurrence. One patient had a small quantity of recollection due to premature closure of the skin window which was successfully corrected. In this preliminary study we had encouraging results in the treatment of pseudocyst of pinna. A large scale prospective study would demonstrate the effectiveness of this procedure.

Cystic chondromalacia of the auricle treated with dual-plane excision with intracartilaginous dissection

Cystic chondromalacia of the auricle is an uncommon condition in which a degenerative process occurs within the cartilage. The disorder affects young and middle-aged people. Clinically, it manifests as a painless, fluctuant swelling that frequently relapses despite various therapeutic approaches. In this article we report a typical case of cystic chondromalacia of the auricle that was successfully treated by surgery-specifically, dual-plane dissection-and we briefly review the literature.

Pseudocyst of the auricle in patients with movement disorders: report of two patients with ataxia-associated auricular pseudocysts

Background:

Pseudocyst of the auricle is a benign condition of the ear characterized by an asymptomatic, noninflammatory swelling on the lateral or anterior surface of the auricle. It typically presents as a 1 to 5 centimeter cystic lesion located within the scaphoid or triangular fossa. In most patients, the lesion develops spontaneously. However, pseudocyst of the auricle has also been associated with trauma to the ear.

Purpose:

We describe the clinical findings of two men who developed pseudocyst of the auricle associated with ataxia-induced trauma to their ear. We also summarize the differential diagnosis, the postulated pathogenesis, and the treatment options for this condition.

Materials and methods:

The features of two men with pseudocyst of the auricle are presented. Using PubMed, the following terms were searched and relevant citations assessed: ataxia, auricle, dyskinesia, ear, Friedreich’s, neurological, pinna, pseudocyst, spasticity, spinocerebellar, and trauma. In addition, the literature on pseudocyst of the auricle is reviewed.

Results:

Pseudocyst of the auricle was observed in two men with neurological disorders: a 33-year-old Asian man with spinocerebellar ataxia and a 47-year-old Caucasian man with Friedreich’s ataxia. Each patient had a history of ataxia-induced head and ear trauma. The clinical features of the lesions were sufficient to establish a diagnosis of pseudocyst of the auricle. Neither patient desired treatment.

Conclusion:

Pseudocyst of the auricle is a benign cystic lesion that is occasionally precipitated by trauma to the affected ear. Patients with neurological disorders, particularly those associated with ataxia and/or dyskinesias, may have an increased risk of developing the traumatic variant of the condition. Diagnosis can usually be established by clinical presentation. However, in some patients, a tissue specimen may be secured for microscopic evaluation to exclude infection or during surgical repair. Various treatment options exist for pseudocyst of the auricle, including: (1) needle aspiration—with or without subsequent injection of an irritant substance—followed by a pressure dressing and (2) surgical deroofing. Alternatively, reassurance of the benign nature of the condition and observation is a reasonable management alternative.

Deroofing of auricular pseudocyst: our experience

AIM

To ascertain a definitive treatment modality for a frequently recurring condition, pseudocyst of pinna in the form of deroofing and compression.

MATERIALS AND METHODS

Thirty patients were diagnosed with pseudocyst of pinna from July 2011 to March 2013. All 30 patients underwent surgical deroofing of the pseudocyst along with compression by buttoning. The patients were followed up for a period of six months Results: No recurrence was seen in 29 patients in the follow up period of six months (96.7%). One patient had recurrence 15 d following the procedure. The recurrence in the case could be attributed to the usage of improper buttons for compression.

CONCLUSION

Despite numerous treatment options for pseudocyst of pinna, there remains high recurrence rate in patients. Additionally, some treatments carry the risk of cartilage damage or visible distortion of the auricle. Surgical deroofing followed by compression using buttons can be considered as first line treatment of this entity as it is associated with very less rate of recurrence and gives a cosmetically acceptable result.

Treatment of Auricular Seroma

Objective:

Auricular seroma is a cystic swelling filled with serous fluid. It occurs spontaneously or following trauma. Successful treatment of the seroma remains a challenge because this disease has a high propensity for recurrence. The aim was to study the results of the Plaster of Paris (POP) cast in treatment of seroma in terms of complete resolution of swelling, recurrence, and auricular aesthesis.

Study Design:

Prospective.

Setting:

Smt. Kashibai Navale Medical College and General Hospital.

Materials and Methods:

A total of 48 patients with auricular seroma were studied. They were treated with aspiration of the cyst followed by compression dressing with a POP cast, taking the contour of the pinna. The POP cast was kept for 3 days. The patients were followed up for 6 months for recurrence.

Results:

Out of 48 patients, 43 patients had complete resolution of the swelling in a single application of the POP cast. Five patients needed 2 applications of the POP cast. Not a single patient had recurrence. Temporary discoloration or thickening of the pinna was noted in 8 patients. No major complications like perichondritis were noted.

Conclusion:

Aspiration and contour dressing using POP is an innovative and effective treatment for management of auricular seroma as it prevents surgical trauma and recurrence and gives cosmetically excellent results.

Pseudocyst of pinna and its treatment with surgical deroofing: an experience at tertiary hospitals

Introduction:

Pseudocyst of pinna is an uncommon condition hardly encountered in routine ENT practice. The involvement is usually seen in scaphoid, triangular fossa, and antihelix. Medical treatment is ineffective. Various treatments are suggested in the literature. The aims of the paper were to study the clinical characteristic of patients with pseudocysts and to share our experience with surgical deroofing and buttoning as a definitive treatment.

Materials and Methods:

Twenty-six patients were diagnosed with pseudocyst of the auricle between April 2011 and 2013 in two medical college hospitals. Clinical characteristics were noted. All patients underwent incision and drainage with removal of anterior cartilage leaflet followed by buttoning for 12 days.

Results and Observations:

Out of 26 patients, only two were females. Involvement of left side was seen more than right one. None had bilateral involvement. Adults in the age group of 31-40 were commonly affected. Most common site of involvement was scaphoid and triangular fossa. The success rate with primary I and D and buttoning was 96%.

Conclusions:

Pseudocyst of the pinna is a benign condition of unknown etiology affecting the pinna, commonly encountered in middle-aged men. Many modalities of treatment have been recommended in the literature with varied recurrence and failure rates. The best form of treatment with minimum recurrence is incision and drainage with removal of anterior cartilage leaflet with buttoning.

A comparative study in the management of auricular pseudocysts

Pseudocysts of the pinna, commonly called seroma are an asymptomatic condition of unknown etiology affecting the pinna, commonly encountered in middle aged men. Prevention is practically impossible as etiology is unknown. However, early recognition and treatment are stressed.In our prospective study of 30 eases we compared the different treatment modalities available namely, wide bore needle aspiration, intracavitary steroid injection and window (de-roofing) procedure. Amongst them, the window (de-roofing) procedure was found to be successful in 109% of the cases to prevent recollection of serous fluid with a minimum of sequelae.

Clinical characteristics and comparative study of different modalities of treatment of pseudocyst pinna

The aims of the article were to study the clinical characteristic of patients with pseudocysts and to compare different common modalities of treatment and introduce the concept of observation in pseudocyst management. Twenty-eight patients were diagnosed with pseudocyst of the auricle between June 2009 and June 2011 in a medical college hospital. The patients were divided into four groups each of seven patients on the basis of primary treatment offered. Four primary treatments offered were simple aspiration, aspiration with intralesional steroid, incision and drainage with removal of anterior cartilage leaflet with buttoning, and lastly, simple observation and reassurance. All 28 patients were male with involvement of right side more than left and no one had bilateral involvement. Adults in the age group of 30-40 were commonly affected. Most of the patients had history of significant trauma by security forces. Most common site of involvement was scaphoid and triangular fossa. The best form of treatment with minimum recurrence was incision and drainage with removal of anterior cartilage leaflet with buttoning. Simple observation as a treatment option was found to be as good as intralesional steroids. Pseudocyst of the pinna is a benign condition of unknown etiology affecting the pinna, commonly encountered in middle-aged men. It is a rare condition and is hardly encountered in routine ENT practice. Bilateral diseases are uncommon. Most common site of occurrence is triangular and scaphoid fossa. Many modalities of treatment have been recommended in literature with varied recurrence and failure rates. The best treatment is surgical deroofing followed by buttoning with minimum recurrences. An option of simple observation for 2-3 months should be discussed with each patient and was found to be as good as intralesional steroids.

Pseudocyst of pinna: a recurrence-free approach

OBJECTIVE

The aims of the article were to study the epidemiological profile of pseudocyst of pinna in non-Chinese population, to propose a hormonal basis of pseudocyst formation, and to compare 2 commonly used treatment modalities of incision drainage with compression and deroofing with compression, so as to ascertain the definitive treatment of this frequently recurring condition.

MATERIAL AND METHODS

Twenty-nine patients were diagnosed with pseudocyst of the auricle between June 2005 and December 2006 in a medical college hospital. All the patients were initially subjected to aspiration with contour dressing. Of the 29 patients, 28 showed recurrence with in 1 week. These 28 patients were divided into 2 groups--13 patients underwent incision and drainage with curettage followed by buttoning, whereas 15 underwent surgical deroofing of the cyst along with buttoning.

RESULTS

All the 29 patients were males with a mean age of 32.6 +/- 4.3 years. Sixteen (55.17%) patients had a right-sided lesion, whereas 13 (44.82%) patients had a left-sided lesion. No case of bilateral pseudocyst was seen. The pseudocyst was most commonly located in the concha. After aspiration with contour dressing, 28 (96.55%) patients showed recurrence within 1 week. Of the 13 patients who underwent incision drainage with buttoning, 5 (38.46%) showed recurrence. Of the 13 patients who underwent incision drainage, 3 (23.07%) showed permanent thickening of the auricular cartilage. The 5 cases that recurred then underwent deroofing with buttoning along with 15 patients. Thus, a total of 20 patients underwent surgical deroofing. No recurrence was seen with this technique. The patients were followed up for 1 month. No complication was noted, and the results were cosmetically acceptable.

CONCLUSION

Pseudocyst of the pinna is an uncommon condition of the auricle presenting as a painless swelling in young adult males. The epidemiological profile of this condition is similar in Chinese and non-Chinese (Indian) population. A hormonal influence modulating the inflammatory process explains the marked male predominance of this condition. Surgical deroofing followed by buttoning is the definitive treatment of this entity as it is associated with no recurrence and gives a cosmetically acceptable result.

Pseudocysts of the auricle in a young adult with facial and ear atopic dermatitis

Pseudocyst of the auricle is a relatively uncommon condition in which serous fluid accumulates between intracartilaginous space of the ear and manifests as a painless, fluctuant outer ear swelling. Pseudocysts of the auricle have been reported in healthy individuals without clear precipitating or causative factors, with little information on this entity in patients with atopic dermatitis. Here, we describe a case of recurrent pseudocysts of the auricle in a young adult with active facial and ear atopic dermatitis. We also present a specific review of the literature on this condition in patients with atopic dermatitis and discuss a possible association between the two conditions.

Pseudocyst of auricle - etiopathogenesis, treatement update and literature review

Pseudocyst of the pinna, a benign idiopathic cystic swelling is an uncommon condition. In the medline search there are over 113 cases reported in literature. Engel in 1966 reported the incidence in Chinese community. In this review article we describe the etiopathogenesis, demographic statistics and treatment modalities.This is a retrospective study of six cases treated by the senior author in the dept of Otorhinolaryngology, Head & Neck Surgery, Apollo Hospital Chennai, South India between 1993 through 2003. There is preponderance of incidence in adult male (5 cases) and a single case in a female. The author highlights the modalities of treatment and opines that the surgical technique described by Lim et al, with little modification is the gold standard, which retains the architecture of the pinna. Conservative methods adopted by others have failed.

Pseudocyst of the Auricle: A Histologic Perspective

OBJECTIVE

The aim of the study is to describe the histologic spectrum in the pseudocyst of the auricle and to identify any consistent histologic features of this condition.

STUDY DESIGN

A prospective study was performed in which the tissue specimen from patients with pseudocyst of the auricle treated at the Department of Otolaryngology, Singapore General Hospital during a 1-year period was sent for histology.

METHODS

Consecutive patients with pseudocyst of the auricle who were treated had their tissue specimen sent for histology. These specimens were independently reviewed by one consultant pathologist.

RESULTS

All 16 specimens revealed an intracartilaginous cyst devoid of epithelial lining. Interestingly, there were consistent perivascular mononuclear infiltrates of lymphocytes evident in the connective tissue layer just superficial to the anterior segment of the cartilage.

CONCLUSION

Pseudocyst of the auricle is a benign condition predominantly affecting young Asian males. Histology characteristically reveals an intracartilaginous cyst devoid of epithelial lining, and there are no pathognomonic features. We postulate that an inflammatory response is crucial to the development of this condition on the basis of a consistent perivascular inflammatory response seen in all our specimens.

Recurrent auricular pseudocyst: a new treatment recommendation with curettage and fibrin glue

BACKGROUND

Pseudocyst of the auricle is a rarely seen fluctuant swelling of the ear. Although various hypotheses on the etiology have been suggested, the exact cause still remains unclear. Chronic minor trauma, which is believed to create intracartilaginous cavity, is accepted to be the most probable cause. Several treatment methods have been used for this benign lesion, but higher recurrence rates can be seen if not properly treated.

OBJECTIVE

To discuss a new treatment modality for this rare disorder.

METHOD

A 44-year-old man presented with a large pseudocyst of the auricle that had been treated several times previously with unsuccessful outcomes. For its treatment, we performed curettage and then used fibrin glue as a sealer between the two leaves of the cartilage.

RESULTS

At postoperative 6-months follow-up, there was no evidence of recurrence. The cosmetic outcome was excellent.

CONCLUSION

The use of fibrin glue both to obliterate the pseudocyst space and to make the two leaves of the cartilage adhere to each other should be kept in mind in this rare disorder in order to avoid recurrences.

Pseudocyst of the auricle

OBJECTIVE

To study the epidemiological profile of patients with pseudocyst of the auricle and to review the effectiveness of surgical excision of the anterior cartilage with compression buttoning in this condition.

STUDY DESIGN

Medical records of patients with pseudocyst of the auricle treated in the Department of Otolaryngology of the Singapore General Hospital were reviewed retrospectively during the period from March 1, 2000, to November 30, 2001.

METHODS

A retrospective descriptive analysis of the epidemiological profile of patients with pseudocyst of the auricle was done. Surgical excision with compression buttoning was evaluated as the definitive treatment in this condition.

RESULTS

Eighty-seven percent of our patients were male and the mean age was 38.9 years old. There was no racial predisposition. All 9 patients who had simple aspiration of the cyst had prompt re-accumulation of the pseudocyst. None of the patients had recurrence following excision and compression buttoning of the pseudocyst. The complication rate in our study was 2.4%. Only one patient developed initial perichondritis with a resultant cauliflower deformity following surgical excision.

CONCLUSION

Pseudocyst of the auricle typically presents as a painless unilateral swelling of the auricle in young adult males. Treatment options are varied. Excision of the anterior cartilage with compression buttoning yielded excellent results with no recurrence.

Pseudocyst of the auricle: diagnosis and management with a punch biopsy

A case of pseudocyst of the ear diagnosed and treated with a punch biopsy is reported. Pseudocyst of the ear is considered to be a benign, asymptomatic condition seen infrequently in clinical practice. Our patient is a 45-year-old white man who presented with a 5-month history of a painless nodule on his left auricle without any preceding history of trauma. Although many treatments have been reported, none appear satisfactory, and many surgical treatment modalities are cumbersome. This is the first report, to our knowledge, of a case of a pseudocyst of the ear confirmed and treated with a 3-mm punch biopsy of the inferior border of the pseudocyst, followed by a pressure bolster.

Lactate dehydrogenase isozymes in and intralesional steroid injection therapy for pseudocyst of the auricle

BACKGROUND

Various treatments for pseudocyst of the auricle have been reported. Recently, several patients have been treated successfully with steroid injections. The lactate dehydrogenase (LDH) levels of cystic fluid have been reported to be high, and the LDH-4 and LDH-5 isozymes were found to predominate, although the serum LDH levels and LDH isozyme patterns were normal.

OBJECTIVE

To find a way of preventing auricular pseudocyst recurrences after steroid injection therapy and to examine the relationships between recurrences and the LDH level and isozyme pattern of the cystic fluid.

METHODS

Steroid injection therapy was given to nine Japanese patients with pseudocyst of the auricle at our clinic between 1994 and 1999. We determined the LDH level and isozyme pattern of the cystic fluid and sera of seven patients.

RESULTS

All nine patients in this series were treated successfully with steroid injections, although three suffered recurrences. Although the serum LDH levels of seven patients were almost normal, their cystic fluid LDH levels were very high. LDH-4 and LDH-5 predominated in the cystic fluid of all seven, although their serum LDH isozyme patterns were virtually normal.

CONCLUSIONS

Auricular pseudocyst recurrences show no relationship with either the LDH levels or isozyme pattern. An undiluted solution of steroid fluid should be used in order to prevent recurrences.

Auricular pseudocysts: a treatment with the Chulalongkorn University vacuum device

Auricular pseudocysts are rare lesions that present as an asymptomatic cystic swelling of the anterior surface of the auricle, particularly the antihelix. Typically, the pseudocysts contain viscous straw-yellow fluid similar in appearance to olive oil; however, a clear pale yellow serous transudate may also be encountered. Various therapeutic approaches have been used with variable success. We describe a simple small vacuum device called the Chulalongkorn University vacuum device, which was developed in our center. The device can be easily made anywhere by any surgeon. We report the outcome in 17 patients treated by means of needle aspiration plus application of the Chulalongkorn University vacuum device for 5 days. A complete resolution of the lesion was obtained in 15 (88.2%) patients. Because the procedure is safe and effective and does not require an operating room setting, it may be accepted as an option in the treatment of auricular pseudocysts.

Bilateral pseudocyst of the auricle in an infant girl

A 6-week-old girl developed bilateral auricular swelling in the absence of trauma. Clinical and histologic findings were consistent with pseudocyst of the auricle. This case is unusual given the age and sex of the patient and the bilateral presentation of the pseudocysts.

Endochondral pseudocyst of the auricle

Endochondral pseudocyst of the auricle is an uncommon, though distinctive clinicopathological entity occurring mainly in young men. An additional case is reported and the differential diagnosis and pathogenesis discussed. It is suggested that lymphatic dilatation of normally present tissue planes could be the most likely causative mechanism. Minor trauma to susceptible ears also seems to be a requirement for development of this condition.

Pseudocyst of the auricle: steroid therapy

We have seen 13 cases of pseudocyst of the auricle in the past two years (1990-1991). Twelve of the 13 cases that were treated with needle aspiration and intralesional steroid injection are reviewed retrospectively. The results were quite satisfactory. In 10 cases, the cystic swelling disappeared without recurrence after such treatments. The remaining 2 cases were lost to follow-up after the first steroid injection. This method of treatment did not cause side effects or discomfort in our study. We also reviewed and analyzed 36 other cases of this cyst we have seen from 1986 to 1989.

Pseudocyst of the auricle

BACKGROUND

Pseudocyst of the auricle is a benign swelling of the ear characterized by collection of fluid within an unlined intracartilaginous cavity. The etiology and pathogenesis of this disorder remain unknown. Various forms of management have been described in several case reports and small series.

OBJECTIVE

Description of a surgical procedure for successful management of pseudocyst of the auricle.

METHODS

Case report of a patient who declined nonsurgical treatment options following failed management with aspiration.

RESULTS

The described procedure resulted in cure of the pseudocyst with good cosmetic outcome.

CONCLUSION

Pseudocyst of the auricle can be successfully managed by surgical excision of the anterior wall of the cyst.

Bilateral auricular pseudocyst: a case report and discussion

Pseudocyst is a rare, often misdiagnosed condition affecting the pinna. A case of bilateral pseudocyst is reported and the recent literature discussed with respect to aetiology and treatment.

Medical management of pseudocyst of the auricle

Four male patients with pseudocyst of the auricle were successfully treated with oral corticosteroids. This condition is an asymptomatic, non-inflammatory, cystic swelling, usually located in the scaphoid or triangular fossa of the anti-helix which if untreated, leads to deformity of the pinna. All successful methods of treatment described in the literature so far have been invasive. All four patients in the above series responded to oral steroid therapy alone.

Relapsing polychondritis: a case diagnosed by direct immunofluorescence and coexisting with pseudocyst of the auricle

A case of relapsing polychondritis with perichondrial IgG and C3, dermoepidermal IgG, and a coexisting pseudocyst of the auricle is reported. The use of direct immunofluorescence testing in establishing a diagnosis of relapsing polychondritis and the expected findings are reviewed. In some cases direct immunofluorescence may allow a diagnosis of relapsing polychondritis before clinical criteria or a routine histologic evaluation suggests a definite diagnosis.