Cartilaginous pseudocyst of the external auricle in children with atopic eczema

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.

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 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.

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.

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 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 ear. Surgical treatment

BACKGROUND

Pseudocyst of the auricle is characterized by an asymptomatic swelling caused by an intra-cartilaginous accumulation of fluid. Treatments include aspiration, steroid injection, and surgical intervention.

OBJECTIVE

To present two cases of pseudocyst of the auricle treated surgically with an open, deroofing technique.

METHODS

Two cases are presented and the relevant literature is reviewed.

CONCLUSION

Optimal treatment for pseudocyst of the ear involves removal of the anterior cartilaginous leaflet of the pseudocyst with repositioning of the overlying flap of skin. This results in a normal-appearing auricle with minimal scarring or recurrence of the pseudocyst.