Congenital cartilaginous rest of the neck | |
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Other names | Cervical accessory tragus, wattle, cervical tab, cervical auricle [1] |
Drawing of a man with two cervical auricles (from the book "Evolution and disease", 1890, page 91) | |
Specialty | Dermatology |
Congenital cartilaginous rest of the neck (CCRN) is a minor and very rare congenital cutaneous condition characterized by branchial arch remnants that are considered to be the cervical variant of accessory tragus. [2] [3] It resembles a rudimentary pinna that in most cases is located in the lower anterior part of the neck. [3]
CCRN histopathology indicates the presence of elastic cartilage enclosed by various skin structures such as eccrine glands, adipose tissue, and pilosebaceous units. [4] To assess the extent of the lesion as well as look for any underlying sinus tracts, ultrasonography alongside computed tomography (CT) scans can be used. [5]
Alternative diagnoses for CCRN consist of thyroglossal duct cyst, hair follicle naevus, fibroepithelial polyp, and branchial cleft cyst. [6] Thyroglossal duct cysts are typically found in the midline of the neck, near the hyoid bone, and move with tongue protrusion or swallowing. [7] Hair follicle naevus appears as a single, skin-colored papule and can be associated with hypertrichosis. [8] Fibroepithelial polyps are soft, fleshy growths of collagen fibers and blood vessels that hang off the skin. [9] Branchial cleft cysts can manifest as cysts, fistulas, sinus tracts, or cartilaginous remnants on the front of the neck and upper chest. [5]
Pilonidal disease is a type of skin infection which typically occurs as a cyst between the cheeks of the buttocks and often at the upper end. Symptoms may include pain, swelling, and redness. There may also be drainage of fluid, but rarely a fever.
A sebaceous gland or oil gland is a microscopic exocrine gland in the skin that opens into a hair follicle to secrete an oily or waxy matter, called sebum, which lubricates the hair and skin of mammals. In humans, sebaceous glands occur in the greatest number on the face and scalp, but also on all parts of the skin except the palms of the hands and soles of the feet. In the eyelids, meibomian glands, also called tarsal glands, are a type of sebaceous gland that secrete a special type of sebum into tears. Surrounding the female nipple, areolar glands are specialized sebaceous glands for lubricating the nipple. Fordyce spots are benign, visible, sebaceous glands found usually on the lips, gums and inner cheeks, and genitals.
A dermoid cyst is a teratoma of a cystic nature that contains an array of developmentally mature, solid tissues. It frequently consists of skin, hair follicles, and sweat glands, while other commonly found components include clumps of long hair, pockets of sebum, blood, fat, bone, nail, teeth, eyes, cartilage, and thyroid tissue.
A thyroglossal cyst is a fibrous cyst that forms from a persistent thyroglossal duct. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages.
The auricle or auricula is the visible part of the ear that is outside the head. It is also called the pinna, a term that is used more in zoology.
The cervical plexus is a nerve plexus of the anterior rami of the first four cervical spinal nerves C1-C4. The cervical plexus provides motor innervation to some muscles of the neck, and the diaphragm; it provides sensory innervation to parts of the head, neck, and chest.
A persistent thyroglossal duct is a usually benign medical condition in which the thyroglossal duct, a structure usually only found during embryonic development, fails to atrophy. The duct persists as a midline structure forming an open connection between the back of the tongue and the thyroid gland. This opening can lead to fluid accumulation and infection, which necessitate the removal of the duct.
The cervical sinus is a structure formed during embryonic development. It is a deep depression found on each side of the neck. It is formed as the second pharyngeal arch grows faster than the other pharyngeal arches, so they become covered. The first pharyngeal arch also grows slightly faster. It may fail to obliterate, forming a branchial cleft cyst or fistula, which is prone to infection.
A branchial cleft cyst or simply branchial cyst is a cyst as a swelling in the upper part of neck anterior to sternocleidomastoid. It can, but does not necessarily, have an opening to the skin surface, called a fistula. The cause is usually a developmental abnormality arising in the early prenatal period, typically failure of obliteration of the second, third, and fourth branchial cleft, i.e. failure of fusion of the second branchial arches and epicardial ridge in lower part of the neck. Branchial cleft cysts account for almost 20% of neck masses in children. Less commonly, the cysts can develop from the first, third, or fourth clefts, and their location and the location of associated fistulas differs accordingly.
A trichilemmal cyst is a common cyst that forms from a hair follicle, most often on the scalp, and is smooth, mobile, and filled with keratin, a protein component found in hair, nails, skin, and horns. Trichilemmal cysts are clinically and histologically distinct from trichilemmal horns, hard tissue that is much rarer and not limited to the scalp. Rarely, these cysts may grow more extensively and form rapidly multiplying trichilemmal tumors, also called proliferating trichilemmal cysts, which are benign, but may grow aggressively at the cyst site. Very rarely, trichilemmal cysts can become cancerous.
Syringocystadenoma papilliferum is a rare non-malignant adnexal neoplasm that develops from apocrine or eccrine sweat glands and can be identified histologically by cystic, papillary, and ductal invaginations into the dermis lined by double-layered outer cuboidal and luminal high columnar epithelium and connected to the epidermis.
Preauricular sinuses and preauricular cysts are two common congenital malformations. Each involves the external ear. The difference between them is that a cyst does not connect with the skin, but a sinus does. Frequency of preauricular sinus differs depending the population: 0.1–0.9% in the US, 0.9% in the UK, and 4–10% in Asia and parts of Africa.
Pseudocyst of the auricle is a cutaneous condition characterized by a fluctuant, tense, noninflammatory swelling on the upper half of the ear, known as the auricle or pinna. It is called a "pseudocyst" because it is not a true cyst, but rather a collection of fluid or blood trapped within the tissue layers of the auricle.
An accessory auricle is considered a developmental anomaly resulting from the persistence of a structure which variably recapitulates the normal external ear.
Nasolacrimal duct cysts are a cutaneous condition that is a developmental defect present at birth.
Midline cervical clefts are a rare congenital anomaly resulting from incomplete fusion during embryogenesis of the first and second branchial arches in the ventral midline of the neck. The condition presents as a midline cutaneous defect of the anterior neck with a skin projection or sinus, or as a subcutaneous erythematous fibrous cord. Surgical excision is the preferred treatment.
The cheek constitutes the facial periphery and plays a key role in the maintenance of oral competence and mastication. It is also involved in the facial manifestation of human emotion and supports neighboring primary structures.
Fiddler's neck is an occupational disease that affects violin and viola players.