Ear Tags and Preauricular Pits in Newborns: A Common Birth Defect

Some parents maybe concerned to see a defect in the front of their newborn’s ear. These are called ear tags or ear pits (preauricular pits). They are common birth defects.

Both conditions are formed in utero, when the ears are formed in early pregnancy. Boys and girls are affected equally, and sometimes there is a family history of ear anomalies.

Ear tags are loose fleshy flaps of skin (or sometimes cartilage) found just in front of the ear or on the cheek. They can be located on one or both sides, and they can vary in size. These skin tags are not associated with hearing problems and are a cosmetic problem only, unless other physical anomalies are also present. They can easily be removed by a surgeon in the future.

Ear Pits;

Ear pits, also known as preauricular pits, are tiny holes located in front of the ear, usually above the ear canal. They are most commonly located on just one side but occasionally can be on both sides. This pit is connected to a tract under the skin that can be short or can be long and branched.

Ear pits can cause a problem if they become infected. The sinus tract can become infected with bacteria, leading to the formation of a skin infection or an abscess at the site of the pit. Symptoms include redness, swelling, pain at the site, and fever. Often pus will begin to drain from the tiny hole. These can be treated with an antibiotic, but if the infection reoccurs frequently, the sinus tract may have to be removed. An otolaryngologist (ENT doctor) may need to completely remove the pit and sinus tract to prevent future reoccurrences.

Ear pits can also develop cysts. These are slow growing lumps that develop in front of the ear at the site of the pit. The presence of a cyst increases the chances that the pit will become infected.

Ear anomalies are usually isolated findings, although rarely they can be associated with a genetic syndrome. If an ear tag or pit is an isolated finding, no further workup needs to be done. They are not associated with hearing loss, so no additional testing needs to be done besides a routine newborn hearing screen. There have been reported associations between congenital ear abnormalities and kidney abnormalities, but the most current recommendations are to not pursue any further workup unless there are other abnormal physical findings present indicating a possible genetic component.

Sources:

• American Family Physician
• Evaluation of Newborns with Preauricular Skin Lesions.
  Archives of Disease in Childhood
• Fetal and Neonatal
• Renal ultrasonography not required in babies with isolated minor ear anomalies.
  Children’s Hospital of Philadelphia
• Preauricular Pits.

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