This leaflet is to help you understand what auricular appendages are, what causes them, and what to look out for during the pregnancy, as well as the implications for your baby once it is born.

What are auricular appendages?

Auricular appendages or ear tags are skin-colored, fleshy attachments in front of the ear. They are a very common ear malformation and affect approximately 1.5% of the population. 

What causes auricular appendages?

Most auricular appendages are sporadic, meaning the development of the condition is random and has no known cause. However, some cases are due to a genetic syndrome. Genetic syndromes are diseases caused by mutations or differences in genetic information. Genetic syndromes often cause multiple anomalies.  

Should I have more tests done?

You should ask if a specialised/advanced ultrasound of the baby during the pregnancy can be performed to see if the baby has other anomalies or if the auricular appendage is the only issue. If there are additional anomalies, a consultation with a genetic specialist is usually recommended to determine if there may be a causative genetic syndrome. 

You may be offered genetic diagnostic testing via an invasive procedure to see if certain genetic changes are the cause of the auricular appendage. Invasive genetic testing does have a small risk of miscarriage. Not all patients choose to undergo this kind of testing. You should discuss options for genetic testing with your doctor to determine what decision is right for you and your family. 

If there are no other anomalies seen on ultrasound and genetic testing gives normal results, then the auricular appendage is more likely to be isolated and unrelated to a genetic cause. 

What are the things to watch for during the pregnancy?

If there are no other anomalies, then you can have your pregnancy checks as normally planned. If there are other anomalies, changes in your care will depend on what they are and what they mean.

What does it mean for my baby after it is born?

Children born with auricular appendages need to be evaluated for possible hearing loss. This will frequently include audiologic testing and may also include imaging to try to detect any abnormalities that may exist with the external auditory canal, middle, and inner ear. Often a team of specialists will be involved including geneticists, pediatric audiologists, pediatricians, and plastic surgery. The auricular appendage can later be removed with plastic surgery for cosmetic reasons.

Will it happen again?

The chance of an accessory auricle affecting a subsequent child depends on the underlying reason for the condition. Familial cases of auricular appendages, meaning cases that run-in families, have been reported. We suggest meeting with a genetic counselor to discuss your specific chance of having another child with an auricular appendage. 

What other questions should I ask?

  • Are there any other abnormalities on the ultrasound?
  • What kind of genetic screening or testing should I consider?
  • How often should I have ultrasound examinations?
  • Where should I deliver?
  • Where will the baby receive the best care after it is born?
  • Can I meet the team of doctors that will be assisting my baby when it is born in advance?

Last updated August 2023