{'fraction_non_alphanumeric': 0.029220287660862983, 'fraction_numerical': 0.010749432248296746, 'mean_word_length': 5.297426120114395, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
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.


Discussion
Pseudocyst of the auricle was first described by the German physician Arthur Hartmann in 1846 [1]. However, the condition did not appear in the English-language literature until 1966, when Engel observed the lesion in Chinese men [2].
One year later, Hansen reported several Caucasian patients who had pseudocyst of the auricle [3].
The initial observations made by Hartmann, Engel, and Hansen remain relevant today. Engel and Hansen both noted that the condition occurs predominantly in men [2,3]. Indeed, in a 1990 world literature review of 114 cases of pseudocyst of the auricle, 93% of auricular pseudocyst patients were men [4]. Their findings were later corroborated by Lim et al., who reviewed the medical records of 41 patients who were treated for pseudocyst of the auricle in Singapore and concluded that 87% were men [5]. The age of onset typically ranges

Introduction
Pseudocyst of the auricle is a benign, noninflammatory, asymptomatic cystic lesion of the ear. It most commonly develops progressively over a 4-to 12-week period in the scaphoid or triangular fossa. The lesion may, or may not, be associated with trauma to the affected ear. Patients with neurological disorders that are associated with motor dysfunction, such as ataxias, may be at a heightened risk for developing trauma-related pseudocyst of the auricle.
We describe two men who developed pseudocyst of the auricle after sustaining ataxia-associated head and ear injuries. We also review the differential diagnosis, the postulated pathogenesis, and the treatment options of pseudocyst of the auricle. between 30 and 39 years [4,5]. However, albeit rarely, lesions may appear in either childhood [6] or old age [7].

Case reports
There is no ethnic predilection.
Pseudocyst of the auricle typically They are filled with a viscous fluid that is usually straw-yellow in color, resembling olive oil. However, serous and serosanguinous fluid may be present [4,9]. Pseudocyst of the auricle typically presents unilaterally-most commonly on the right ear-but bilateral presentations have also been reported [4,[10][11][12].
Histologically, pseudocysts are characterized by an intracartilaginous cystic space with surrounding fibrosis.     in permanent deformity of the auricle and therefore may not be appropriate for first-line treatment [4,17].
A conservative surgical approach for the management of pseudocyst of the auricle involves induction of fibrosis and scarring on the intracartilaginous cavity of the pseudocyst.

Job et al. described a procedure in which incision and drainage
of the lesion is followed by curettage of the pseudocyst walls.
Bilateral contour pressure dressings are then applied in order to prevent fluid accumulation in the underlying tissue [26].  [14,25,29]. Deroofing entails curetting and cauterizing the base of the pseudocyst and removing the degenerated cartilage from the roof of the pseudocyst; this procedure eliminates the possibility of any future recurrence.
However, it is critically important to excise only the anterior wall of the pseudocyst; accidental removal of the posterior wall can result in deformity of the auricle [18]. Surgical deroofing should be followed by button bolstering for optimal results [27].
Pseudocyst of the auricle is usually asymptomatic. Therefore, observation is a reasonable alternative to management if the patient is unconcerned about the cosmetic appearance of the lesion. In addition, clinical monitoring of the auricular pseudocyst may be appropriate in patients with neurological conditions associated with uncontrolled movements of the head and the potential for repeated trauma to the affected ear.

Conclusion
Pseudocyst of the auricle is a rare condition of the ear. It typically presents as an asymptomatic, noninflammatory, unilateral cystic swelling affecting the upper auricle. Lesions may develop spontaneously or, less commonly, in response to trauma. Pseudocyst of the auricle occurs predominantly in middle-aged men, but may also occasionally be observed in women, children, and the elderly. Patients with neurological conditions that are associated with movement disorders may