uncommon presentation of an extra-cranial high flow arterio-venous malformation [AVM] involving the left auricle

A 34-year-old male presented with a pulsatile lesion of the left external ear. Previous attempts at excision had resulted in uncontrollable bleeding. This time, under general anesthesia and a hypotensive technique, the lesion was approached distally and anteriorly through the conchal cartilage, the feeder vessels were ligated and the lesion was removed successfully with no resultant deformity to the external ear