How do prominent ears develop?

Prominent ears are a congenital deformity. The protruding part of the ear, or pinna consists of cartilage covered by skin. Normally the pinna lies parallel to the head around 8mm away from the skull.

The pinna develops a fold that holds it at this angle (see arrow above). This is called the antihelical fold. If the fold does not develop properly the pinna sticks out away from the head.

Boys with prominent ears are especially teased at school because short haircuts make the ears even more prominent.

Holding prominent ears in with bands around head does not alter the position of the ears.

This depends on cartilage development and is usually undertaken from the age of 6 upwards. The pinna matures during the first decade of life.

Procedure

The Operation

The operation for correcting prominent ears is called otoplasty or pinnaplasty.

The operation is carried out under general anaesthesia. The length depends on whether one or both ears are operated and on the complexity of the correction.

An incision is made at the back of the ear in the crease between the pinna and the head so it is invisible. The cartilage is sculpted and sutures may be put in to improve the appearance of the ear and give it a natural look.

A headbandage is kept for 1 week and the suture removed then. The ears would feel sore but this should respond to ordinary pain-killers such as paracetamol or non-steroidal anti-inflammatories such as diclofenac.

Ears are not exactly the same-one is higher than the other or more prominent than other. Therefore although they will look the same to the layman they will not be precisely equal to the trained eye.

Aftercare

After removal of the head bandage and sutures the ears will look red and swollen but quickly start returning back to normal. A sports sweatband may be worn over the ears at night for the first one or two weeks to prevent any injuries during sleep.

Complications

The main complication which the surgeon tries to avoid is that of the patient not liking the result of the operation, especially if one ear is slightly different from the other.

It is possible to have granuloma formation (localized inflammation) at the site of permanent sutures in cartilage. This is unusual but the sutures may have to be removed and thus ears may return to their former position. In the great majority of cases, however, a natural-looking result can be attained without complications.

Pre-operative Post-operative

Pre-operative Post-operative

Pre-operative Post-operative

Disclaimer: Patients are advised to discuss their medical condition and any indications for medical treatment or surgery with their general practitioner or the specialist who is delivering health care. This article is designed to help with frequently asked questions and does not take any responsibility for specific patients.

©Mr. Adrian M Agius