Ear Deformities and Malformations

What Causes Deformed Ears?

Minor problems during normal development in a mother’s womb can cause a baby’s ears to protrude unnaturally far from the head or may result in constricted ear or cup ear. This is when the patient’s ears are abnormally small (microtia) and a majority of the external ear is missing. In these instances, ear surgery, known as an otoplasty, may be able to give your child’s ear a more balanced and natural-looking appearance.

What are the types of ear deformities and malformations?

Although every child is unique and every patient requires his or her own distinctive approach, congenital ear deformities tend to fall into two categories:

1. Prominent ears: Between the third and sixth month of development in the womb, the cartilage forming the outer ears begins to undergo a series of folds that give the ear its appearance. In some cases, the process can be interrupted, and a missing fold can cause the ears to protrude more than 2 centimeters from the side of the head.

Cosmetic otoplasty techniques can often decrease the prominent ear by re-creating the missing cartilage folds, bringing the ear closer to the head and reducing the size of the earlobes in order to give the ear a more normal anatomical appearance. These procedures are generally carried out on children between the ages of 5 and 7, when the ear is of nearly adult size and the cartilage is of adequate thickness to tolerate scoring or to hold sutures. While it is optimal to perform the procedure as early as possible to avoid many of the psychological and social difficulties that may occur, the procedure can actually be performed on patients of any age.

2. Constricted ears: Also known as a cup ear or lop ear deformity, this malformation occurs when the upper helical rim of the ear is folded over, wrinkled or tight. In the most severe cases, the ear may be rolled up almost into a tube with the front part tilted forward, requiring additional cartilage to be taken from elsewhere in the body to fully correct the malformation.

What is microtia?

Microtia is a birth defect that happens when a baby’s external ear is underdeveloped. It can occur on one or both sides. Microtia may occur with atresia, another ear-related birth defect in which a baby is born without an external ear canal. Depending on the severity of the defect and whether the outer ear is blocked, hearing loss may occur.

In addition to appearance, reconstructive ear surgery can help with a child’s hearing loss issues. Magdalena Soldanska, MD, a Pediatric Plastic Surgeon at Children’s Healthcare of Atlanta, has received extra training in microtia surgery.

Can otoplasty (ear surgery) affect my child’s ability to hear?

Otoplasty, also known as ear surgery, addresses the ears but does not directly affect the internal structures that control hearing. It cannot improve hearing, but choosing a board-certified and experienced plastic surgeon like we have at Children’s will help minimize complications and risks.

Can otoplasty fix ears that stick out too far?

Protruding or prominent ears are a common complaint for ear surgery patients. Children often complain of being teased and embarrassed by their protruding ears. Usually, this prominence is caused by the lack of a fold within the cartilage of the ear. During cosmetic otoplasty, we construct a fold in the cartilage to help the ears lie flat.

Can ear surgery correct the appearance of cauliflower ear caused by trauma?

Yes, we perform reconstructive ear surgery for children with congenital defects, as well as conditions like cauliflower ear caused by trauma. Surgery may be postponed in cases of cauliflower ear if immediate attention is sought because this condition is the result of gradual fluid buildup within the ear from being struck repeatedly in the ear (common among boxers and wrestlers). However, if fluid collects, the internal fluid can harden and affect ear cartilage.