Prominent Ears

What are prominent ears?

When children are born with “oversized” ears, they are more correctly referred to as prominent ears (or, protruding ears). However, prominent ears do not necessarily mean enlarged ears. Ears can be prominent for two main reasons: 1) the ear lacks an antihelical fold (on the outer perimeter of the ear), and/or 2) an excessive amount of cartilage comprising the bowl of the ear (ie, concha). In either case, the ear sticks out from the side of the head, as opposed to being tucked against the head. The resulting appearance is a frequent source of anxiety for children, especially as they reach school age.

Why do prominent ears occur?

There is no known cause of prominent ears, although there can be a strong family history. There is, otherwise, no environmental or specific genetic reason for why this occurs.

What are the associated problems of prominent ears?

Prominent ears have no associated abnormalities or syndromes.

Can prominent ears be passed on?

The short answer is no; prominent ears are not hereditary. However, there may be sometimes a strong resemblance to a parent or sibling.

How are prominent ears corrected?

Non-operative treatment of the prominent ear is possible by taping or splinting the ear from a very young age (less than 6 months of age). The window of opportunity is small due to the favorable, but brief plasticity of the newborn’s ear. Dr. Panossian uses the EarWell™ device to correct early ear deformities including prominent ears. Use of the device may require weeks to months to achieve a favorable appearance. Results may vary.
The optimal timing for surgical correction (ie, otoplasty or “ear pinning”) is around 4 years of age. The goal of surgery is to re-establish the lost antihelical fold by the use of sutures and/or to reduce the excessive cartilage comprising the conchal bowl. By correcting these deformities, the ear is effectively set back to a more natural position next to the head. The incision is usually placed behind the ear where it is not visible. The surgery takes less than 2 hours.

What is the recovery from prominent ear surgery (otoplasty)?

3Otoplasty is typically an outpatient procedure. Following surgery, a head dressing is applied to secure the ears as they heal. The dressings are typically changed after one week, and a removable headband-style dressing is applied continuously for an additional 3 weeks. Patients are allowed to remove the headband to wash the area with soap and water in the shower daily. The headband is then worn only at nighttime for the next 6-8 weeks. Absorbable sutures are usually used; however, non-absorbable sutures (if placed) will be removed at the first postoperative visit.

What are the risks and complications of prominent ear correction (otoplasty)?

As with any surgery, risks related to bleeding, infection, or anesthesia complications apply. However, these are rare problems, and the surgery is relatively safe. Complications postop can include hematoma or extensive bruising. Although bruising may be common and will resolve on its own, a hematoma will need to be drained either in the office or under light anesthesia. The final appearance is usually excellent, however, slight asymmetry may be present on occasion.