Ear Deformity
What is
Ear Deformity?
Deformities of the auricle can be categorized into two types: external ear malformations or external ear deformities.
Understanding an Ear Deformity
An external ear malformation is defined as an ear that lacks part or all of the external ear cartilages, typically referred to as Microtia. Surgical correction is necessary to restore the normal shape of the external ear. Microtia often involves hearing issues, and an evaluation by an Otologist (a fellowship-trained ear surgeon) is recommended to determine if natural hearing can be restored.
In contrast, an external ear deformity involves fully formed ear cartilages that are abnormally shaped. These deformities generally do not cause hearing loss, but an assessment by an Otologist is advisable to rule out any internal issues. Various types of external ear deformities exist, including Grade II Microtia, Stahl’s ear (also known as Elf ear or Spock ear), Cup ear, Lidding or Lop ear, Helical rim deformities, and Prominent/protruding ear.
Ear Molding and Earwell™ Infant Ear Correction System
Correction of the external ear deformities can take place in either of the two distinct stages of life. The first, and most preferable, time for correction is within the first two weeks after birth. During this period, the maternal hormones still circulating in the infant’s bloodstream make the ear cartilage pliable and moldable. Therefore, ear molding performed during this time yields excellent cosmetic outcomes, correcting over 95 percent of all pediatric ear deformities.
The EarWell™ Infant Ear Correction System makes the process of ear molding easier for parents and infants. Typically, ear molding treatment lasts between 2 to 6 weeks and should ideally commence by the second week of life to achieve optimal results. This treatment is painless, non-invasive, and does not require anesthesia or numbing. Additionally, there is no recovery time necessary post-treatment.
Otoplasty
If correction of an external ear deformity is not performed during the first few weeks of life, the next suitable period for correction is usually after the age of 5. By this time, the ear has reached adult size, and surgical correction will not interfere with the growth of the cartilage. This surgical correction at this stage is known as otoplasty.
Otoplasty is typically done for protruding ears, although it can address any of the above-mentioned ear deformities. During this procedure, excess cartilage can be removed or abnormal cartilage reshaped to resemble a normal ear. Otoplasty is generally performed through a discreet incision hidden behind the ears and has a relatively short recovery period. Anesthesia is typically required for this surgical procedure.
While otoplasty can be performed at any time after the age of 5, it is often recommended to correct the ear deformity before the child starts school. This approach minimizes the psychological impact of trauma from teasing by other children.
Microtia and Grades of Microtia
Microtia is a fairly common congenital ear deformity characterized by either underdevelopment or complete absence of the ear (also known as anotia). It can be associated with a narrow ear canal or no ear canal at all. Surgical reconstruction techniques vary depending on the severity of the deformity. Microtia is typically classified based on the extent of ear development, with grade III microtia being the most common classification. In grade III microtia, a significant portion of the external ear or pinna is not formed, and there is often no ear canal present.
Grade I
Slight underdevelopment of the external ear and external ear canal. Normal ear structure and landmarks are preserved.
Grade II
Partially undeveloped external ear with absence of classic ear structure and landmarks. The external ear canal is typically sealed/obstructed. Middle ear structures such as the eardrum are present. Conductive hearing loss is typical.
Grade III
Near total absence of identifiable external ear structure, external ear canal, and ear drum.
Grade IV
Complete absence of the external ear, external ear canal, and ear drum.
Treatment
Several surgical techniques have been used to reconstruct the deformed ear:
- – One technique uses cartilage, typically harvested from the ribs to reconstruct the shape of an ear. This is then implanted in the skin behind the malformed ear and raised, in stages, to look more like a normal ear.
- – Another technique uses an implantable material such as Medpore® that is already shaped to resemble an ear. This is provided with blood supply and covered with the patient’s own skin. This technique usually requires one stage.
The absence of an ear canal leads to a type of hearing loss referred to as conductive hearing loss. Restoration of hearing can be accomplished by either of the following methods:
- – Implantable Hearing Aid: An implantable hearing aid can be used to transmit the sound waves through the bones of the skull and restore some of the hearing.
- – Reconstruction: In some patients, the ear canal can be re-constructed to restore natural hearing without the use of hearing aids.
- – The procedures above are typically performed after the patient is at least 6 years of age to ensure that the other ear has fully grown to adult size for comparison.
When patients are considering treatment, it's important to select a surgical team that includes both a fellowship-trained facial plastic surgeon and an otologist (ear specialist). This ensures not only optimal cosmetic outcomes but also maximizes the potential for hearing improvement.
Still have questions regarding the condition?
While the information in this website may be helpful, it will never fully relate ear treatment to you. If you are facing any ear problem, please call our office and one of our representatives will talk to you.
CONTACT USTESTIMONIALS
What are patient say about us
Thanks to the expert care and skillful ear surgery I received, my life has been transformed. I can hear clearly again, and I’m forever grateful for the life-changing experience provided by the talented team
“Dr. Nazarian, who gave me back the wonderful gift of hearing!”
“Since the very first time of seeing Dr. Nazarian, I feel that I have been in the best of care- and from the first day and through the my surgery, I have felt that Dr. Nazarian is a very compassionate and caring doctor- more than I have ever seen. I feel very fortunate to have been referred to Dr. Nazarian. He is the best!”