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Defining the protruding ear.
Juliette P Driessen1, Johannes A Borgstein, Hadé D Vuyk
1Department of Otolaryngology, Head and Neck Surgery, Sophia Children’s Hospital, Erasmus University Rotterdam, the Netherlands.
The Journal of Craniofacial Surgery
|November 10, 2011
Summary
This study defines prominent ears using anthropometry, establishing sex-specific protrusion measurements for diagnosis. Results suggest upper ear protrusion is key for corrective otoplasty and existing asymmetry criteria may be too strict.
Area of Science:
- Craniofacial anatomy
- Pediatric plastic surgery
- Otoplasty outcomes
Background:
- Protruding ears (prominent ears) are common congenital deformities.
- A clear definition based on objective measurements is lacking in current literature.
Purpose of the Study:
- To establish objective, anthropometric definitions for prominent ears.
- To differentiate criteria for prominent ears in boys and girls.
Main Methods:
- Computer-assisted anthropometry was used on photographs of 102 children with normal ears (ages 5-18).
- Measurements were compared to 44 patients undergoing prominent ear correction surgery.
- Prospective cohort study design.
Main Results:
- Statistically significant differences in ear protrusion were found between sexes.
- Proposed definitions: Boys - upper protrusion >21.5mm or lower >20.0mm; Girls - upper protrusion >17.5mm or lower >15.5mm.
- Prominent ears showed larger auricular length and surface area; 87.5% of operated ears met proposed criteria. Normal ears exhibited up to 19.3% asymmetry >3mm.
Conclusions:
- Sex-specific criteria are necessary for defining prominent ears.
- Upper ear protrusion is a primary factor in perceived prominence and a key target for otoplasty.
- A strict <3mm asymmetry criterion post-otoplasty may be overly stringent given normal population variations.
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