EAR, NOSE & THROAT
Congenital Ear Deformities
Congenital Ear Deformities are birth defects that occur either before or at birth. These deformities are detected at birth and in most cases are fixed once the ear has stopped growing, which is before adolescence. It is rare to see congenital deformities, especially those that are cosmetic to be found in adults unless it was not corrected as a child. When you hear the word Congenital Deformities, you will typically think of other areas of the body such as the feet, face, or hands not necessarily the ear. Many congenital deformities affect the ear. Some of the most common deformities are Microtia, Lop/Cup Ears, and Protruding Ears. These birth defects tend to be more of a cosmetic issue than a real life threatening problem. Congenital deformities are easy to fix and allow a child to grow up living a normal, healthy life.
Microtia is what the name says, small ear. Children born with microtia have all the proper inner structures but lack the formation of the outer ear structures such as the ear lobe and auricle. Sometimes children do not even have the opening to the ear causing hearing and balance issues. Microtia requires between 2-4 surgeries depending on the severity. The outer ear has to be completely constructed by using cartilage from other areas of the body. Microtia is one such deformity that is not typically fixed right at birth because the ear is still growing. Once the ear is done growing, between ages 6-8, surgery can begin. Due to this delay in surgery, some children will need therapy for hearing problems.
Lop ears also known as cup ears is a folding of the outer rim of the cartilage of the ear. The outer ear is flexible but in the case of lop ear; the outer edge is stiff and restricted. Lop/cup ears can range from mild to severe. In more serious cases, the ear will be rolled up to look like a tube. Treatment of this condition requires surgery. In minor cases, the cartilage of the rim of the ear may be removed to make the ear look normal. In more severe cases, the ear has to be completely restructured and sometimes repositioned.
Protruding ears are ears that are extremely noticeable because they protrude out instead of lying near the side of the head. Protruding ears do not affect hearing in any way because all the structures of the ear form normally. The only adverse effect of protruding ears are the cosmetic concerns. As a child, it can affect self-esteem especially if a child is getting picked on at school. Surgery is the treatment for protruding ears. The surgeon does not have to restructure the ear in any way. They only pin the ear back to avoid the look of prominence. Once the ears have fully grown, surgery can be done.
Ear pits are tiny, benign pits located in the front of the ear and mark the entrance to the sinus tract. It can travel under the skin near the cartilage. This deformity happens during development in the womb. When the ears begin developing, they do not fuse together properly causing pits. Ear pit removal occurs through surgery. Untreated ear pits can result in infection and may cause other problems later on.
Stahl’s Ear also known as Spock’s ear is another congenital abnormality that deals with the development of the auricle. A child with Stahl’s ear has a pointy shaped ear. The rim of the ear is flattened, and the cartilage is misshapen causing a pointy look. The deformity ranges from mild to severe. In more moderate cases, surgery is not needed; the ear looks relatively normal, and there are no subsequent hearing problems. In more severe cases, surgery would be used to restructure the cartilage, so the ear does not have a pointy look. Surgery is for cosmetic issues because this deformity does not affect the hearing.
Low set ears is a common congenital deformity that relates to the position of the ears. The ears are placed in a way that if a straight line were drawn from the eye to the ear, the line would connect the outer corner of the eye to the top of the ear. Low set ears fall way below that line and are positioned where a straight line could be drawn from the nose. Low set ears, besides its position, function normally. This abnormality affects the look of the child rather than the child’s hearing ability. Surgery is not necessary but in most cases parents will choose surgery for their child for cosmetic reasons.
Most congenital deformities of the ear are cosmetic deformities. The ones mentioned above are some of the most common deformities found. These congenital deformities can range from mild to severe in each case. Most of them are treated with surgery, but surgery is not always necessary. Surgery is typically done for cosmetic reasons. In the most severe cases of pits, lop/cup ears, or microtia, surgery is a must to prevent hearing impairment. Congenital deformities happen during the development of the child in the womb. Many times it is not even a genetic problem. Therefore, parents should not blame themselves for congenital deformities. Although it may seem overwhelming at the moment, these deformities of the ear can be easily resolved.
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