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Prominent ears are a developmental abnormality where the normal architecture of the ear has not developed and the ear becomes clearly prominent and cup shaped. A fold in the ear referred to as the anti helix is typically absent and also the conchal bowl (close to the entrance of the ear canal) may be found to be deep.

The ear is made of pliable cartilage and is significantly developing in the first few years of life. The cartilage from birth, during the neonatal period is responsive to splinting in the event of prominent ears being noticed early. This can help mould the ear into the correct shape.

Most children become conscious of their prominent ears on entrance to school where teasing is common. Girls can often hide the developmental abnormality more than boys due to the fact that they grow their hair to cover their ears. The cartilage needs to develop significantly and not be too immature before the ear can be surgically corrected. This typically is around the age of 5-6.

Otoplasty

The surgery typically is aimed at recreating the ‘antihelical’ fold typically missing or making the conchal bowl more shallow. This is undertaken with an incision behind the ear and the anti helix is formed, the cartilage may be scored to keep its shape and stitches may be used to keep the cartilage in place.

The ear is carefully dressed with a head bandage that is often worn for 1 week post-operativeley. At this stage the dressings are taken down and the ears are notably bruised but clearly their position has usually been altered for the better. Most surgeons like to protect the ears during the night with a headband so that the cartilage is not sprung back inadvertently.

Prominent ears are a reasonably common phenomenon that are troublesome to children because of teasing that occurs at school but that can be treated very well with surgery.

Prominent ears are noticeable from birth and in the first few weeks of life the cartilage of the ear is malleable and certain proprietary brands of splints can actually be used with some success. What is commonly seen though is the prominent ears do not become a problem until teasing starts at schooling age.

Many different techniques of surgery are used to correct these deformities but it is key to understand the anatomic problem with development that has caused the prominence and then to correct it.

Correction can make a massive difference in the quality of a childs life and can be a hugeley beneficial operation. Parents are often nervous about undertaking an operation for essentially a cosmetic operation but anaesthesia in children is significantly safer than it ever has been and the benefits of surgery outweigh the risks in most circumstances.