Big Ears, Big Problems: Children and Otoplasty

The condition of protruding ears is one that has attracted many epithets – bat, elephant, donkey, dumbo, butterfly, lop, flop and jug ears to name but a few. There was a day when these terms may have been used somewhat humorously, or considered only as a teasing term. Today we all recognize that these words really constitute a form of verbal bullying, and their use is much less socially acceptable.

Protruding ears are actually a sign of good fortune in certain Asian countries, and even a sign of wealth. However, North American studies have shown that protruding ears can lead to feelings of insecurity and even neurosis. They have been associated with poor academic performance, and in adolescence are associated with a 40% incidence of behaviour problems.

This condition is actually congenital, the gene being present in 5% of Caucasians. It is an autosomal dominant, meaning that if one parent has it, it will be genetically expressed in half of their children. However, it has variable penetrance, meaning that even if a person has the gene, the actual deformity is not always actually expressed, and therefore may not be seen.

Interestingly, a child’s ears grow to almost adult size by age five – the reason for the expression, “A child grows into his ears.” And so any time from age five onwards is a reasonable time to have protruding ears surgically corrected. This age is also when other children begin to notice such differences in others, which makes this a good age to correct the problem before teasing starts.

Correction through Otoplasty

Today there are a number of different, very effective, otoplasty procedures to treat protruding ears. Usually, by the removal of some soft tissue behind the ear, combined with buried sutures to create a new fold in the upper ear to turn the superior pole backwards, a natural result can be obtained. There is little or no associated pain, and the procedure is tolerated well even by young (or adult!) patients.

So if you know someone with this condition, it is important to recognize that even playful teasing may be very harmful to their sense of self-image and self-esteem. And also that it can be corrected at any age after five years if it is of concern to them.

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