Protruding ears

Written by Dr Roger Henderson, GP

What are protruding ears?

We are all built differently and even our own faces are not symmetrical.

Some peoples ears stick out more than normal – a condition sometimes called 'bat ears' – and this can be a source of great misery for children affected in this way.

Although protruding ears do not cause any actual physical problems, they can cause self-consciousness and teasing.

About 1 to 2 per cent of people in the UK believe their ears stick out too much, and because ears are one of the first body parts to reach full size they can be more noticeable in children.

Sometimes this problem can run in a family so that a parent or sibling also has protruding ears. Although the ears may be larger than normal it is more often the case that they are normal-sized but simply protruding, with both ears being affected.

It is usually due to a defect in part of the cartilage (gristle) of the ear.

How can protruding ears be treated?

Until recently the mainstay of treatment was surgery – known as otoplasty – usually at the age of five, when the ear cartilage is firm enough to allow reshaping by scoring or suturing. (Surgery at an earlier age carries an increased risk of less success.)

However, new work done on non-surgical techniques in reshaping protruding ears suggests this may be an effective alternative to surgery and which may be undertaken at a much earlier age than is possible with surgery.

This has been known about and used in Japan for some time but has only recently come to prominence in the West.

It is a simple procedure that can be carried out by parents after instruction. Small 'splints' that comprise a flexible wire core cast in a thick protective silastic surround are fitted to the ears as soon as possible after birth and help to mould the ears to their correct shape.

The period of splintage required is shorter (about one to two weeks) when the splints are applied early after birth, and longer (three months) when the splint is first applied at three months of age.

The younger the child, the less likely they are to dislodge the splint and they should be worn 24 hours a day if possible.

They are designed to be comfortable and a baby should be able to sleep on a splinted ear untroubled.

Parental persistence with the treatment is essential for a satisfactory outcome, and the time for correction varies widely from a few days to a number of months.

If splinting has not occurred, or the neonatal period has passed then a surgical procedure is needed to treat prominent ears.

There are a number of approaches a surgeon can use that best suits the patient's problem and the surgeon's experience.

Paediatric patients usually require a general anaesthetic whereas older children may be suitable for a local anaesthetic.

The basis of an otoplasty is to remove a small amount of cartilage and then tag the ears closer to the scalp. The child can usually go home the same day of the operation.

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