The Cleft and Craniofacial Surgery Center at Mount Sinai manages a variety of congenital anomalies affecting the ears. Common concerns include prominence of one or both ears or partial or complete absence of the ear(s). At Mount Sinai, our team has unparalleled experience and expertise in treating all kinds of ear abnormalities.
Prominent Ear Deformity
Children may be born with a prominent abnormality affecting one or both ears. This may be due to incomplete folding of the ear cartilage in the womb that produces the normal shape of the ear. Then, for a short time after birth, the ear cartilage is malleable and may be molded into a better position or left alone. As school age approaches, social pressures may emerge, warranting intervention.
Otoplasty is the surgical procedure most commonly used to correct a prominent ear deformity. This is usually offered when the child becomes concerned with the appearance of his or her ear(s) and when they are of a sufficient age to participate in the postoperative care. Often, this is around six years of age, but it may be sooner depending on the maturity of the child. Surgery involves placement of stitches to reform the normal folds of the ear and to reposition the ear closer to the side of the head. It may also involve removal of a portion beneath the skin, which may be overly developed. After surgery, a headband is worn for three weeks to prevent recurrence and then for an additional three weeks only at night.
Children may be born with incomplete formation of one or both ears. In some cases, this may be caused by a broader congenital anomaly, such as hemifacial microsomia. The ear may be normal in appearance, but small in size or may be almost unrecognizable as a normal ear.
The diagnosis of a small ear may be seen prenatally on an ultrasound and is usually noted at the time of delivery. The ear may simply be smaller than the opposite side or lack structural features of the normal side. More often, it occurs solely on one side of the face.
There are several techniques for reconstructing the ear. These include sculpting a new cartilage framework from the ribs, removing the abnormal cartilage, and placing the sculpted framework beneath the skin in the region of the ear. In follow-up procedures, the new ear is lifted off the side of the head with a skin graft and the bottom portion is rotated into a better position.
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