Protruding ears


Medical: Apostasis otum Synonyms: Sail ears, “dumbo ears “One speaks of protruding ears when the auricle protrudes over 30 degrees from the head. Protruding ears are usually not pathological but the result of various hereditary factors. On old child photos of the parents, one often notices that one parent already had protruding ears.

Occasionally, however, it is also a cartilaginous malformation of the auricle (dysplasia), whereby the various sections of the auricle underwent a faulty development and deformed the entire auricle. Approximately one in 20 people in the European population has protruding ears. Injured feelings of shame and inferiority are the result of being teased by others at school and at work, but not of impaired hearing.

Apart from the earlobe, the auricle is formed by elastic cartilage and covered by skin. Protruding wrinkles and indentations are described by various Greek terms (tragus and antitragus, helix and antehelix, crura anthelices, cavum conchae). The auricle has the function of capturing sound.

Many animals can even align their ears to the sound source. Even we humans could theoretically do this if the small control muscles had not atrophied. However, some people can still wiggle their ears today.

In most people, the auricle has an angle of inclination of about 12 to 18 degrees to the back. The ratio of the width of the auricle to its length is about 1:2. Even as a child at about 3 years of age, the growth of the auricle’s length is 80%, at 5 years it is 90%, and in teenage years it is finally complete.

Ethnic influence

Ear shapes differ greatly among ethnic groups: The ear shape is probably inherited from one parent (autosomal dominant). – Eskimos have the longest ears

  • Japanese have grown earlobes
  • Black people tend to have small ears
  • Europeans have the most diverse variations of auricle shapes

Effects on hearing

Protruding ears in no way cause functional disturbances. The child will not suffer from hearing loss due to the deformation of the auricle. On the contrary, a protruding auricle is more likely to be able to capture frontal sound waves.

On the other hand, the psychological consequences for the child are more serious and should encourage parents to seek advice from a competent ENT doctor or plastic surgeon. The child’s feelings of shame and inferiority are the real reason to think about a treatment of protruding ears (“gliding ears”). Children can be very mean to each other and look for various reasons to annoy and offend each other.

Straight protruding ears are an excellent reason for this. The terms for protruding ears like “sail ears” or “Dumbo” (Walt Disney comic) do not have their origin in the adult world! But also relatives and acquaintances of the child can take the view that they can approach the child’s protruding ears with a certain sense of humour and cannot hold back with some smiles or blasphemous remarks.

The child is unlikely to complain about this, but suffers considerably from feelings of inferiority as a result of this constant teasing! There is still no alternative treatment available today that is as effective as surgical correction (earmould, “ear-fitting”). Measures such as binding ears to the skull with a plaster or rubber band will not lead to the desired result!

Depending on the severity of the deformation of the auricle, different surgical procedures can be considered. In most cases the inner fold of the auricle (antehelix fold; fold opposite the edge of the auricle) is too weak and is fixed with a suture in the correct fold. An incision behind the auricle allows a slight rotation of the auricle and thus a positioning of the ear.

The incision behind the auricle is neatly sutured and leaves hardly visible scars. After about 6 months the scar has almost completely disappeared. Depending on the experience of the surgeon, the operation takes about one hour per ear and is performed under general anaesthesia in children, and in adults, if necessary, also under local anaesthesia.

After the operation an inpatient stay of 4-5 days is necessary. During this time a head bandage is worn. After discharge, a wide headband should be worn at night for another month to protect the ears while still sleeping on the side.

Your child should sleep on its back for two weeks after the operation so that the wound can heal well. The stitches are removed after 10 to 14 days at the clinic or at the doctor’s office. For one month, the child should refrain from any bending and stressing of the operated auricles.

Ointments such as Bebanthen® can accelerate the healing process, keep scars soft and facilitate the removal of crusts. In principle, a surgical correction of the auricle can be performed at any time from the age of 5 years. From this age, it is assumed that the growth of the auricle is almost completely finished.

If the protruding ears are very pronounced, the child should be protected from the beginning from the teasing at school and treated before school starts. If the parents find it difficult to decide on surgical therapy, detailed discussions should be held with the doctor. He will tell you from his wealth of experience whether the child’s ears will still change in further development or will be the cause for later teasing at school. If the child has sailing ears (protruding ears), it does not have to be unhappy about it from the outset! As long as the child does not complain about the shape of his or her ears or there are no signs that he or she is annoyed about the shape of his or her ears, no therapy is necessary.