Introduction
Congenital ear deformities are the deformities of the outer ear or the visible ear and ear canal and are present from birth. Approximately one in every 6000 newborns can get affected with an outer ear deformity. Helical rim ear deformity is also a congenital ear deformity, giving the outer ear a folded C shape. However, this can even become irregularly shaped or compressed.
These deformities may cause psychosocial problems in children. Therefore, to avoid this, the deformity can be corrected by doing surgical procedures to give an appropriate shape to the malformed ear.
What Are Ear Deformities?
The deformities of ear anatomy can lead to various complications ranging from cosmetic issues to hearing and developmental problems. According to various investigations, it has been found that 6 to 45 percent of children are born with congenital ear deformities. However, some of the ear deformities are temporary and get corrected with the growth of the children. Likewise, if the deformity is caused by the abnormal positioning of the child in the uterus or during birth, it gets resolved as the child grows, which makes the ear unfold and take a normal shape.
Irrespective of that, some of the deformities need medical assistance, either surgical or non-surgical. The operative techniques can be carried out at the age of five to seven years.
What Is the Anatomy of the Outer Ear?
The ear consists of three parts: the external, middle, and outer ear.
The outer ear comes in different shapes and sizes, making its appearance unique for everyone. This is also known as the auricle or pinna. The outer ear is made up of cartilage and skin and is formed of three different parts: tragus, helix, and lobule.
The ear is made up of cartilage covered by skin, and the earlobe has no cartilage and is made of skin and fat.
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The ear is shaped like the letter C, which is formed by the helix and earlobe. Inside the letter C, another Y-shaped structure is formed by the antihelix and superior and inferior crura. This part of the ear is shaped like a conch sea shell which is why it is named concha.
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There is a small bump in front of the ear canal called the tragus, and on the opposite side is another bump called the antitragus.
The outer ear is composed of the following structures such as -
Ear Canal - The ear canal is the passage starting from the outer ear and ending at the eardrum. The canal is approximately 10 to 12 centimeters long and is very sensitive to pain and pressure. The outer one-third of the canal is cartilage, and the inner two-thirds is bone.
Ear Drum - The eardrum, also known as the tympanic membrane, is a size of a coin and remains the same size even in adulthood. It is a transparent gray membrane, and a middle ear bone called the malleus is attached to it.
Middle Ear - The space inside the eardrum is called the middle ear. The smallest bones of the body are found in the middle ear, called the malleus, the incus, and the stapes, and together, they are known as the middle ear ossicles.
What Are the Causes of Ear Deformities?
Ear deformities are usually present at birth (congenital), and various factors can lead to their development which includes -
Environment - The congenital deformities of the ear can occur when the developing baby in the uterus is exposed to harmful conditions. This includes exposure to certain drugs such as Thalidomide and alcohol consumption during pregnancy is also linked to the development of outer ear deformities.
Fetus Positioning - In some cases, deformities can occur due to the position of the baby in the womb. The unusual position can reduce blood supply to the outer ear, causing abnormal development.
What Are the Different Types of Ear Deformities?
There are various types of ear deformities which include -
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Protruding Ear - Also known as prominent ears, these are normal-looking ears that stick out more than two centimeters or 40 degrees from the side of the head.
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Constricted Ear (Helical Rim Deformity) - Also called cup ear, the helical rim is either folded, wrinkled, or tight in this deformity.
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Stahl’s Ear - In this deformity, an extra fold of cartilage is present on the upper ear, which gives it a pointy appearance.
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Cryptotia - Also called hidden ear, usually occurs when the ear cartilage gets embedded under the fold of the scalp skin on the side of the head.
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Ear Tags - These consist of skin and cartilage, also known as accessory tragus or branchial cleft remnant.
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Cauliflower Ear - The development of abnormal cartilage on top of the normal cartilage gives a bulky appearance to the ears.
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Earlobe Deformities - These can vary in appearance, such as earlobes with clefts, duplicate earlobes, and skin tags.
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Ear Keloids - This occurs due to scar formation after minor trauma.
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Ear Hemangiomas - Most common benign tumors can occur anywhere on the body, such as the external ear and salivary gland in front of the ear.
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Split Earlobes - This can occur due to large or heavy earrings.
How Are Congenital Deformities Diagnosed?
Congenital deformities of the ear are generally diagnosed at birth during the physical examination of the baby. The doctor will carefully examine the baby to assess symmetry, proportionality, and jaw defects. Moreover, they can also examine the ear using an otoscope to visually examine the ear canal and tympanic membrane.
What Is the Treatment for Congenital Ear Deformities?
Most people with ear deformities do not require any treatment and get resolved with age. However, surgical and non-surgical treatments can be done in cases with severe ear deformities, which aim at correcting the shape and restoring the functioning of the ear.
In cases where all the essential elements of the ear are present, and only the abnormal shape, size, or position of the ear has to be corrected, ear molding can be done.
Ear Molding - In the starting weeks of life, the cartilage of the ear is very flexible, and it can be reshaped using ear molding. This procedure uses a custom-fit, soft plastic mold to reshape the deformed ear. The mold is temporarily attached to the ear of the infant using adhesive strips. This procedure works well in various types of ear deformities, such as protruding ears, Stahl’s ears, constricted ears, lop ears, and cryptotia, and takes about two to four weeks.
Surgical Treatment - This option is for those whose ear deformities cannot be corrected with the ear molding technique. The doctors recommend that the child reach school age to perform these procedures.
Conclusion
Ear deformities are common conditions that usually get corrected with age. The deformed shape of the ear is easy to diagnose, and parents should consult the doctor if they find the same. Most ear deformities do not affect hearing ability; however, they do have an impact on the self-confidence of the child.
