Introduction
One to two percent of people are born with prominent ears, a genetic condition whose prevalence varies depending on what is deemed a prominent ear. It develops from a loss of cartilage during primitive ear development in intrauterine life and can be unilateral or bilateral. The external ear structure is complex, consisting of strong cartilage and thin skin. Later, the ear develops laterally or has aberrant helical folds. Sometimes, folds that are present from birth dissolve on their own. So, it is essential to understand the signs and symptoms, causes, and management of prominent ears.
What Are Prominent Ears or Bat Ears?
Ears that protrude more than two centimeters from the head are considered prominent ears or bat ears. They are typically brought on by the ear's lack of a cartilage fold. Prominent ears typically begin to emerge in early childhood.
Prominent ear surgery is one of the few surgeries where individuals do not need to wait until they are eighteen. This is because having prominent ears makes a person severely psychosocially disabled and exposes them to social and educational ridicule; therefore, surgery is performed after the patient is twelve years old.
What Are the Signs and Symptoms of Protruding Ears or Bat Ears?
Most children with bulging ears do not exhibit any other symptoms, and their hearing is typically unaffected.
Why Do Protruding Ears or Bat Ears Occur?
The most common cause of protruding ears in babies is abnormal development of the ear fold on the outside before birth. Although the reason behind this is unknown to doctors, it may be connected to the baby's position within the womb. The blood supply may be cut off, and the ear may not form generally if it presses against the side of the womb. Extruding ears can occasionally run in families.
What Are the Problems Caused by Prominent Ears or Bat Ears?
Physical Problems
About 30 percent of kids with prominent ears are born with normal-looking ears, and the issue only becomes apparent in the first three months of life. Prominent ears also do not usually go. Repetitive bending of the delicate cartilage, especially during nursing, may worsen this. Prominent ears are not related to any functional issues.
Psychological Problems
Prominent ears can cause significant psychological distress. Prominent ears primarily have clinical significance since they can cause aesthetic issues that might negatively impact one's quality of life, self-esteem, social avoidance behavior, and academic achievement. School bullying results in temporary dissatisfaction as well as possible long-term effects on self-worth and self-image assessment. Children and adults with prominent ears may suffer psychological harm as a result of self-criticism and mockery from others.
How to Manage Prominent Ears or Bat Ears?
The management of prominent or bat ear typically involves the following procedures:
Conservative Treatment
The ear cartilage is incredibly soft until six months of age, at which point it may be able to be molded and splinted. While bandaging and taping were once common treatments, more advanced splints have been developed to address issues more precisely. Ear splinting can greatly help treat infants with deformity and auricular malformations. The sole course of action after six months is surgical repair. The natural course of prominent ears, the appropriate age to begin utilizing ear splints, the duration of their use, and their long-term effectiveness are all still up for debate. Ear splints are frequently suggested for trials in infants due to their shallow hazards.
Surgical Management
Children as young as five can undergo otoplasty or pinnaplasty (surgery to pin their ears back). The key is to strike a balance between doing the procedure right away, which could result in bullying or teasing, and giving the child enough time to see if it bothers them. The latter group is more likely to be cooperative during the procedure and happy with the outcome. Adult patients can also have the procedure. After making a choice, a patient may be referred to a plastic surgeon or the ENT team. Most patients must go privately because the operation is typically unavailable on the NHS.
Procedure:
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This procedure is often performed under local anesthesia in adults and general anesthesia in youngsters. However, children as young as 5 years old can undergo otoplasty safely and effectively when given local anesthesia.
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There are various methods at one's disposal. The kind and quantity of cartilage involved in the procedure may determine whether to use percutaneous adjustable closed otoplasty (PACO) or cartilage-sparing techniques.
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PACO should be the procedure of choice for noticeable ear abnormalities with soft cartilage due to its advantages, which include a shorter recovery period, the elimination of the requirement for a lengthy compressive bandage following surgery, and the ability for patients to see the results right away.
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It has been demonstrated that incisionless otoplasty is a safe, successful procedure that may be carried out on both adult and pediatric patients. Compared to an open operation, this method is less intrusive and has fewer potential consequences.
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Adults under local anesthesia can have a modified incisionless otoplasty with favorable outcomes. Patients can immediately resume their regular activities following the procedure. It is linked to a high rate of patient satisfaction and a low rate of complications.
Postoperative Care
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Some patients may be instructed to wear a protective headband for a few weeks following their procedure, especially at night.
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After 14 days, patients can wash their hair, but they should be urged to take extra care to thoroughly clean and dry the affected region.
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At least two weeks should pass before swimming (preferably, wait four to six weeks). Eight weeks should be spent away from contact sports.
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After the operation, patients can travel by plane whenever they choose.
What Are the Complications of Prominent Ear Surgery?
Complications following prominent ear surgery are generally uncommon, never exceeding five percent overall.
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General anesthesia complications.
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Formation of keloid scars.
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Ear numbness, which may not go away for a few weeks.
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Unequal distribution of the ears.
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Hematoma (Formation of Clot): Consult the surgical team for guidance (patients may occasionally need to return to the operating room to have a clot removed).
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Dehiscence: If the gap does not result from an infection, it can typically be mended with the right dressing (applied by the surgical team).
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Severe Infection: This may cause the wound to collapse completely, including the cartilage, resulting in long-term abnormalities that may require additional surgery to rectify.
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Recurrence.
What Is the Prognosis of Prominent Ear Surgery?
This prominent ear does not go away on its own. Surgical correction is currently the only treatment available after six months of age. Following a successful procedure, there is typically a high satisfaction rate, with patients reporting improvements in their social lives, leisure activities, and self-esteem. Appropriate corrective surgery might help lessen psychological issues related to large ears. Parents have noted a notable increase in their children's quality of life regarding their health after otoplasty.
Conclusion
Prominent ears are a prominent aesthetic issue that can substantially affect a person's psychological health. Even if this is primarily a cosmetic concern, the choice to seek remedial measures should be made considering the patient's physical and emotional needs. Modern surgical methods, like otoplasty, provide efficient ways to deal with protruding ears and restore a more harmonious facial appearance. However, non-surgical measures, including shaping an infant's ears, are also very important for early intervention and averting possible psychological discomfort.
