Protruding ears are not a problem for children until other kids start making jokes about them. Nasty nicknames can really hurt kids and lower their self-confidence. So if a child is complaining about their ears, we should listen to them. There are several ways to make things better.
The notion of protruding ears is relative. Generally we talk about it in children if the distance between the apex of the concha and the cranial bone is 2 cm or more. Children usually don’t notice and aren’t upset by their ears, that is, until they hear rude comments from their friends. Some children have thicker skin and don’t react, but some can’t deal with the criticism so easily and protruding ears can lower their self-confidence and give them the feeling of being unaccepted by their peers.
Mum, why do I have such big ears?
The shape of the ears depends on the structure of their cartilage skeleton and their protrusion is most often caused by the antihelix, that is, the convex element of the cartilage. Just behind it the concha bends towards the skull. ‘If the antihelix develops abnormally, or does not develop at all, the concha is deformed. This takes place during intrauterine life, usually around the 12th week of pregnancy,’ explains Anna Krysiukiewicz-Fenger, MD, PhD, a paediatrician at the Medicover Hospital. Ears can stick out simply when they are big (in this case the antihelix does not affect their shape). In most cases protrusion is caused by genes, so if either of a child’s parents has protruding ears, we can be almost certain that the child will inherit them.
However, we should know that having protruding ears at birth does not mean that they will look this way for the child’s entire life. ‘In some children it is a short-term issue that is due to ear deformation caused by an abnormal head position in the mother’s womb. When this is the case, the problem usually disappears,’ adds Anna Krysiukiewicz-Fenger, MD, PhD.
Mask or operate?
We should not underestimate the extent to which protruding ears can be a source of inhibition for children – what we do in such situations can have wide-ranging implications. First, we have to take care of a child’s self-esteem and self-acceptance. We should also remember not to convince them that they’re only imagining things or to promise that they will grow out of it. Clever camouflage can also be helpful. This is easier for girls, as they can wear their hair loose or tied in a way that covers their ears. Boys can choose to grow their hair out a little or wear a nice hat. Yet this will only ever mask, not eliminate, the issue. The only way we can change things for good is with plastic surgery.
Correcting the ears
Correction surgery for protruding ears can be performed on children as young as eight years old. It’s best to schedule the procedure during the summer break so that your child can start the new school year without any unpleasant comments from their peers. ‘The procedure is performed under local anaesthetic with the use of various surgical techniques. It involves modelling the cartilage to allow the concha to better adhere to the head,’ explains Janusz Obrocki, MD, PhD, a plastic surgeon at the Medicover Hospital. To keep the ears in the shape they are given, insoluble stitches are used. ‘After their removal, a special supporting band must be worn for two weeks. After this, it should be worn every night for another two months,’ adds Janusz Obrocki, MD, PhD. After the procedure, a small scar is left behind the ear that becomes less visible over time.
Staying in hospital is always stressful for a child, so if we decide on corrective plastic surgery we need to make sure that the chosen hospital takes good care of the little patient. ‘We perform protruding ear correction in a treatment room where a parent can accompany the child at all times, making it easier for the child to remain calm. In addition, the patient can usually leave the hospital around three or four hours after the procedure,’ says Janusz Obrocki, MD, PhD. ‘The presence of mum or dad is particularly important when the kid is facing other, more complicated surgery, for example under general anaesthesia. In those cases, in our hospital the parents accompany the child during preparations for the surgery and stay with them until they fall asleep in the operating room. They only leave the child with the staff for the operation itself, but they come back once it over and participate in the waking-up process,’ adds Anna Krysiukiewicz-Fenger, MD, PhD.