Ears that stick out more than 2 cm from the side of the head are considered to be prominent or protruding. They may also be called “dumbo” ears.
In most people, protruding or prominent ears are caused by an underdeveloped antihelical fold. When the antihelical fold does not form correctly, it makes the helix (the outer rim of the ear) stick out (see a diagram of a normal external ear).
Most people with protruding ears also have a deep concha, the bowl-shaped space just outside the opening of the ear canal, which pushes the entire ear away from the side of the head. Although protruding ears don’t cause any functional problems such as hearing loss, children are often teased by their peers.
There are both non-surgical and surgical options for treating protruding ears.
Non-surgical ear molding
Protruding ears can often be corrected without surgery if your child comes to us early enough, while their ears are still soft. Ear molding uses a combination of a commercially available ear molding system and orthodontic molding materials to reshape the ear and bring it closer to the side of the head. The ear is splinted by the mold, and the amount of time required may vary depending on the age of your child.
For a newborn, two weeks of treatment may be enough to correct the deformity. For older children, several months of ear molding may be required to achieve permanent correction. This is because as your child grows, her ears become less flexible and less responsive to molding.
If your child’s ears are already protruding and too stiff for molding, surgical correction is an option. This type of ear surgery is sometimes called ear pinning, or setback otoplasty. It may be preferable to wait until about age 6, when ears are almost fully grown. This is also the age when children typically begin to be teased by their peers, which provides additional incentive for them to undergo surgery. As your child grows, she may also have an increased opinion and desire for surgery and may participate in the discussion and decision about her treatment options.
The procedure to correct protruding ears is usually performed through an incision behind the ears. A combination of cartilage scoring and suturing is used to create an antihelical fold. Additional sutures on the back of the conchal cartilage bring the entire ear closer to the side of the head. A postoperative dressing is used to help keep the ears in their new positions. Although a general anesthetic is needed, the operation is done on an outpatient basis and your child will be able to return home the same day.
After surgery, your child’s surgeon will monitor him for infections and wound healing. Occasionally, some children may need another surgery to re-correct the problem as often the ears' tendency is to return to their previous position.
Insurance companies often consider otoplasty to be a cosmetic operation, and therefore they may not cover the cost of this procedure. If you have questions about insurance, your CHOP care team is here to assist and answer any questions you may have.