Written by J. Dayne Petersen
Dumbo. Mickey Mouse. Goofy.
All names my patients with prominent ears have been called. You know those kids. Their ears stick out from the side of their head in a most distracting fashion. While they talk to you, you are watching their ears. When you sit behind them you can’t help but stare.
My son was one of those kids. My wife took him with her to her first appointment with a new doctor. That doctor walked in the room and said to her, “Whoa! Those are some elephant ears. Are you going to do something about that before he starts school?” She was devastated. Even a doctor may say the worst of things.
I remember the day my son lost the blessing of childhood obliviousness and became aware of his own appearance. We were in a hotel and he was sitting in front of a full length mirror. He suddenly began to laugh hysterically. I mean he was falling over laughing. We were perplexed. “Look at my ears!” he managed to squeak out. From then on he was always aware. No amount of loving parental talks about loving your differences and being special made a bit of difference.
That is where otoplasty comes in. Otoplasty is a surgical technique to reshape the ears or “pin” them into a more natural position. It usually involves an incision in the back of the ear and sometimes one on the front. If there is too much cartilage in the bowl of the ear, contributing to their exaggerated shape, a small amount of that cartilage can be removed.
The most common cause of prominent ears is that a major fold of the cartilage of the ear fails to develop. If you look at the profile of an ear, the major fold forms a Y shape. Some individuals are missing the top branch of that Y and thus the fold that holds the ear close to the head is missing. The missing fold can be recreated by reshaping the cartilage with sutures—kind of like sewing a fold into a garment. Often this condition runs in families. My son comes from a long line of prominent ears, in varying degrees.
Junior High is a rough time for any adolescent. Often we recommend that a youth have this corrected before hitting that rocky road. But even when this condition extends into adulthood, it can be addressed. Otoplasty is usually done as an outpatient procedure. It takes a couple of hours. There is some initial pain, but it is relatively brief and easily treated with medication. The head is wrapped initially and when the dressing is removed a head band is worn for a few weeks to support the new shape and allow the ears to fully heal. Normal activities can generally be resumed during this time.
After my son’s surgery he was thrilled. I kind of missed his trademark appearance. Most kids look instantly more mature after otoplasty. But he didn’t miss it at all. His happy expression said it all; “My ears are like door, they used to be open and now they are closed.”
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