Exploring the Variety and Complexity of Auricular Malformations
Did you know that at least one in every six thousand babies is born with a congenital malformation in one or both ears?
If you have any changes in your ear or even in the ear canal, don't be alarmed, as this is much more common than you might think.
What is congenital malformation? If you've never heard the term, don't be surprised! Although the word "malformation" sounds scary, it simply means that some organ has a change in its structure since birth. The cause can be genetic or due to external influences, but it often occurs simply by chance.
How do ear malformations occur?
Just like a baby's entire body, the ear canal and ears are structured during pregnancy. As the fetus grows, these two cavities that allow hearing are formed, but in some cases it happens that the ear and ear canal stop developing or move to where they shouldn't be.
This leads to malformations, which can damage only the external part of the structure or also the ear canal, impairing the future child's ability to hear.
When a child is born with a malformation, parents often think: what did I do wrong?
While there is the possibility that the factors that cause these deformities are genetic or external - such as a mutation in one of the parents, or some trauma that the mother went through during pregnancy, for example - in many children, the malformation happens at random, for no specific reason.
Learn about ear malformations and how to treat them
Unfortunately, little is said about ear malformations in Brazil. When it's not a common malformation, few receive the correct diagnosis and treatment, which means that many go through life unaware that they have a congenital alteration and that it could be affecting their daily lives.
Swollen Ears, or Prominent Ears, are a common condition characterized by ears sticking out further from the head, which can affect the self-esteem of children and adults.
Constricted ears, also known as "cup ears", are deformities characterized by the incomplete formation of the ear structure, affecting aesthetics. It corresponds to a folded or "crumpled" ear with varying degrees of severity as the fold of the ear increases. This ear is known for being more closed and having a shell-like appearance. The upper or lower part is also more shrunken. There are two levels of constricted ears: the lop ear and the cup ear. The first occurs when the upper part of the structure is bent, and this level of curvature can be discreet or even give the impression that the ear is bent. In the case of the cup ear, the structure is even more curved and is almost all turned inwards. Cup ear x Microtia: many people confuse cup ear with microtia, due to the appearance of these malformations, which can be similar. However, in microtia you have to recreate an entire structure that wasn't developed there during pregnancy, in cup ear you just have to remodel the area.
There are specific treatments for each case of a constricted ear: Lop ear When only the upper part of the ear is bent, it is necessary to perform a surgical intervention that will lift, structure and reposition the part that was curved. Cup ear As with microtia, in some cases it is necessary to use a cartilage graft to give the ear the height it needs. However, this surgery is much more straightforward, as the necessary structures are there and all that is needed is to realign them to the standard shape.
Cryptotia is a rare condition where the upper part of the ear is hidden under the skin of the scalp. It can go unnoticed at birth and become more obvious as the child grows. Treatment varies according to the severity of the case and can include non-invasive therapies or surgical interventions to free the ear and restore its position naturally.
To correct cryptotia, surgery is needed to recreate the first third of the ear. In it, the doctor in charge will "unearth" the structure that is buried under the skin. This makes it possible to build this curvature that didn't exist before, as well as creating this groove behind the structure. As a result, in addition to the aesthetic aspect, the patient will be able to give that part of the ear a function, whether it's to support glasses, use a headset or even hold their hair in that part, something that was impossible due to the malformation.
Unlike microtia, macrotia is characterized by an increase in the size of the ear, making it more prominent and out of harmony with the rest of the face. Most cases of macrotia occur in the elderly, when there is an increase in the lower part of the ear due to advanced age. However, there are cases in which this condition is congenital and the baby is born with the external structure of the ear canal larger than is considered normal. Don't confuse macrotia with "floppy ears": although both have the appearance of being larger than normal, the more prominent ear, or floppy ear, is not caused by a genetic malformation, but rather due to the cartilage being more "detached" from the bone structure, but its measurements are still normal. The normal dimensions: length of 5.5 to 7cm and width of 50-60% of the length.
As with microtia, macrotia can only be treated with surgery, as the ear needs to be restructured so that it can reach the right size. However, the good news is that macrotia doesn't damage hearing, despite its aesthetics. It is therefore much easier to diagnose and treat than other malformations. When reduction surgery is performed on an elderly person, usually only the lobe area is affected by the procedure. The surgeon reduces this area and the scar is hidden behind the ear. In cases where it is congenital, the surgery aims to reduce the area around the ear, so it can shrink up to 1.5 centimeters in length and 0.5 centimeters in width.
Also known as "little ear", this is one of the most talked about malformations. It is characterized by a decrease in the size of the outer part of the ear, and in more severe cases there may even be an absence of this visible structure, so it is a deformation that can be recognized even by laypeople. The first step if you suspect your child has microtia is to go to a specialist doctor. They will be responsible for finding out the level of the malformation and how much it will affect the baby's ear canal. Take tests to check the functioning of the kidneys and heart: during pregnancy, the facial part develops in the first three months, as do the kidneys and heart. That's why, when microtia is diagnosed, it's necessary to undergo a battery of tests to find out if any other part of the body was affected during the period in which ear development failed. With the diagnosis in hand, it will be possible to discover the consequences of microtia in the child and seek the most appropriate treatment.
Treatment will depend on how much the microtia has affected the patient's hearing, and there are several alternatives for this malformation: When the canal has not been affected In this case, there are three possible options: keeping the ear as it is, using an ear prosthesis and carrying out reconstruction using cartilage. In the first case, the patient keeps the shape of the ear as it is, as this would only be aesthetic, since hearing has not been impaired. In the second case, it is possible to implant a prosthesis that will only have aesthetic purposes, as it will serve as a camouflage for the absence of the structure. In the third, with the help of rib cartilage, a mold will be sculpted that will copy the shape of the ear and will be used to reconstruct the region. When the canal has been affected There are cases in which the microtia is so severe that it closes the canal between the ear and the ear, impairing hearing function. In this case, it is best for the patient to use hearing aids to facilitate or enable hearing. In these devices, sound reaches the patient via small electrodes.
Stahl's ear is a deformity in which the ear has a more pointed shape and there is a greater amount of cartilage in the first outer part of this structure. This gives the appearance of an ear reminiscent of mythical figures such as fairies and aliens. Did you know that this malformation is also nicknamed Spock's ears, which is a reference to the television series Star Trek? In it, Spock, played by Leonard Nimoy, has a pointed ear just like those who have this deformity. However, the actor didn't have stahl ears and, to bring his character's pointed ears to life, he used prosthetics. It is caused by the accumulation of cartilage and, in some cases, when there is a further "fold" in the structure of the ear, a deviation develops in the upper part, shaping a more pointed part. Although it can cause discomfort, this deformation does not damage the ear canal.
Stahl's ear is easy to diagnose and can be discovered in the first few days of a baby's life. This makes treatment easier, as newborns are much more flexible and this allows the cartilage to be restructured. Therefore, when it is discovered quickly, it is possible to treat this malformation with a mold that adjusts the shape of the upper and lower part of the ear. When the diagnosis is late, surgical intervention is needed to shape this structure. In these cases, the plastic surgeon in charge reshapes and repositions the ear in order to bring it up to standard. Despite being surgery, it is a low-risk procedure with a quick recovery.
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