Wide Spectrum of Care Treats Cosmetic and Functional Concerns
Children with a deformed or missing ear will benefit from the compassionate, expert care provided at Duke Children’s. Our specialists use surgical techniques and nonsurgical innovations to correct major ear deformities resulting from birth defects, trauma, or tumors. Our plastic surgeons also address minor deformities, such as excessively large, protruding, or misshapen ears.
Personalized Care for Your Child’s Ear Deformity
We treat a variety of ear deformities that affect the ear’s structure, appearance, and/or function including:
- Birth defects in which a child is born with a partial ear (microtia) or complete absence of an ear (anotia).
- Unusually shaped ears.
- Ear deformity resulting from trauma, such as a sports injury. These are often called “cauliflower ears” and result from a buildup of blood, scar tissue, or cartilage.
- Protruding or large ears for which cosmetic correction is desired.
A comprehensive evaluation gives us the information we need to determine your child’s needs. Our team of specialists may include pediatric plastic surgeons; ear, nose, and throat doctors (otolaryngologists); audiologists; and speech-language pathologists.
Treatment is tailored to the needs of your child and can range from simple ear molding to complex surgical reconstruction. In all cases, our goal is to put you and your child at ease, answer your questions, and make your child comfortable with his or her appearance and function.
If Your Child Needs Surgery to Correct Ear Deformity
If your child requires a surgical correction, you can feel confident in our level of skill and experience.
- Our pediatric plastic surgeons and otolaryngologists undergo advanced training and have years of experience repairing and reshaping all types of ear deformities.
- Duke Children’s is one of only seven hospitals in the U.S. verified as a level I children's surgery center by the American College of Surgeons. This Level I designation recognizes our commitment to providing the safest and highest-quality surgical care to our young patients.
- We understand the emotional impact an ear deformity can have on your family. Our family-friendly services include Child Life specialists who help relieve your child’s fears when facing a procedure, while in the hospital, and through recovery.
- Our care coordinators and social workers can help you navigate the medical system and coordinate the health services your child needs.
Treatment of Minor Ear Deformities
Minor ear deformities such as cup ear or lop ear may be reshaped with custom ear molds. A soft silicone mold is created to hold your child's ear in a better, more normal shape. These achieve the best results when used during the first month of life. Your baby's ear cartilage will gently remodel over the next several months. When the cartilage starts to harden, the new shape is retained. Ear molding is an office-based procedure and does not require an anesthetic.
Some children are born with extra tags of skin and cartilage attached to their ear or on their cheek in front of the ear. The ear is otherwise normal in appearance. The plastic surgeon removes the extra skin and cartilage and closes the skin with small stitches. This short, outpatient procedure is usually performed around six months of age.
Protruding or abnormally large ears may be corrected with otoplasty, a common cosmetic procedure used to pin one or both ears closer to the head. This procedure should be delayed until the ears are fully grown, around seven to 10 years of age. Our plastic surgeons pay particular attention to matching the two ears so their position and appearance are as alike as possible.
Treatment of Major Ear Deformities
More complex treatment is required for small, deformed ears (microtia) and missing ears (anotia).
Autologous refers to the use of your child’s own cartilage to reconstruct the missing or severely deformed ear. This process usually requires two to three procedures. In the first operation, the plastic surgeon will remove deformed ear tissue. Cartilage is taken from your child's ribs, then carved and shaped into the framework for a new ear. The framework is then placed in its new position under the scalp. After surgery, your child may wear a head wrap and have drainage tubes to prevent blood from accumulating under the scalp. The second- and third-stage operations continue the work to create a normal appearing ear. Whether two or three stages are required depends on the type and severity of your child’s original ear deformity.
A deformed or missing ear may also be replaced by a prosthetic ear made of medical-grade silicone and plastic materials. During this procedure, a plastic surgeon and otolaryngologist work together to remove deformed ear tissue. Metal implants are placed in the bone, similar to dental implants. These serve as the anchors upon which to attach the prosthetic ear. There are several reasons that parents may prefer prosthetic ears to autologous reconstruction: First, whereas autologous reconstruction requires a series of operations, prosthetic reconstruction only requires one operation. Second, the prosthetic ears are created by expert anaplastologists. These prostheses look lifelike and appear identical to the other side. Third, many children with an ear deformity may also receive a BAHA hearing aid. Its placement and this procedure can be done at the same time.
Children with ear deformities who experience hearing loss may be candidates for a bone-anchored hearing aid (BAHA). The surgery is performed by otolaryngologists. Audiologists and speech pathologists work closely with your child to help him or her adjust to this implanted hearing aid. If autologous ear reconstruction is planned, BAHA placement is typically deferred until after ear reconstruction. If prosthetic ear replacement is planned, the BAHA procedure may be performed under the same anesthetic.