1) Disease Description (Causes and Symptoms)
- Definition: Prominent ear refers to a condition in which the angle between the ear and head (auriculocephalic angle) is abnormally large because the auricle (antihelix) is spread outward (e.g., approximately 40° or more), or the edge of the auricle is far from the head (approximately 2.5 cm or more). Synonyms: donkey ears, Mickey Mouse ears, bat ears.
- Causes·Pathophysiology: Primarily a congenital deformity, in which the ear protrudes outward due to underdevelopment or absence of the antihelix fold or an enlarged auricle (excessive conchal hypertrophy). A genetic predisposition may be present, and it may occur on one or both sides.
- Main symptoms: Visible changes in the shape of the ear (a protruding auricle). Hearing is generally not affected. Psychological and social discomfort due to appearance (such as teasing by peers or social withdrawal) is often the main concern.
2) Treatment Methods
- Conservative (non-surgical)
- Newborns (within several days after birth): Correction may be possible with ear molding or splinting/taping while the cartilage is flexible. The timing of the procedure and the duration of treatment have a major effect on the outcome.
- Surgical (plastic-surgical correction, otoplasty)
- A method that creates and fixes the antihelical fold with sutures from behind without incising the cartilage (non-excisional suture method).
- A method that partially excises or reshapes excessive cartilage (cartilage excision/incision method); cartilage reconstruction or grafting may be performed if necessary.
- The surgical method is selected according to the patient’s age, the condition of the cartilage, and the cause of protrusion (antihelix deficiency vs. conchal hypertrophy).
- Medication/adjunctive treatment
- Local care to prevent infection after surgery (antibiotics if directed), and use of a compression bandage (headband) to prevent hematoma.
- Lifestyle management and precautions
- During the early period after surgery, take care to prevent pressure or trauma to the ear (for several weeks). Activity restrictions (vigorous exercise and contact sports) are recommended.
- Neither surgery nor non-surgical treatment guarantees complete symmetry or a completely normal shape.
- Risk of complications
- Infection, hematoma, scarring, partial cartilage deformity or recurrence (return due to the elasticity of the cartilage), asymmetry, and anesthesia-related risks, among others.
- Prognosis
- Most patients achieve cosmetically satisfactory results, but recurrence is possible and complete symmetry is difficult. If complications occur, additional treatment or revision surgery may be necessary.
3) Checklist Before an Outpatient Visit (Items to Bring and Things to Confirm)
- Items/materials to bring
- List of medications currently being taken (including anticoagulants and aspirin)
- History of previous surgery and anesthesia, and allergy history (medications, latex, etc.)
- Time of birth and when symptoms began, and family history (similar deformities)
- Previous photographs (including childhood photographs, for comparison of asymmetry)
- Records of previous correction (taping or splinting) or related treatment records
- Information to tell the doctor in advance during the outpatient visit
- Whether the symptoms are on one side or both sides, when they first became noticeable, and whether there has been a psychological impact (problems at school or in social life)
- In children, growth and overall health status (e.g., birth history)
Examples of questions to write down in advance for the doctor:
- "Is surgery absolutely necessary, or is a non-surgical method possible?"
- "What is the recommended age for surgery (for a child), and how long is the recovery period?"
4) Examples of General Questions to Ask the Doctor
- What are the advantages and disadvantages of this surgery (or non-surgical treatment)? What complications are expected, and how often do they occur?
- How long is the recovery period after surgery, and when can the patient return to daily activities (school and exercise)?
- What type of anesthesia will be used, and what are the risks of anesthesia (especially in children)?
- How likely is recurrence, or the need for an additional procedure (revision surgery)?
- How often do postoperative scars or asymmetry in the shape of the ears occur?
5) Examples of Condition-Specific Questions
- For newborns and infants: "My child is several days/weeks old. Is taping (ear molding) still effective? When should it be started, and how long should it be continued?"
- When considering surgery: "Is the cause of my (or my child’s) prominent ear antihelix deficiency or conchal hypertrophy? What were the evaluation results, and what surgical method is recommended based on them?"