Disease Description (Causes and Symptoms)
- Definition: A condition in which the auricle (antihelix) is flattened, increasing the angle and distance between the ear and head (auriculocephalic angle/distance), making the ear appear to protrude from the head (prominent ear). Synonyms: donkey ear, Mickey Mouse ear, bat ear.
- Pathophysiology: Mainly due to underdevelopment (or absence) of the antihelical fold and excessive auricular cartilage (especially a large conchal bowl), resulting in an increased auriculocephalic angle or increased distance between the ear and scalp.
- Causes: Although the exact mechanism is unclear, genetic predisposition and abnormalities in cartilage development may be involved. It may occur bilaterally or unilaterally.
- Main symptoms: A cosmetic abnormality in the shape of the ear (hearing impairment is generally absent). It may cause psychosocial problems, such as psychological stress or teasing by peers.
- Diagnostic criteria (clinical): A diagnosis is supported when the edge of the auricle is approximately 2.5 cm or more from the scalp or when the auriculocephalic angle has increased to approximately 40 degrees or more. Diagnosis is primarily based on clinical findings.
Treatment Methods
- Conservative (non-surgical):
- Newborns (several days to several weeks after birth): While the ear cartilage is flexible, shape correction may be attempted using tape fixation or an ear molding device. The effectiveness decreases after this period.
- Surgical treatment (plastic surgery):
- Cartilage-sparing suture techniques (e.g., Mustardé sutures): An incision is made in the posterior skin, and the protrusion is corrected by creating folds with sutures without cutting the cartilage.
- Conchal resection or conchal setback: When the conchal cartilage is excessive, part of it is removed or fixed to pull it toward the head.
- Combined techniques: Suture techniques are combined with cartilage resection or reshaping.
- Anesthesia: Most children receive general anesthesia; in adults, local anesthesia with sedation or general anesthesia may be used.
- Postoperative care: Maintain a compression bandage (such as a headband) for a certain period (e.g., about one week), prevent infection and hematoma, and restrict activities (especially activities that apply pressure to the ear).
- Precautions (risk of complications and self-care):
- Surgical complications: Infection, hematoma, suture extrusion, scarring, asymmetry, possible restoration of the cartilage shape (reprotrusion), and, rarely, decreased sensation at the surgical site.
- Self-care: Follow postoperative instructions (such as the period for wearing the bandage or headband and wound care), and visit the hospital immediately in case of bleeding, severe pain, or fever.
Outpatient Visit Checkpoints (Including Example Questions)
- Items/records to prepare:
- A list of currently taken medications (including anticoagulants and aspirin)
- Past surgeries and anesthesia history, presence of bleeding disorders, and allergy history
- Whether tape or ear molding treatment was attempted during the newborn period and the results
- Records of changes in the shape of the ear (when it first became noticeable, whether it affects one or both sides, etc.)
- Psychological effects caused by the condition (problems at school or in social life, etc.)
- Photographs (front and both sides) — helpful for evaluating the shape during the outpatient visit
- Show the doctor during the outpatient visit: Photographs, medication list, and previous treatment records (if any)
Examples of General Questions to Ask the Doctor
- What are the expected benefits and main risks of this treatment (or surgery)?
- What is the expected recovery period after surgery, and when can normal daily activities be resumed?
- Are any tests or additional examinations needed (such as blood tests or photographs)?
- How likely is recurrence after surgery? If repeat surgery is needed, when would it be considered?
- What are the risks related to anesthesia (especially for children)?
Examples of Condition-Specific Questions
- If the patient is a newborn: My baby is a newborn. Is this the right time to have already started or to start tape or ear molding treatment? (Possibility/effectiveness/recommended duration)
- If surgery is being considered: Which surgical technique is recommended for my child (or for me), and how much symmetry between both ears can be expected after surgery?
(Note: Diagnosis and treatment vary depending on the individual patient's condition, so consult the treating specialist before making a final decision.)