Dr. Lesavoy most commonly performs plastic surgery of the ear to correct the position of ears that protrude significantly from the sides of the head. Such protrusion makes the ears appear to be larger than normal. Overly large ears are a rare condition called macrotia. Protruding ears may occur on one or both sides in varying degrees and are not associated with hearing loss. Even adult dissatisfaction with previous ear surgery is a basis for plastic surgery of the ear.
Less common ear deformities can affect one or both easr, and may or may not affect hearing ability. The constricted ear, or a lop or cup ear, has varying degrees of protrusion, folding or flattening or the upper helical rim, reduced ear circumference, and lowered ear position. The Stahl’s ear is distorted in shape due to an abnormal position of the superior crus, or extra crus to the antihelix. In cryptoia, (or “hidden ear”) the upper rim of the ear is buried beneath a fold of scalp secondary to an abnormal folding of the upper ear cartilage toward the head. The folding is reverse of that which is commonly seen in the protruding ear.
The most complex congenital ear deformity is microtia. In microtia, the outer ear appears as either a sausage shaped structure that resembles the earlobe, or it may have more recognizable parts of the concha and tragus or other normal ear features. It may or may not be missing the external auditory or hearing canal. Hearing will be impaired to varying degrees. Reconstruction of microtia usually requires three staged surgical procedures in order to create a more normal external ear. These surgeries may then be followed by surgery to improve hearing.
Treatment of protruding or disfigured ears is usually possible as early as age 5, when a child’s ear cartilage is stable enough for correction. Children who are good candidates for the surgery are:
Healthy, without a life-threatening illness or untreated chronic ear infections
Cooperative and follow instructions well
Able to communicate their feelings and do not voice objection when surgery is discussed
Teenagers and adults defined as good candidates for ear surgery are:
Healthy individuals who do not have a life-threatening illness or medical condition that can impair healing
Individuals with a positive outlook and specific goals in mind for ear surgery