ears, misshapen

My personal philosophy concerning cosmetic defects in children is that while they may appear acceptable to adults, they are often not trivial to the child. Cosmetic problems, even minor ones, can be damaging to a child's self-esteem and should be addressed. A child's peers can be unbelievably cruel. One of the more easily correctable classes of cosmetic deformities of children is those that affect the ear.

Some children are born with external ears (what is technically termed the auricle) that are not as attractive as might be desired. Some of these features, such as ears that are large or point more outward, may be genetic; others such as folding over of the auricle or flattening of the normal curl of the outer part of the ear can be caused by compression while the fetus is in the uterus.

We have a unique opportunity to correct or reduce some of these deformities in newborns. The cartilage of the external ear is soft and malleable for the first few weeks of life. It can be formed and allowed to "set" during this perid, to a sufficient degree to correct many common problems. Ears that protrude outward can be taped with hypoallergenic tape flat against the skull for several weeks, after which they will not protrude. Ears that are folded can likewise be corrected by taping.

Some ears are "ironed out," flattened by intrauterine pressure. This can give the ear an elfish, Dr. Spock sort of appearance. These ears require a bit of creativity. A splint or stent can be fashioned from dental wax and the helix formed and taped around it for several weeks until the ear cartilage has taken a normal curl.

Ear taping is not done as much as it should be, which is regrettable. Fortunately, all is not lost for children with protruberant ears. A plastic surgeon can tack these back in a minor operation. This is surgery that should really be considered for any older child who is self-conscious about his or her ears.

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