Ear Anomalies

What Is an Ear Anomaly?

An ear anomaly is when the size or shape of the outer, middle, or inner ear is different than usual. It can change how the ear looks and how a child hears.

What Happens in an Ear Anomaly?

A child with an ear anomaly could have:

• no ear (anotia)
• a small ear (microtia)
• no ear canal (aural atresia)
• constricted ears (the outer part of the ear is either wrinkled, folded, or flat)
• a hole or bump just in front of the ear (an ear pit or ear tag)
• protruding or prominent ears (the ear sticks out)
• the top part of the ear underneath the skin (cryptotia)
• a narrow ear canal (ear canal stenosis)

Many kids with an ear anomaly of the outer ear also have problems inside the ear, like hearing loss. Ears that only stick out usually don’t cause hearing problems, but kids might feel self-conscious about them.

What Are the Signs & Symptoms of an Ear Anomaly?

Often, ear anomalies are easy to see because one or both ears look different.

If a baby has an ear anomaly that affects only the middle or inner ear, it might be found during the newborn hearing screening test. Some anomalies aren’t found until children get older and have symptoms, such as:

• many ear infections
• hearing problems
• speech and language problems

What Causes Ear Anomalies?

Doctors don’t always know why kids get ear anomalies. Sometimes they run in families. Kids with some kinds of health problems are more likely to have ear anomalies. These include Treacher Collins syndrome, Down syndrome (trisomy 21), and osteogenesis imperfecta (brittle bone disease).

How Are Ear Anomalies Diagnosed?

Many ear anomalies are diagnosed at birth when the doctor does an exam, or through the routine newborn hearing test. Then, the doctor will check the ears carefully to look for other problems.

An ear, nose, and throat (ENT) doctor — or otolaryngologist — may order tests to find out what is happening inside the ear. These can include:

• computed tomography (CT)
• hearing tests
• magnetic resonance imaging (MRI)

Sometimes, imaging studies aren’t done until a child is older. This lets the ears develop further before the doctor makes any treatment decisions.

How Are Ear Anomalies Treated?

Some ear anomalies, such as cupped ears, can be fixed by gently reshaping the ears with ear molds when a baby is very young. Others, such as a small ear or no ear, may need treatment by doctors who specialize in craniofacial surgery.

Depending on the ear anomaly and the child’s age, doctors can reshape or build a new ear using a child’s own cartilage. Some kids may get a removable plastic ear (prosthesis) or a permanent ear implant.

If an ear anomaly affects a child’s hearing, there are different ways to help. Early treatment of any hearing loss is very important. Hearing aids are a good solution for many kids. Other kids may need implants or surgery to fix problems that prevent sounds from reaching the inner ear. These treatments often help improve hearing, which can help kids with their speech and language skills.

How Can Parents Help?

Be sure to take your child to all regular checkups. The doctor will do an exam at every visit and check your child’s hearing regularly.

Tell the doctor if you have any concerns about your child’s hearing or speech. They can order follow-up tests or refer you to an ENT doctor, if needed.