What Causes Protruding Ears?

Protruding ears can be an embarrassing feature for anyone to live with. Causes occur at birth to development later in life. There is medical treatment available for protruding ears. It is a recognized irregularity now, and many are choosing to have it corrected.

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Protruding ears come in many forms, on a variety of people and for different reasons. Infants can be born with protruding ears or folded ears and some will develop normal ear shape after birth, others will not. Some protruding ears seem to have a Dumbo-like appearance, while others protrude from the lobe like abnormally elongated lobes. Ears can protrude due to a falling over of the upper ear like a flopped-over ear. As people age the tissue of the ear (cartilage) can build up and cause the appearance of protruding ears.


There are many causes for protruding ears ranging from genetics or birth defects to trauma or nerve damage. Many infants are born with protruding, floppy or abnormal ears. For infants it can be just a developmental defect; protruding ears are the most common birth defect in infants because of the very delicate process of their development in the womb. A baby can be born with abnormal-looking ears and be perfectly healthy and eventually grow out of the protruding ears. In some infants, flopped over and protruding ears are a sign of a greater chromosomal abnormality and are usually a doctor’s first sign along with widely spaced eyes to do chromosomal testing. Protruding ears along with other physical defects can be a sign of Down syndrome and other chromosomal disorders. In adults, trauma to the ear or side of the head can damage the delicate cartilage of the ear and cause protruding or flopping. Most commonly seen in boxing as cauliflower ear, this is a form of permanent protruding from repeated trauma to the cartilage of the ear. Nerve disorders like Bell's palsy can cause drooping of the ears because of the loss of facial nerve function usually on one side of the face, causing the entire side to droop. The cartilage in the human body never stops growing, although it is at an extremely slow rate as we age; ears and noses continue to get larger. In some people as they age the ears become so large that they will start to protrude, more so in people who had larger ears to begin with.


Protruding ears are normally defined by how they look. Some, like those mentioned in Section 2, develop a permanent swelling of the cartilage due to trauma, which causes the ear to stick out because the upper portion of the ear swells. Specialists refer to ears with elongated lobes as bat ears. Folded ears are noted in children with Down syndrome and fetal alcohol syndrome. Genetics will cause what is known as true protruding ears, which are when the folds of the cartilage have not developed normally, causing the ear to stick out from the side of the head. All of these types of protruding can be very uncomfortable and embarrassing, but most can be treated.


Cosmetic surgery is the treatment option for protruding ears. The operation is called an otoplasty, and should be performed by a cosmetic surgeon, an ear nose and throat surgeon, or an otolaryngologist that does this type of surgery. For true protruding ears an incision is made behind the ear, the fold is reshaped to pull the ear closer to the head and then sewn back up with dissolving stitches. This type of operation takes about two hours under local or general anesthetic. Most people recover fully in about five days and the bruising and swelling are gone in about three weeks. This operation can safely be done on children as young as 5. A similar operation can be done with a plastic surgeon for elongated lobes in which they remove the extra cartilage and tighten the skin to form a smaller lifted lobe. In children with chromosome disorders causing flopping ears, they can be corrected but not until the age of 5 or 6. Children’s ears have reached adult size by age 6 and a size difference will not be noticed between age 6 and 40 or 50. It is normally in our 60s and up when we notice slightly larger noses and ears. Cartilage damage from trauma is something that can also be corrected by surgery but if the trauma continues to occur like in boxing, then there is no point in having it corrected until you will no longer be exposed to the trauma.


If left untreated, protruding ears in children can cause them to suffer great ridicule and teasing throughout school, which can have serious effect on their self-esteem and confidence as they get older. Children with folded ears will have trouble hearing and this can affect speech and mental development, so it is important to have them in special education programs until they are old enough for surgical correction. Cauliflower ear, if left untreated and trauma continues it can cause a closure of the ear canal blocking the opening to the ear and hearing will be sacrificed. Cauliflower ear can also swell to a point of rupturing and if infected can lead to amputation of the outer ear. All of this can be avoided by checking into a simple procedure to correct the ear or ears that are suffering from any of the forms of protruding ears.