Prominent ears and congenital or post traumatic ear deformities are referred to the plastic surgery service for correction or reconstruction. In NHS Lothian we have the national ear reconstruction service.
Prominent ears are extremely common and there is often a familial predisposition. There is a short window of opportunity to treat babies with ear deformations including prominent ears, using splints (ear buddies). Such treatment has to be instituted within 3 months of birth to be effective, but the sooner the better. Beyond that age, the splints are ineffective.
Older children can be treated surgically when they themselves want to have surgery and are of sufficient maturity to understand the process and comply with the post operative regimen. This is generally beyond age of 5 years. Operating on younger children at the parent’s request is rarely justified. There is no evidence to support the notion that prophylactic otoplasty reduces the incidence of teasing or emotional upset. The complication rates from operating on younger children are higher.
Patients over the age of 18 years who request otoplasty can only be treated if approved by the exceptional aesthetic referral pathway.
Other forms of congenital ear deformity or post-traumatic deformity can be referred to the ear reconstruction service for assessment without the need for EARP approval.
Who to refer to the Plastic Surgery department
- Patients with prominent ears (aged 5 to 18) who have sufficient maturity and understanding to undergo surgical correction and comply with the post-operative regimen.
- Any patient with Microtia, Atresia or Cryptotia (severely deformed Pinnas or absent ear canals) can be referred to our nationally funder ear reconstruction service based at Royal Hospital for Sick Children and at St John’s Hospital for adults. We can offer surgery to reconstruct the ear and to restore hearing using implants.
- Post Traumatic ear deformities including ‘cauliflower’ ears.
Who not to refer:
- Children who are themselves unwilling to undergo surgery and the primary motivation comes from the parents.
- Adults over 18 requesting prominent ear correction must be referred via the EARP.
How to refer:
Via SCI gateway to the national ear reconstruction service at the Royal Hospital for Children & Young People or St John’s Hospital. Simple prominent ear patients can be referred to the Plastic Surgery service at either hospital.
