Congenital Disorders of Pinna

The external ear consists of auricle or pinna, external acoustic canal and the tympanic membrane. The pinna may be affected by congenital, inflammatory, traumatic or neoplastic conditions.

Various congenital disorders

The developmental disorders of the auricle may be minor or major variations from the normal.

Anotia (or Missing auricle) – It is the condition in which there is complete absence of pinna.

Macrotia (or Big ears) – Presence of excessively large pinna is called Macrotia. Normal range of height of ear is 5-6 cm and normal width is 1-1.8 cm. In a condition called Scaphoid ear deformity, only the upper third part of the ear is big.

Microtia – It is a major anomaly with presence of very small pinna. The degree of microtia varies in different cases and may appear unilaterally or bilaterally. Hearing loss is frequently seen in such cases.

Bat ear (or Lop ear) – In this condition, the ears protrude out from the side of the head and do not lie flat against it. This condition is not associated with any mental abnormality. Sometimes some swelling behind the ear may also cause the ears to protrude. So checking for any swelling or presence of cup shaped ears (feature of Down’s syndrome) is a must before labeling the disease. The deformity demands surgical correction for cosmetic reasons, which can be done after 6 years of age.

Preauricular sinus (or Preauricular pit) – Sinus means a blind track leading from the surface down into the tissues. Preauricular sinus develops from imperfect fusion of tubercles that form the pinna and may be single or multiple. This sinus is asymptomatic unless its opening gets blocked to form a cyst. When infected, this cyst forms an abscess, which may rupture and form a chronic, non-healing ulcer. The sinus is treated by complete surgical excision.

Preauricular appendages – These are skin-covered tags that appear from the auricle to the angle of the mouth.