There is a wide range of normal variations in physical characteristics among newborns. ‘Low set ears’ is one such characteristic, often observed in newborns, which requires a high degree of understanding and interpretation. This article aims to bring awareness about what it means when we use the term ‘low set ears’ in relation to newborns, and how it is associated with certain malformation syndromes.
Primarily, what we classify as ‘low set ears’ are ears that are positioned lower on the head than typical. This is determined by drawing an imaginary horizontal line across the highest point of the outer part of the two ears. In most people, this line will fall at the level of the eyes or above. If the line falls below the level of the eyes, the ears are considered to be ‘low set’. However, low set ears are only regarded as a ‘feature’ and it does not necessarily indicate a significant problem.
Low set ears can occur as a normal variant in some people. But it is also commonly seen in conjunction with a variety of different genetic conditions, which include Down syndrome, Turner syndrome, and trisomy 18. It is not the presence of low set ears alone but the combination of this feature with other physical or developmental issues that suggests the prospect of a genetic or developmental disorder.
One such syndrome that may lead to low set ears in newborns is Hemifacial microsomia. Hemifacial microsomia results in one side of the face being underdeveloped in relation to the other side. The ears can be affected in different ways, including being smaller than normal (microtia) or even completely absent (anotia). Low set ears can also occur in Hemifacial microsomia. Hemifacial microsomia surgery is often used to address this condition, helping to balance the face and achieve a more normalized appearance.
During the surgery process, reconstruction of the underdeveloped facial structures, including the lower jaw and the ears, occurs. For infants with low set ears due to Hemifacial microsomia, the ears may be repositioned to a more typical place on the head. However, the timing and approach of this surgical intervention might be influenced by the severity of the condition, the child’s age, and additional health considerations.
Examination of low set ears should always be accompanied by a comprehensive health evaluation, such as genetic testing or a full-body physical examination, to permit a broader scrutiny of the likelihood of an underlying disorder. For infants with an isolated finding of low set ears and no other physical anomalies, the prognosis is very good, and typically, no treatment is necessary.
However, it is fair to clarify that the notion of low-set ears is highly subjective and depends on the observer’s discernment. It is not among those physical attributes that are outwardly noticeable. Hence, most people with low set ears are not aware of it and lead a normal, unhindered life.
In conclusion, low set ears can be a naturally occurring variation in the human body or be a characteristic trace of certain genetic disorders. The presence of low set ears alone does not necessarily signify a severe condition. It is the associated syndromes, such as Hemifacial microsomia and the consequent use of hemifacial microsomia surgery, that imply a more complex health context. Regardless, increased awareness and knowledge about these conditions can lead to early diagnosis and timely treatment in severe cases, ensuring the overall well-being of the newborns.