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Ear Reconstruction & Atresia Service NHS Lothian | Our Services

Appearance Issues

This page describes the most common problems we see relating to the appearance of the outer ear in children.

Most problems occur from birth either as isolated deformities or as part of a broader range of issues. If some of these deformities appear together then they are often given a collective name to make diagnosis and discussion easier. Terms such as craniofacial microsomia or Treacher Collins syndrome are two of the more common conditions that we see.

Craniofacial Microsomia

Craniofacial Microsomia is an umbrella term used to describe a range of abnormalities that generally affect the development of the skull (cranium) and face. ‘Microsomia’ means abnormal smallness and can affect a variety of areas.

The jaw – both upper and lower jaws – can be underdeveloped which may causes problems with breathing, feeding and speech. Rarely, there may also be a cleft palate and problems with tooth development. The mouth may be wider than normal and missing some of the muscles surrounding it, leaving it weak and slanted downwards on the affected side.

If the skull bones are affected, the forehead and cheek on one side may appear flattened and the eye socket may be smaller than usual or out of place. Occasionally, the eye on the affected side may also be smaller or absent. The ear on the affected side may be an abnormal shape, smaller than usual (microtia) or absent. The ear canal may also be absent resulting in associated hearing loss. There are also sometimes skin tags in front of the ear although these do not interfere with hearing but can potentially be removed..

The soft tissues of the cheek can be underdeveloped causing further asymmetry and sometimes other areas of the body can be affected, but children are given a full check-up and diagnostic tests to confirm or rule out any other problems.

Treacher Collins Syndrome

Treacher Collins Syndrome is the name given to a birth defect which may affect the size and shape of the ears, eyelids, cheek bones, and upper and lower jaws. It can be very mild making it almost undetecable at birth but can also be severe enough to impact on a child’s, breathing, eating and hearing. The extent of facial deformity varies from one affected individual to another.

We will do our best to discuss any associated problems with you as soon as possible after receiving your child’s referral to our service. 

Whilst we will be focusing primarily on your child’s ear(s) and hearing, other associated issues might need to discuss. Our team have a wealth of knowledge, experience and contacts within the greater NHS to ensure that your child can receive all the necessary expertise in an efficient and timely manner.