My child has prominent ears, what can they do in hospital?

Hi, I’m Olivia and this film shows you how doctors can help you when you are worried about the shape of your ears. My name is Emma Murray and I’m one of the plastic surgery doctors, please to meet you. And this is Orla. Orla is one of our specialist nurses working in the psychology department and she works within the plastic surgery team. So together, we’re going to show everybody what happens, when children who have concerns about prominent ears, come to hospital to see a doctor. What are prominent ears? Some children have ears that stick out more than others and we call those prominent ears. Do many children have sticky out ears? Absolutely, I can reassure you that the complaint of prominent ears is a very very common one. So this is a picture of a normal ear. Now in patients who have sticking out or prominent ears, they tend to have a lack of a fold here, so that the top of the ear appears flattened and can look as if it is sticking out and the bowl area here, sometimes pushes away slightly from the head, and more so in other children than others, again to create the appearance of a sticking out ear. Okay. We can also see that in these photographs here. Here are some examples. So this patient, has a complete lack of this curvy fold. This patient has a bit of a fold here, but not as much as I do or this model does. When children have prominent ears does that mean they have a problem hearing? No, children with prominent ears have normal hearing. Sometimes however, prominent ears can attract unwanted attention and this can lead to teasing. Do many children get teased because of the shape of their ears? Well, you know children can be teased for any reason, anything at all, from their hair to their shoes. What’s really important is how children respond to any teasing, questions or comments. Is there a best way to respond? Well, it’s different for everybody, but there’s a few strategies that we can use. So, for example, if somebody asks the child about their ears or makes a comment about their ears, they could simply say “They’re just ears” and that is showing the other children that actually, “I’m Okay, this isn’t a problem for me, so it shouldn’t be a problem for you.” And there’s other things like body language. That’s really important. We know that as adults, but that’s something we need to help children learn, sometimes. That having head up, shoulders back, looking somebody in the eye, and smiling, can make all of us feel a little bit more confident. What should children do if they are being teased? One of the really important things to do is to talk about, to tell somebody. So for example if it’s in school, telling a teacher or guidance teacher, and especially telling mum, dad or somebody close to you, so they can help you with it. When children come to our clinic we ask them if we can take a look of their ears and examine them. So we can see here Olivia, on your ear that the normal curvy fold is slightly flattened and the bowl of your ear is slightly rotated away from the head and this causes the appearance of a slightly sticking out ear. Now there is an operation that we can offer children who have prominent ears, to set them back a bit and make them less prominent. So this is an operation called a Prominent Ear Correction. We’re going to put you to sleep for the operation, so that you don’t remember anything and that you don’t feel anything. Mum and Dad can come down to the operating room with you. Now when you’re in the operating theatre, the operation takes us usually around one and a half to two hours, at the most. When you are fast asleep, we make a small cut about this size, behind the ear here. We then put some permanent stitches in to recreate that fold of the ear. We also put some stitches behind the bowl of the ear, to help set the ear back a bit. Once we’ve done both sides and after we decided we are happy with the symmetry of the ears, we wrap the ears and the head up in a big head bandage. Will it be sore when you wake up? No, we put some special numbing medicine in, around the ears, once you’re fast asleep, so that when you wake up, you won’t feel any pain in your ears. When is a child able to go back to school? And when can they do sports after the operation? Theoretically a child to go back to school the day after their operation, however, we find that because of this big head bandage, most people like to wait until the head bandage has been removed, and that happens a week after your surgery. After the headband is removed, we’d asked that you wear a sports headband, which we would ask you to purchase yourself, for six weeks, both at night and during any sports. Can you go straight home after operation? Most children go home about two to three hours after the operation. Once we’re happy that they’ve had something to eat and drink and that they don’t feel sick. Before you go home we’ll make an appointment for you to come back to our plastic surgery dressing clinic, to see our nurses one week after your surgery. After the operation does the child have scars? It’s normal to have a short straight line scar behind the ear where we make the cut. This will initially be red and with time it will fade to a pale, fine, white line. Occasionally, we do see abnormal scaring behind the ear and abnormal scars usually occur as raised red lumpy uncomfortable or itchy scars that can continue to grow, in time. This is quite unusual, but there are certain groups who are more prone to them than others. These include people with very fair skin or red hair, people with dark or Asian skin types and those who have a history of bad scarring in the family. Are there any risks involved with the surgery? Some of the risks are common to any operation and those include bleeding and bruising, infection and wounds that can be slow to heal, or wounds that can split apart. Other than those general complications, there are some complications which are more specific to a prominent ear correction operation and those include, the permanent stitch that we put in the cartilage behind your ear, working it’s way out through the skin. We would sometimes see that over time, the ears, one or both ears, can drift back out again and that happens in about one in twenty cases and quite commonly, it’s normal to have a bit of sensitivity in the ear, particularly in cold weather. Finally, there’s the general anesthetic itself, which the anesthetist will chat to you about. What’s the best age for a child to have the surgery? We normally like to wait until children are at least five years old before we undertake prominent ear correction and that’s for a multitude of reasons. Firstly, we like to make sure that the child themselves, wants the surgery and is in control of the timing of it. And secondly, we want to make sure that the child is mature enough, to be able to cope with these rather large head bandages. We understand that many parents are anxious to have prominent ears corrected before a child starts school, but in our experience, it’s better that the child is in control of the timing of the surgery. Do a lot of children choose to go ahead with the surgery? Well, it’s different for every child and every family, but what’s really important is that we listen to what the children are telling us to see whether it’s right for them to have the operation, whether it is the right time for them to have the operation, if at all. Are there any more questions that you have for me today? No, thank you for filming with us today. Oh, you’re very welcome. It’s been lovely to meet you both, today. Thank you very much. Thank you.

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