Ear Length

Definition Maximum distance from the superior aspect to the inferior aspect of the external ear (pinna).

Landmarks Measure from the superior aspect of the outer rim of the helix to the most inferior border of the earlobe or pinna (Fig. 7.55).

Instruments Tape-measure or transparent calibrated ruler.

Position The head should be held erect (in the resting position) with the eyes facing forward. The head should not be tilted forward or backward. The facial profile should be vertical and the patient viewed from the side.

Alternative A young infant or child can be held prone with the head turned to one side.

Remarks Ear defects are important in syndrome diagnosis, particularly in the newborn infant. Small ears have been found to be a consistent clinical characteristic of Down syndrome and are the most clinically apparent malformation in Treacher Collins syndrome and hemifacial microsomia. External ear abnormalities are common in the 22q11.2 microdeletion syndrome. Ears are often protuberant in the presence of a myopathy. The ear is one of the few organs that continue to grow during adulthood. It is

Figure 7.55 Measuring ear length.

Figure 7.55 Measuring ear length.

Earring Length Measurement

mainly an increase in length, since ear width changes little after 10 years of age. The ear is generally longer in males than in females. The sex difference increases with age. Charts of ear length from birth to 16 years of age are presented in Figs. 7.56 and 7.57.

Pitfalls In the presence of a posteriorly rotated ear, the measurement should still be taken from the most superior portion of the helix to the inferior portion of the pinna, even though the axis of this measurement is not in the vertical plane. If the superior aspect of the helix is overfolded, do not unfold it to measure the length.

t 30

Head Circumference Gestational Age

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Gestational age (weeks)

Figure 7.56 Ear length, both sexes, at birth. From Merlob et al. (1984), by permission.

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Gestational age (weeks)

Figure 7.56 Ear length, both sexes, at birth. From Merlob et al. (1984), by permission.

Figure 7.57 Ear length, both sexes, birth to 16 years. From Farkas (1981) and Feingold and Bossert (1974), by permission.

Age from birth (years)

Figure 7.57 Ear length, both sexes, birth to 16 years. From Farkas (1981) and Feingold and Bossert (1974), by permission.

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