Ear Protrusion

Definition Protrusion of each ear is measured as the angle subtended from the posterior aspect of the pinna to the mastoid plane of the skull.

Landmarks Measure between the posterior aspect of the pinna and the mastoid plane of the skull. The zero mark of the protractor is placed above the point of attachment of the helix in the temporal region, and its straight side is pressed against the subject's head. The extent of the protrusion is indicated on the curved side of the protractor (Fig. 7.60).

Instruments Transparent protractor.

Position The head should be held erect with eyes facing forward.

Alternative A linear measurement can be made with a tape-measure, calipers, or transparent ruler if a protractor is not available. If the greatest linear distance between the external ear and the temporal region of the

Figure 7.60 Measuring ear protrusion.

Angle

Figure 7.60 Measuring ear protrusion.

skull is more than 2 cm, then excessive protrusion of the ear is considered to be present.

Remarks Ear protrusion values are shown in Fig. 7.61. Ear protrusion generally indicates weakness of the posterior auricular muscles, as in a myopathy. By contrast, a lop ear denotes weakness of the superior auricular muscles, and a cup ear generally reflects weakness of all three external auricular muscles.

Pitfalls Several measurements should be taken in order to ascertain the maximum angle or maximum distance between the ear and the mastoid area.

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