Prominent ears is a common congenital anomaly affecting approximately
5 percent of the general population. The etiology has been attributed
to three basic deformities in the ear structure: valgus of the concha
with a cranioauricular angle greater than 40 degrees, under-folding of
the anthelix, and rarely, hypertrophy of the concha. It is believed t
hat by virtue of its insertion onto the ponticulus, the cranial surfac
e of the concha, the posterior auricular muscle may function to pull t
he auricle back toward the head. A proximally (anteromedially) displac
ed insertion site would decrease the length of the effective momentum
of the muscle, leading to protrusion of the auricle. This study was co
nducted to determine if indeed a relationship between the posterior mu
scle insertion site and ear projection could be established clinically
by measuring these parameters intraoperatively in patients presenting
for otoplasty and in patients without prominent ears who required con
chal cartilage grafts for other procedures.