Stahl Ear Deformity

The Stahl ear deformity occurs when an extra crease or fold is present in the cartilage of the ear. This extra fold extends through to the helical rim and tends to give the ear a prominent appearance and often a pointed shape. Some people have described the ear as looking elfish. To appreciate the changes caused by the Stahl ear deformity first look at the anatomy of the normal ear.

Normal Ear Anatomy

The normal antihelix splits into the superior and inferior crus, giving the antihelix a curved Y-shape.

The normal antihelix splits into the superior and inferior crus, giving the antihelix a curved Y-shape.

Stahl Ear Anatomy

The antihelix, outlined in RED, splits into the superior and inferior crus, giving the antihelix a curved Y-shape.

The antihelix, outlined in RED, splits into the superior and inferior crus, giving the antihelix a curved Y-shape.

Note how the extra crease (BLUE ARROWS) rolls out the outer rim of the ear giving the ear a pointy appearance.

Note that the third crus (extra fold in the ear) extends to the edge (helical rim) causing the ear to look pointed. If detected in the first month of life, the Stahl deformity can be treated effectively with ear molding. If not caught in the first two months of life, the treatment for Stahl’s ear is to have a surgery called otoplasty.

The cartilage of the ear is very soft and weak before age five, so we usually wait until after five years of age to let the cartilage strengthen and increase the chance that the otoplasty will be successful. The key to this procedure is complete excision of the abnormal, third crus.

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Dr. Derderian

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