Stahl’s ear

Stahl’s ear deformity consists of an extra cartilage fold in the middle (scapha) portion of the ear. This results in a pointy ear shape. Stahl’s ear is a defect that babies are born with.

If Stahl’s ear is treated very early in life (first 8 weeks of life), it can be corrected with the use of a mold that the patient wears for a couple of months. In older children, molding is not as effective. Surgical correction of a Stahl’s ear deformity is then required. This is typically performed when the child is around 7-10 years old.

Figure 1. Stahl’s ear deformity (before and after ear moulding)

Stahl’s ear cause

Stahl’s ear is caused by misshapen cartilage. But the exact reason that this occurs is unclear. Stahl’s ear is characterized by an extra horizontal fold of cartilage (crus). Normally, there are two: superior and inferior. In Stahl’s ear, there is a third horizontal crus. The helix (or upper portion of the ear) may uncurl, giving the ear a pointed shape.

What are the symptoms of Stahl’s ear?

Other than the physical appearance of the ear, there are no other symptoms associated with Stahl’s ear. Affected children usually have normal hearing.

Stahl’s ear treatment

If Stahl’s ear is discovered in the first few weeks to months after birth, ear molding may correct this deformity and avoid the need for surgery. Infants’ ears are still soft and flexible, which makes them responsive to molding. Like many other conditions in which ear molding is useful (such as cryptotia, constricted ears and protruding ears), the earlier the intervention, the shorter the treatment. Early treatment also often leads to better outcomes.

In older children, surgical correction is necessary to correct the deformity. Surgery to correct Stahl’s ear involves reshaping, repositioning and suturing the abnormal cartilage to reverse the pointed shape of the ear. Although a general anesthetic is needed, the operation is done on an outpatient basis and your child will be able to return home the same day.