The auricles also have an effect ____ facial appearance. In Western societies, protruding ears (present ____ about 5% ____ ethnic Europeans) have been considered unattractive, particularly if asymmetric. The first surgery to reduce the projection ___ prominent ears was published ____ the medical litreature ___ 1881.
The ears have also been ornamented ____ jewellery for thousands ____ years, traditionally by piercing ___ the earlobe. ____ some cultures, ornaments are placed to stretch and enlarge the earlobes to make them very large. Tearing ___ the earlobe from the weight ___ heavy earrings, or from traumatic pull ___ an earring (___ example by snagging on a sweater being removed), is fairly common.
A cosmetic surgical procedure to reduce the size or change the shape ___ the ear is called an otoplasty. ____ the rare cases when no pinna is formed (atresia), or is extremely small (microtia) reconstruction ___ the auricle is possible. Most often, a cartilage graft ___ another part ___ the body (generally, rib cartilage) is used to form the matrix ___ the ear, and skin grafts or rotation flaps are used to provide the covering skin. However, when babies are born ___ an auricle on one or both sides, or when the auricle is very tiny, the ear canal is ordinarily either small or absent, and the middle ear often has deformities. The initial medical intervention is aimed ____ assessing the baby’s hearing and the condition ____ the ear canal, as well as the middle and inner ear. Depending ____ the results of tests, reconstruction ____ the outer ear is done in stages, with planning for any possible repairs of the rest ____ the ear.