• Vol. 37 No. 5, 383–389
  • 15 May 2008

Auricular Anthropometry of Newborns at the Singapore General Hospital



Introduction: External ear abnormalities accompany many syndromes and genetic conditions. Yet, there are currently limited Asian references and no local norms for ear measurements and definitions for “low-set ears”. The authors therefore describe ear measurements in a Singapore newborn population and seek to establish the applicability of the general accepted definition of “low-set ears” being that of “less than a third of the entire ear height being above the inter-medial canthal line”.

Materials and Methods: Babies managed by the Department of Neonatal and Developmental Medicine during a 3-week period were measured by 2 investigators using the Feingold and Bossert technique. Intra- and inter-rater reliabilities were calculated. The influence of various anthropometric factors on and their relationships with ear length (EL) and width (EW) was analysed.

Results: A total of 104 neonates (20% preterm at birth) were included in this study. Median gestation was 38 weeks (range, 32 to 42). Mean birth weight was 2910 ± 657 g. Mean EW and EL for term infants were 2.1 ± 0.1 cm and 3.6 ± 0.3 cm respectively, without significant differences for different-sided ears, investigators, race or gender. Mean percentage of right and left ear above the denoted line was 52 ± 9% and 47 ± 10% respectively (P = 0.000), with 3rd percentile being 33%.

Conclusions: Singaporean neonatal ears are comparable with other Asian neonates – larger than Hong Kong Chinese babies, though similar to Japanese newborns – but smaller than Caucasian neonates. The definition of “low-set ears” is consistent with the general accepted definition.

Abnormalities of the external ear are described in many syndromes and genetic conditions. Melnick et al reported an incidence of 1 in 90 births for external ear malformations and branchial sinuses and tags, with about 1 in 670 births having malformations of the pinna.

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