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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 24
| Issue : 1 | Page : 22-26 |
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The public awareness of protruding ears and its management in Saudi Arabia
Badi Aldosari1, Mohammed Khan2, Mohammed Alkarzae3, Atheer Abdulaziz Alzubaidi4, Johara Abdulkarim5, Bayan Alsharif6
1 Department of Otorhinolaryngology, Head and Neck surgery, Facial Plastic, Riyadh, Saudi Arabia
2 Department of Otorhinolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
3 Department of Otorhinolaryngology, Head and Neck surgery, Facial Plastic, Security Forces Hospital, Riyadh, Saudi Arabia
4 Department of Otorhinolaryngology, Head and Neck surgery, Maternity and Children Hospital, Makkah, Saudi Arabia
5 Family Medicine academy, Makkah, Saudi Arabia
6 Department of General Surgery, Security Forces Hospital, Makkah, Saudi Arabia
| Date of Submission | 20-Dec-2021 |
| Date of Decision | 28-Dec-2021 |
| Date of Acceptance | 22-Jan-2022 |
| Date of Web Publication | 30-Mar-2022 |
Correspondence Address:
Dr. Atheer Abdulaziz Alzubaidi
Department of Otorhinolaryngology, Head and Neck surgery, Maternity and Children Hospital, Makkah
Saudi Arabia
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/sjoh.sjoh_49_21
Background: Protruding ears are a well-known auricular deformity characterized by dominant autosomal inheritance A corrective surgery for protruding ears was developed with positive postoperative outcome. Currently, there has been no research conducted in Saudi Arabia to assess the public's awareness of protruding ears and its management. Materials and Methods: This observational cross-sectional study of 1002 participants distributed through electronic questionnaire in the Arabic language. By taking advantage of social media, the study represents the population in different regions. It was used to estimate the awareness of protruding ears among the public in Saudi Arabia. Results: 42.7% of the participants were aware of protruding ears. The most common sources of awareness were the Internet (37.4%), social media (33.2%), and brochures/scientific journals (17.6%). Awareness about protruding ears was observed more among participants working in a medical field than those working in a nonmedical field (58.9% vs. 34.6%, P < 0.001). Most of the participants who were aware of the protruding ears (70.6%) were aware of the cosmetic surgery option to repair protruding ears. The Internet (41.3%) and social media (37.1%) were the most reported sources of hearing about cosmetic surgery for repair of protruding ears. The majority of who had heard of the cosmetic surgery were working in the medical field (82.3%). Conclusions: Our study is the first to demonstrate the public awareness about protruding ears and its management. The results showed that there is a lack of awareness about the disorder and its management in Saudi Arabia. We recommend increasing the efforts to raise the awareness in the population.
Keywords: Awareness, cosmetic, ear anomalies, ear deformities, otoplasty, protruding ear
How to cite this article:
Aldosari B, Khan M, Alkarzae M, Alzubaidi AA, Abdulkarim J, Alsharif B. The public awareness of protruding ears and its management in Saudi Arabia. Saudi J Otorhinolaryngol Head Neck Surg 2022;24:22-6 |
How to cite this URL:
Aldosari B, Khan M, Alkarzae M, Alzubaidi AA, Abdulkarim J, Alsharif B. The public awareness of protruding ears and its management in Saudi Arabia. Saudi J Otorhinolaryngol Head Neck Surg [serial online] 2022 [cited 2023 Jun 4];24:22-6. Available from: https://www.sjohns.org/text.asp?2022/24/1/22/341364 |
| Introduction | |  |
Protruding ears is a well-known auricular deformity and the most common congenital deformity of the ear. It is characterized by dominant autosomal inheritance with varying degrees of penetrance and is commonly caused by two developmental defects: over-development of the conchal wall and underdevelopment of the antihelical fold.[1] Protruding ears can also cause negative psychological and social impacts. For example, in Germany, it was found to be the most common auricular deformity for which patients sought consultation.[2]
Fortunately, there are several techniques which have been described to correct this deformity that provide excellent postoperative outcomes,[2],[3] including corrective surgery.[4] Many surgeons prefer to operate on children between the age group of 3 and 6 years old to limit social impact, psychological distress, and emotional problems such as anxiety and depression, all of which not only intensely affect a child, but also which tend to increase in intensity and persistence as the child gets older.[4] Another study revealed that most children requested the corrective operation because of psychological and social reasons, and 10% of the children studied had previously been referred to child psychiatric care.[5]
When the child behavior checklist was applied to children with protruding ears during both the preand postoperative periods, there were statistically significant decreases in scores in the domains of anxiety and depression, social problems, difficulties in thinking, and total behavioral problems; and near-significant decreases in scores for attention problems and aggressive behavior.[6],[7],[8] The social impact of the surgery was positive, providing confidence, and it reduced bullying in school, which therefore raised overall academic achievement and performance.[7] Klassen et al.[9] demonstrated improvement in the quality of life after corrective surgical treatment. Sarwer et al.[10] reported improvements in self-esteem and minimization of psychosocial anxiety after corrective surgery in individuals with prominent ears.
There has been no research conducted in Saudi Arabia to assess the population's awareness of protruding ears and its management. Because of its importance on an individual's quality of life and its psychosocial impacts, we aimed to gauge the public's awareness of protruding ears in Saudi Arabia.
| Materials and Methods | | |
Study design
This was an observational cross-sectional study using an electronic questionnaire in the Arabic language. The questionnaire distributed through social media, 1002 participants responded to the questionnaire who represented the population in different regions of Saudi Arabia. The questionnaire was written in English and validated, then translated to Arabic. The goal of the study was to discover the awareness of protruding ears among the public.
Statistical analysis
Results were analyzed using the Statistical analysis was performed by using statistical package for social sciences, IBM SPSS® v21 (IBM, Armonk, New York).
Statistical analysis performed using basic statistical measurements. In our data tables, numeric data presented as mean ± standard deviation or as median and range according to the type of distribution of each variable. For categorical variables, percentages are used. Chi-squared tests are used for the categorical values.
Questionnaire
Demographic data:
1-Aga (number)
2-Gender
3-City
4-Reigons:
5-Educational level:
- Noneducated
- Elementary
- Middle
- Secondary
- Graduated
- Diploma
- Bachelor
- Higher learning
- Master
- Ph. D
6-Working field:
- Educational field
- Health field
- Others.
7-Economical status:
- <5000 SR
- Between 5000 and 15,000 SR
- More than 15,000 SR
Questions defined your level of awareness about protruded ear.
8-Have you ever heard about protruded ear?
9-If your answer is yes, from where did you hear it?
- Internet
- Social media
- Newspapers
- Scientific journals
- Others
10-have you ever heard of cosmetic treatment for protruded ear
without affecting the hearing?
11-If your answer is yes, from where did you hear it?
- Internet
- Social media
- Newspapers
- Scientific journals
- Others
12-Do you have a family members/friends with protruded ear?
If yes, mention of relation (.)
13-Have you diagnosed with protruded ear?
If YES, ist
14-Did it affect your life?
15-Did you go to the doctor for consultation about protruded ear?
16-Did you know there is cosmetic treatment for protruded ear without
affecting the hearing?
17-Did you do the surgery for protruded ear?
18-Did it affect your life after the surgery?
| Results | | |
Awareness about protruding ears
42.7% of the participants were aware of protruding ears [Figure 1]. The most common sources of awareness were the Internet (37.4%), social media (33.2%), and brochures/scientific journals (17.6%) [Figure 2]. | Figure 2: Sources of awareness about protruding ears among the participants (n = 428)
Click here to view |
Of the participants who were aware of protruding ears, over half (56.8%) were aged over 55 years, and 32.7% were 45–55 years old (P = 0.003). Females were more aware compared to males about protruding ears (47.3% vs. 35.9%) (P < 0.001). The highest rate of awareness of protruding ears reported among participants from Al-Madinah (53.5%), whereas the lowest rate observed among those from Jazan (12.2%) (P < 0.001). Awareness about protruding ears was predictably higher among participants working in the medical field than those working in a nonmedical field (58.9% vs. 34.6%) (P < 0.001). Postgraduate participants were more aware of protruding ears than those who had an education level below secondary school (58.5% vs. 15.4%) (P < 0.001). Participants whose income exceeded 10,000 SR/month had the highest protruding ears awareness rate (53.2%), whereas those whose income ranged between 5000 and 10,000 SR/month had the lowest rate (38.1%) (P = 0.002).
Regarding the awareness of cosmetic surgery to correct protruding ears, the majority of the participants who were aware of the condition (n = 428; 70.6%) were also aware of the corrective surgical option [Figure 3]. Internet (41.3%) and social media (37.1%) were the most reported sources of hearing about cosmetic surgery for repair of protruding ear. The majority of those working in a medical field (82.3%) compared to 61.8% of those not working in a medical field were aware of that. Other studied factors (age, gender, educational level, region of residence, and income) were not significantly associated with the awareness about cosmetic surgery of treatment of protruding ear. Almost one-fifth of the participants (21.3%) reported family history of protruding ear among relatives or friends whereas personal history mentioned by 4.8% of the participants; mostly in both ears (79.2%). More than a third of affected subjects (39.6%) claimed affection of their life by protruding ear and only 22.9% of them consulted physicians for the problem. More than half of them (52.1%) were aware of the existence of a cosmetic surgery for repairing the problem and only 14.6% of them underwent the operation. Most of those performed cosmetic surgery (71.4%) reported positive influence on their life. | Figure 3: Awareness of surgical treatment among those aware about protruding ear (n = 428)
Click here to view |
| Discussion | | |
The current study is the first to demonstrate the public awareness of protruding ears and its management in Saudi Arabia. To date there is no published studies in the literature about awareness of protruding ears to compare it to our present study. Since many studies demonstrated the negative impact of protruding ears on the social and psychology of people having protruding ears and the positive impact of the surgical management on their quality of life, We believe that conducting study to estimate the level of awareness in the population is the first step to highlight the importance of the social and psychological impact of the protruding ears on the affected persons and to increase the awareness of the disorder and the importance of its management. Obviously, the Internet and social media play a major role as a source of awareness for protruding ears and its surgical management. They were the most reported sources among the aware participants. The study results show there is a lack of awareness about the disorder and its management. There was statistically significant difference in the awareness about protruding ear and its surgical management in [Table 1], among participants working in the medical field and those not working in the medical field. Participants not working in the medical field were less aware; making the overall awareness in the population less if, the participants working in the medical field excluded. Participants holding bachelor degree and higher were more aware. Higher education level was associated with higher awareness as the results demonstrated that participants holding high school degree and below were less aware. Income of participants was a factor associated with higher awareness; participants' income exceeded 10,000 SR/month had the highest protruding ear awareness rate (53.2%) as summarized in [Table 1]. Further studies need to be conducted to study the prevalence of the protruding ears in our population and to study its impact on the affected population. We recommend increasing the efforts by health practitioners to increase the level of awareness of the disorder, its impact and its management through different platforms, especially the Internet and social media as the study demonstrated they were the most reported source of awareness among participants.
| Conclusions | | |
Our study is the first to demonstrate the public awareness about protruding ears and its management. The results showed there is a lack of awareness about the disorder and its management in Saudi Arabia. We recommend increasing the efforts to increase awareness of the population.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 2. | Heppt W, Trautmann Y. Otoplastic techniques for the correction of protruding ears. HNO 1999;47:688-94. |
| 3. | Nazarian R, Eshraghi AA. Otoplasty for the protruded ear. Semin Plast Surg 2011;25:288-94. |
| 4. | Janz BA, Cole P, Hollier LH Jr., Stal S. Treatment of prominent and constricted ear anomalies. Plast Reconstr Surg 2009;124:27e-37e. |
| 5. | Bradbury ET, Hewison J, Timmons MJ. Psychological and social outcome of prominent ear correction in children. Br J Plast Surg 1992;45:97-100. |
| 6. | Songu M, Kutlu A. Long-term psychosocial impact of otoplasty performed on children with prominent ears. J Laryngol Otol 2014;128:768-71. |
| 7. | Gasques JA, Pereira de Godoy JM, Cruz EM. Psychosocial effects of otoplasty in children with prominent ears. Aesthetic Plast Surg 2008;32:910-4. |
| 8. | Niemelä BJ, Hedlund A, Andersson G, Wahlsten VS. Prominent ears: The effect of reconstructive surgery on self-esteem and social interaction in children with a minor defect compared to children with a major orthopedic defect. Plast Reconstr Surg 2008;122:1390-8. |
| 9. | Klassen A, Fitzpatrick R, Jenkinson C, Goodacre T. Contrasting evidence of the effectiveness of cosmetic surgery from two health related quality of life measures. J Epidemiol Community Health 1999;53:440-1. |
| 10. | Sarwer DB, Pertschuk MJ, Wadden TA, Whitaker LA. Psychological investigations in cosmetic surgery: A look back and a look ahead. Plast Reconstr Surg 1998;101:1136-42. |
[Figure 1], [Figure 2], [Figure 3]
[Table 1]
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