Pediatric Pearls: Infant's Ear - Pits, Tags, and the Pinna
April 11, 2023
I have been a pediatrician for over four decades and my goal is to share some of my knowledge with you about familiar pediatric findings and conditions. A new topic for Pediatric Pearls is posted weekly post. This marks our 4th week. All posts are available by scrolling down and clinking on see all.
The Head: Bumps, Lumps and Soft Spots
The Eye Part 1: Red, Puffy, Big
The Eye Part 2: Color, Cross Eyes, Discharge
The Ear - Pits, Tags and the Pinna
The full posts are behind a paywall and costf $50 a year. Part of the cost of Pearls will go to keep The Lactation College on Substack (the free posts for learners) up and running. Our sixth semester starts next week.
When I teach residents and medical students about the physical examination of the ears of an infant, I suggest they think about 5 things to check:
Pits
Tags
Pinna (Position and Shape)
Hole
Behind
Preauricular Pits
The picture below shows an ear pit in front of the infant’s right ear. (It’s the little dot the size of a pin point.) When you find a pit, be sure a hearing screen is performed.
Preauricular Tags
This picture shows an ear tag. Tags can be comprised of skin, fat or cartilage. If you find a tag, be sure a hearing screen is performed.
The recommendation for hearing screen testing with pits and tags comes from a study published in Pediatrics in 2008. (Reference 1)
68,484 infants were screened for hearing impairments during the study period that lasted 7.5 years. The study was conducted at the Speech and Hearing Center at the Chaim Sheba Medical Center in Tel Hashomer, Israel.
637 (0.93%) of the infants had preauricular skin tags and/or ear pits.
A significantly higher prevalence of permanent hearing impairment was found among infants with preauricular skin tags or ear pits (8 of 1000), compared with infants without tags or pits (1.5 of 1000).
The authors concluded: Infants with preauricular skin tags or ear pits are at increased risk for permanent hearing impairment.