lowset

Low-set ears refer to a position of the external ears (pinnae) that is lower on the head than is typical. The assessment relies on the relative placement of the pinnae to facial landmarks, such as the outer canthi of the eyes or the level of the cheekbones. In newborns and infants, ear position can vary with age and head shape; a mildly low-set appearance can be a normal variant, whereas more pronounced low-set ears may be associated with developmental disorders.

Clinical significance: Low-set ears are a common clinical finding in several congenital syndromes and anomalies, but can also occur in isolation with no health impact. They are non-specific features of conditions such as Down syndrome, Turner syndrome, Noonan syndrome, DiGeorge syndrome, Kabuki syndrome, and fetal alcohol spectrum disorders; however, most individuals with low-set ears do not have a diagnosable syndrome.

Evaluation and management: When low-set ears are observed, clinicians examine for additional dysmorphic features and document family history. If other anomalies are present or there is concern for a genetic syndrome, genetic evaluation or referral to a geneticist may be offered. Audiology testing is often considered because ear and hearing function can be related. Management focuses on any associated conditions rather than the ear position itself; isolated low-set ears require no treatment.

Terminology: The term is usually written as “low-set ears” or “low-set ear” and may appear as “lowset” in some texts; the term describes ear position rather than a diagnosis.