Effect of protruding ears on visual fixation time and perception of personality.

[IMPORTANCE] Protruding ears are often thought to be a stigma, supposedly drawing attention and negatively influencing the perception of personality. These purported negative effects that may indicate corrective aesthetic otoplasty in patients too young to provide informed consent have not been quantified.

[OBJECTIVE] To quantify attention directed toward protruding ears and its effect on the perception of selected personality traits.

[DESIGN, SETTING, AND PARTICIPANTS] In this observational study conducted from August 1, 2013, to October 31, 2013, visual scan paths were recorded of 20 lay observers looking at photographs of faces of 20 children (age range, 5-19 years) with either protruding ears or ears morphed via computer software to appear nonprotruding. Subsequently, the observers rated 10 perceived personality traits based on the same photographs.

[MAIN OUTCOMES AND MEASURES] Visual fixation time on protruding vs nonprotruding ears was compared and correlated with observers' scores for personality traits.

[RESULTS] Fixation time on protruding ears was significantly longer compared with that for morphed nonprotruding ears (mean [SD], 9.6% [5.6%] vs 5.8% [3.2%] of total fixation time, P = .04). The difference between the overall personality questionnaire scores and between individual scores for assiduousness, intelligence, and likeability was not significant for protruding and nonprotruding ears. Faces in which the protruding auricles received the highest percentage of visual attention scored higher than average for the overall personality scores (mean [SD], 66.09 [4.50] vs. 55.81 [13.36]) and for assiduousness (6.64 [0.74] vs. 5.59 [1.41]), intelligence (6.78 [0.74] vs. 5.83 [1.31]), and likeability (7.29 [0.47] vs. 6.28 [1.40]).

[CONCLUSIONS AND RELEVANCE] Protruding ears had the potential to draw viewers' attention but did not cause a negative perception of personality traits. This study therefore does not provide confirmatory evidence for the stigmatizing nature of protruding ears.

[LEVEL OF EVIDENCE] 3.