"Low-set ears" is a term commonly used in the description of various malformation syndromes (Table). Perhaps many pediatricians think they "know low-set ears when they see them." Those who are less certain of their judgment or who demand greater precision will be dismayed to discover that there are no generally accepted criteria and no norms.
Objective assessment of ear position should be based on the level of the external meatus, so that size and shape of the auricle do not enter into the determination. One can now ask, "Is the external auditory meatus lowset?" and next, "In relation to what?"
The meatus is attached to the lateral edge of the cranial base, between the petrous and tympanic portions of the temporal bone. While the level of attachment of the meatus to the cranial base cannot vary a great deal, the relationship of the meatus to other cranial landmarks