To the Editor.—In the April issue of the Journal (125:482-483, 1973), Meinhard Robinow, MD, and Alex F. Roche, MD, have done a most useful service in pointing out five factors that can contribute to an impression that a child's ears are low-set. But how does one define when the head is extended? Extension can be produced by extension of the head on the neck or by extension in the neck itself.
The trouble arises because the external auditory meatus enters into the ordinary anthropometric definition of the head being in a "normal" or vertical position. Neither Joseph and Dawbarn1 nor Smith2 solve this problem.
Can we use a line from the inion to the subnasal point and say that when this is horizontal, the face is vertical? This definition has the disadvantage of linking a bony point to a soft tissue point but is the best way