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Acquired Ear Lobe Clefts – Information for GPs

Referral criteria / commissioning position

NHS Scarborough and Ryedale CCG will routinely commission the immediate surgical repair of completely split ear lobes that have occurred as a result of direct trauma or violence.

NHS SRCCG IFR Panel will consider requests from secondary care consultants to commission surgical repair of rare cases of congenital cleft earlobes or cleft ear (pinna).

NHS SRCCG will not routinely fund surgical repair of acquired ear lobe clefts because this is considered a cosmetic procedure. This indication includes:

  • partially split lobes (i.e. where the split does not reach the edge of the lobe)
  • elongated holes in lobes
  • a split that recurs after a previously repaired earlobe has been pierced

Before surgical repair patients must be given pre-operative advice regarding:

  • likely surgical success rate
  • individual risk of keloid and hypertrophic scarring at this site
  • risks of further trauma with re-piercing of the ear lobule

Patients who are not eligible for treatment under this policy may be considered on an individual basis where their GP or consultant believes exceptional circumstances exist that warrant deviation from the rule of this policy. Individual cases will be reviewed as per the CCG policy.

Investigations prior to referral


Information to include in referral letter

  • Details of how the patient meets the above criteria OR demonstrates clinical exceptionality
  • Impact on activities of daily living
  • Treatments and interventions tried including the results
  • Drug history (prescribed and non-prescribed)
  • Relevant past medical/surgical history
  • Current regular medication
  • BMI
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