Abnormal pinna morphology Question mark ear Cosman ear Question mark ears Constricted ear Cleft between the helix and the lobe. Question mark ear UMLS:C3888103 Relatively few cases have been reported. Variation from a small notch to complete separation of the helix from the lobe is noted, there may be unilateral or bilateral involvement. The lobe is relatively laterally recessed compared to the upper portion of the ear and the scapha may be absent. This is distinct from a Cleft helix where the cleft is within the helix.