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In part, the look of those “big eyes” was informed by a mastoid operation that permanently damaged Ms. Keane’s hearing when she was 2.

From childhood, when a mastoid operation resulted in permanent eardrum damage and hearing loss, she had been fascinated with eyes, watching for cues to amplify what was being said.

From the mastoid they created a 2-millimeter opening — roughly the width of a spaghetti noodle — into the middle ear.

But on the right side there was something else: A mass about the size of a strawberry had destroyed much of the mastoid bone just behind her ear.

For example, a small change of direction on the mastoid process, a bony projection behind the ear, indicates whether a person has detached or attached earlobes.