Infant Ear Deformities
Infant Ear Splints
Ear molding consists of applying a custom-fit, soft plastic mold that corrects the ear deformity and holds the ear in a more normal position. Be wearing this device continuously (usually for 2-6 weeks), the ear can be reshaped to correct the deformity. The device is held in place with adhesives and tape; there is no pain to the infant during the application process. Several different ear molding devices are available ranging from those that can be applied at home to those requiring physician application.
A useful analogy is to think of an infant’s ear cartilage as wet clay. This soft, malleable cartilage can be held in a new position by the ear mold. As weeks pass, the cartilage hardens and holds its new shape. The device can then be removed while the ear shape remains permanently improved.
Nonsurgical Ear Molding
The decision to treat an ear deformity is one that should be shared among parent and physician. Treatment is aimed at restoring a more normal appearance to the external ear by reshaping any irregular cartilage. Treatment consists of both non-surgical and surgical options. The most effective non-surgical option is ear molding.
· Ear molding – the cartilage (the tissue that gives the ear its shape) of an infant differs from that of an adult. An infant’s ear cartilage may be molded into a new shape, unlike that of an adult’s. This pliability of an infant’s ear lasts only a few weeks so it is critical that the treatment be started quickly. Ear molding consists of applying a custom-fit, soft plastic mold that corrects the ear deformity and holds the ear in a more normal position.
· Surgical treatment – surgery is reserved for bothersome ear deformities that persist. Surgery is performed no sooner than 5-7 years of age, when the ear growth has neared completion. Unlike ear molding, this technique involves a plastic surgeon making an incision behind the ear and reshaping the cartilage framework.
Infant Ear Deformities
Ear deformities in infants refer to irregularly shaped ears without any functional, hearing issues. It is estimated that anywhere between 15-29% of newborns will have some degree of ear deformity. There is typically no identifiable cause for the ear deformity in the large majority of infants. Genetics as well as prenatal environmental issues may play a role. Children with ear deformities are at risk of being bullied, teased, or taunted, particularly in grade school years.
Although some of these ears will improve on their own, it is very difficult to predict which ear deformities will resolve by themselves and which will benefit from treatment. There are numerous classifications of ear deformities and multiple types many be present within a single ear. All these types reflect misshapen cartilage (the tissue that gives the ear its shape). These include:
· Prominent ear – the ear is too protrusive when looking head on.
· Constricted (Lop) ear – the top of the ear is tightly folded onto itself.
· Stahl’s ear – an extra fold at the top of the ear can create a pointed appearance
· Cryptotia – also known as “hidden ear,” the upper portion of the ear is buried under scalp skin.
Ear malformations are a more severe form of ear deformities and are much rarer. Ear malformations indicate part of the ear is absent and hearing can often be affected. Ear malformations will be discussed in another article.
The EarWell® system is an ear molding system that was developed by Dr. Byrd, a highly respected pediatric plastic surgeon. Numerous clinical studies have been performed using the EarWell® system, with a 90% success rate if applied early in an infant’s life. The system must be applied by a physician. Ideally, treatment begins within the first 2 weeks of life. Applying the EarWell® is painless for the infant. The physician will have to clip some of the hair around the ear, apply a plastic adhesive base plate, mold retractors and formers to fit your infant’s ear, and apply a breathable covering. Once applied, the parents are asked to keep the device dry and monitor it for loosening. The system should not interfere with the infant’s ability to hear or his/her language development.