Ear shape abnormalities are one of the most common congenital deformities, and affect 4-5% of the population. Embryologically ears are complicated structures that form in the first 18 weeks of development from the coalition of six separate ‘hillocks’. So it’s not surprising that sometimes Mother Nature doesn’t get them quite right.
It’s been known for years that it is possible to mold the ears of newborns to address misshapen ears using tape, foam, wire and plastic tubing, but until recently there has not been a simple or reliable way to treat misshapen ears without surgery. Now there are, and these methods can be used in the first weeks of life to treat misshapen or deformed ears to save the need for future surgery.
Is ear molding effective?
Yes, if started early. Plastic surgeons around the world are in agreement on this. Dr Steve Byrd’s results with 831 infant ears with the EarWell system were published in 2010 in the Plastic and Reconstructive Surgery Journal, and the article concluded:
“Congenital ear deformities are common and only approximately 30 percent self-correct. These deformities can be corrected by initiating appropriate molding in the first week of life. Neonatal molding reduces the need for surgical correction with results that often exceed what can be achieved with the surgical alternative.”
Byrd HS, Langevin CJ, Ghidoni LA. Ear molding in newborn infants with auricular deformities. Plast Reconstr Surg 2010 Oct; 126(4):1191-200
British surgeon Dr Andrew Linford published on splinting of ear deformities in the British Medical Journal in 2007 and stated:
“Postpartum splinting can completely correct congenital ear deformities and obviate the need for later surgery.”
Lindford AJ, Hettiaratchy S, Schonauer F. Postpartum splinting of ear deformities. BMJ 2007;334:366
New Zealand plastic surgeon Dr Swee Tan concluded in the New Zealand Medical Journal that it:
Ear molding “is an effective treatment strategy that will largely negate the need for surgical correction of deformational auricular anomalies”.
Tan S, Wright A, Hemphill A, Ashton K, Evans J. Correction of deformational auricular anomalies by moulding, NZMJ 2003 Vol 116 No 1181
Ear molding can treat prominent ears, cup ear, lop ear, mixed ear deformities, Stahl’s ear, helical rim abnormalities and cryptotia.
At what age should ear molding be started?
Ear molding should be started as early as possible as the younger an infant is, the more malleable their ears are, and the better the ears respond to molding. Ear cartilage is very pliable immediately after birth, but becomes more elastic and firm within a few days of birth. This is attributed to high oestrogen levels in the newborn infant, which are high at birth due to the high maternal oestrogen levels during pregnancy, but fall rapidly in the first six weeks of life. The elasticity of ear cartilage is increased by oestrogen, because oestrogen increases the amount of hyaluronic acid, which increases the proteoglycan concentration in the cartilage.
What duration of ear molding is required?
The duration of molding varies according to the age of the child and the degree of molding required. The earlier that molding is commenced the higher the likelihood of a successful outcome and the shorter the duration of molding required. It has been suggested that babies who are breastfed may require a longer period of molding than those who are bottle fed, because the ear cartilage remains malleable for longer, but there is no published evidence on this.
“Auricular deformities can be corrected nonsurgically in the early neonatal period (1st week after birth), obtaining satisfactory results with minimal cost and without discomfort.”
Matsuo K, Hayashi R, Kiyono M, Hirose T, Netsu Y. Nonsurgical correction of congenital auricular deformities. Clinics in Plastic Surgery. 1990; 17, 2: 383-395