Ear deformities are not rare in newborns and there are many variations of them. Given the complexity of how the ear forms from six separate cartilage islands in utero, it is no surprise that there are going to be birth defects associated in their shape. It is well known that some neonatal ear forms can be reshaped by early modeling of the ear cartilage. The question is how early does neonatal ear reshaping need to be started to be most effective.
In the January 2012 issue of the Journal of Plastic, Reconstructive and Aesthetic Surgery, a paper was published entitled ‘A Prospective Study on Non-Surgical Correction of Protruding Ears: The Importance of Early Treatment’. In this paper, a study of 209 ears in 132 babies was done using a splint in the scaphal hollow in combination with tape (Earbuddies). Treatment continued until the desired shape was obtained visually. Roughly 20% of the ears treated (27 patients) had to stop treatment due to skin irritation or device fixation problems. In those that completed treatment, results were judged as good in 1/3 fair in 1/3, and poor in 1/3. The effectiveness of ear splinting decreased with the age of initiation with mainly poor results after six weeks of age. Older children needed to be splinted longer.
It is not uncommon to get contacted by a mother sometime in the first month or two after birth about their infant’s ear deformity. They want to know if it is too late to start ear molding therapy. While it is known that the ear cartilage becomes stiffer quickly as the infant grows, it has never been specifically determined at what age is too late to begin treatment. This study shows that when considering device molding therapy for misshapen ears, a reasonable chance of success can only be offered to parents of children up to six weeks of age.
Even when beginning ear molding at the right time, a certain percentage (about one-fifth) of patients will not be able to have a successful result due to problems with tape irritation and instability of the device. But for those infants that complete the therapy successfully, they have a significant chance of avoiding the need for otoplasty surgery later in life.
Dr. Barry Eppley
Indianapolis, Indiana