Ear Molding

What are
ear deformities?

When the babies are in the womb, low positioning or compression may cause the ears the get deformed given how soft the cartilage is at this moment. Ears may appear squished or constricted or even prominent and sticking out from the head.

Ear deformities come in a wide variety of shapes and severities. Some may be so mild at first, that only a well-trained eye can spot it. Others are so apparent that they are difficult to not notice and can obviously be a source of teasing one day. Non-surgical ear molding can benefit patients with any and all ear deformities, provided treatment is initiated early. Here are some of the most common deformities seen in infants:

Ear Deformities, Microtia in Infants | Non-surgical ear molding NJ

Stahl Ear

The upper portion of the ear is pointed causing a “Spock” or “Elf” appearance. Compared to a typical ear the helical rim is not continuous and there is a fold running up from the anti-helix. This creates a triangle shape to ear which is strange looking (although maybe cute at first).

Ear Deformities, Microtia in Infants | Non-surgical ear molding NJ

Lidding

Rather than being pointed like in Stahl ear or curved as expected, lidding results in downward folding of the upper part of the ear. The helical cartilage flops over making it hard to see the upper part of the anti helix.

Ear Deformities, Microtia in Infants | Non-surgical ear molding NJ

Helical Rim Deformity

These deformities vary in appearance; they affect the outer most rim of the ear known as the helix. The rim will often appear compressed or squished. The ear doesn’t have the typical round shape that is considered anatomically ideal.

Ear Deformities, Microtia in Infants | Non-surgical ear molding NJ

Cup Ear

This deformity often has a striking appearance where the entire ear appears to be rolling in on itself. The ear often sticks out and the deformity is readily visible.

Conchal Crus

An atypical fold of cartilage divides the conchal bowel and can limit the use of in-ear headphones in the future. This may also cause the ear to be stick out more than usual (see prominent ear).

Prominent Ear

This is sometimes referred to as dumbo ear, the ears stick out further than usual and often results in teasing at school. Surgical correction may be the only option if not addressed early.

Cryptotia

The upper part of ear cartilage is tucked under the scalp skin; this can limit the use of eyeglasses in the future because the sulcus where glasses would normally sit is not well defined and lacks the space for the glasses to sit comfortably. Cryptotia is interestingly, one of the ear molding problems that can be fixed even several months later.

While these deformities can occur independently, we often see a combination of these deformities that can often be corrected simultaneously with non-surgical ear molding. The key to obtaining the best outcome possible is starting treatment early. However, treatment options exist for older children and adults with concerns about their ear shape.

How long do we have until we need to start ear molding?

The plasticity (moldability) of our ear cartilage is very high when we are born, and it decreases rapidly until plasticity is pretty much completely lost by the age of 4-6 months. It is for this reason that any concerns about your baby’s ear shape should be brought to our team’s attention as soon as possible.

The plasticity (moldability) of our ear cartilage is very high when we are born, and it decreases rapidly until plasticity is pretty much completely lost by the age of 4-6 months. It is for this reason that any concerns about your baby’s ear shape should be brought to our team’s attention as soon as possible. Ideally, ear molding, which is the gold standard treatment for ear deformities, is started before 3 weeks of age. We have seen parents bring in infants as young as 2 days old for ear molding, but we have also treated patients older than 3 weeks old with success. Before 3 weeks of age ear cartilage plasticity is very high and remains high for the duration of treatment, which is typically 4 weeks when initiated early. Once an infant is older than 3 weeks, treatment duration may need to be longer (6-7 weeks( , or an infant may be ineligible for ear molding. Early initiation of ear molding is ideal for 3 main reasons:

01

Higher likelihood of a good outcome

As previously mentioned, ear cartilage plasticity is highest at birth and decreases rapidly with age. Research conducted by our own team and other research groups around the world suggests that outcomes are the best when treatment is stared before infants reach 3 weeks of age. However, recent research conducted by our team has shown that parents are happy with even modest improvements in ear shape when treatment is initiated late.

02

Shorter treatment needed

Because cartilage plasticity decreases with age, older infants who are still candidates for ear molding are typically treated for 6 or more weeks instead of the 4 weeks done for younger infants. Extending the treatment can increase the effectiveness of treatment for older infants but may be annoying to keep on for a long time.

03

Easier to maintain

The ear molding device is secured with medical tape and must be kept on 24 hours a day for the duration of treatment. As infants become older and begin to actively explore the world, they are more likely to pull or knock the device off. While this is not pain for the infant, it does require the device to be put back on, often by the healthcare team that is overseeing treatment. If this happens often, it can be a burden for parents. In our experience, this tends to happen much less with younger infants who sleep most of the day.

Ear molding is a safe and effective, non-surgical treatment option for ear deformities that is covered by most insurances. Early identification and treatment initiation increases the efficacy and ease of treatment. While infants under the age of 3 weeks are the ideal candidates for ear molding, older infants still have many options available. Parents who are concerned about their baby’s ear shape should schedule an appointment with an ear shape specialist as soon as possible to maximize treatment ease and effectiveness. While toddlers and adults may be too old for ear molding, other options may be available to those who are concerned about their child’s or their own ears. Our all-star team of ear shape specialists are happy to speak with you and help you explore potential options.