Late Presenting Ear Molding: Nicholas Bastidas, MD
It’s not unusual for me to see babies who are older then 3 weeks old when they first come to our clinic for ear molding. Parents often express frustration that they didn’t know about it and that their pediatricians didn’t tell them about this possibility. Ear molding is a relatively new technique, having really only gained popularity in the last 7 years. Many pediatricians are just now becoming familiar with this technique and some even say that it feels awkward bringing it up to families. Some even have said patients have been insulted but he suggestions that their “child isn’t perfect”. Many state they now only bring it up if parents mention it first.
All that being said, ear molding can still be done in older infants with good success. In particular, constricted ear stahl ear, cryptotia and conchal crus deformity can all be helped with ear molding even in babies older then 3 weeks. I have had success molding infants as old as 3 weeks however, i find it can be much more difficult. The data suggests that extended periods of molding must be done (6-8 weeks instead or 3-4). Older infants are also more alert and therefore more likely to remove the ear molds since they are more aware of their environment. Ear molds in older infants need more maintenance and are more likely to fall off. I usually reinforce these molds with extra tape to help prevent dislodgement.
Late Presenting Prominent Ear
Prominent ear is the most difficult to mold and in my opinion may be due to some intrinsic genetic predisposition to having softer cartilage. I find my results with prominent ear to not be as significant as with other ear deformities and these babies may end up needing otoplasty in the future. Lidding may also be more difficult in older infants as the tendency to relapse is high.
When babies present late a careful analysis and discussion is performed to determine the best way to do the ear molding. Parents must commit to visit us every 2-3 weeks for modification of the ear molds and maintenance. Over 80% satisfaction has been noted with late presenting ear molding patients based on a recent study that we did.
We offer ear molding in our NJ and NY offices for our patients and are in-network and par with most major medical insurances.