There are many types of ear anomalies that may be present at birth (congenital ear deformities). These can be broken down into 2 major groups based on how they are treated. Ear malformations occur when there are missing elements of the ear. These conditions typically require surgical correction later in life.
In ear deformities, or deformations, all parts of the ear are present, but they may be abnormally shaped or positioned, or have abnormal folds. Some of these conditions may self-correct over time, but others may not. These types of ear anomalies may be corrected non-surgically during infancy by a process called ear molding.
What is ear molding?
Ear molding is a treatment technique used during infancy to mold deformed ears into a normal shape. Ear molding has been applied to a variety of congenital ear deformities with excellent results. Ear deformities that can be corrected with ear molding include protruding or prominent ears, constricted/lop/cup, Stahl’s ear, cryptotia, deformities of the outer rim of the ear, also called helical rim deformities, or a combination of these deformities.
How does ear molding work?
Ear molding works best in the first few weeks of life when infant ears are soft and pliable. Infant ears have very high levels of maternal estrogen (estrogen which crossed from mother to baby while in the womb and during the birthing process). Because of the increased estrogen levels, infant ears are very moldable, soft and responsive to external molding during the first few weeks and months after birth.
By 6 weeks of age, these levels of maternal estrogen fall to normal, and the ears become more rigid and less pliable. This is why early intervention is so important. If neonatal ear deformities are recognized early enough, they can often be successfully treated by non-surgical molding, preventing the need for surgery later in life.
Because some ear deformities will self-correct over time, your child should be monitored closely for the first 7 to 10 days of life. If the shape or deformity of the ear doesn’t improve in the first week or two, non-surgical infant ear molding may be recommended as the most appropriate treatment approach.
What to expect during ear molding
Ear molding uses a combination of commercially available ear molding devices and orthodontic molding materials to reshape the ear.
First, your child will be fit with a non-surgical molding appliance. At The Children’s Hospital of Philadelphia, we use several external ear molding devices.
For the best results, the device should be applied within the first one to two weeks of life. The device is worn continuously for two weeks.
After two weeks, we will examine your child’s ear. If the deformity has not been corrected yet, a new device will be reapplied. This process is repeated every two weeks until acceptable improvement or correction is seen.
Most ears, if treated early, respond to ear molding to improve the shape of the ear. In general, the younger your child is when treatment for ear deformities is started, the shorter the duration of therapy. However, children a few months of age have been treated successfully with non-surgical ear molding.