The gold standard for ear molding is to start treatment before 3 weeks of age. We are currently studying to see what other factors may contribute to the effect, such as breast feeding, prematurity, the way the cartilage feels on exam, and length of treatment. We have also studies ear molding on late presenting infants (older then 3 weeks) and have seen good results when properly treated.
Prominent Ear
Ears that are prominent are visible from the front and may be a source of anxiety for children when they enter school age. Prominent ear was usually treated by surgery with a procedure called otoplasty or ear pinning. In this surgery, which can be performed under local anesthesia, the ear is numbed and then stitches are placed within the cartilage behind the ear to help fold the ear back reducing the appearance of it sticking out. This surgery is usually done by age 5/6 or whenever the child is amenable to it.
When identified early, ear molding can be used to reduce prominent ear. Prominent ear in particular must be treated with ear molding as early as possible, such as 1-2 weeks. In our experience, prominent ear is the most susceptible to relapse and therefore we may even continue the treatment for 4-6 weeks, instead of the usual 3-4 weeks. Prominent ear is corrected by placing the EarWell device, clip that will recreate the antihelical fold and thus push back the helix of the ear, and also placing there conchal former which will reduce the conchal hypertrophy. The goal is to reshape the cartilage in its new position so that as it hardens it will assume the newly created and desired shape.
Lop Ear (Folded Ear)
Lop ear or folded ear is when the helix of the ear folds over like a rabbit. There is a loss of definition of the anti helical fold and the ear does not appear to be round in shape. Sometimes the cartilage of the helix will fuse to the base of ear creating a complete loss of definition. To correct this problems, Dr. Bastidas can use the ear molding device to push the cartilage of the helix in a more superior (upward) position which will therefor create a deeper sulcus (fold) for the antihelix and helix. Approximately 4 weeks of ear molding is needed to correct this problem. We have seen success in treatment even for older infants using our unique modified technique of ear molding.
Cupped Ear
A cupped ear can appear like an ear that stick out at the bottom and top, almost like pinching the ear from the side. To fix this problem, ear molding can be used to push the top part of the ear up and the bottom part back which will also improve the overall height of the ear using the Ear Well device. Cup ear can be a difficult problem to treat and 4-6 week of treatment may be needed for optimal results.
Stahl Ear or Spock Ear or Elf Ear
Dr. Spock is a well loved character on the show star trek who had pointy ears that resembled an elf. While this looks cute on an infant, unfortunately this may be a source of teasing for an older child. Stahl ear has what looks like an extra piece of cartilage off the anti-helix which forces the abutting portion of the helix to unfold and lose definition. The result is a pointy, elf like ear. Using ear molding we an push the extra cartilage inwards to help re-define the crease while simultaneously creating a rounder, more anatomic looking ear. Stahl ear can also be improved in late presenting infants using our modified techniques for ear molding.
Conchal Eversion
When the conchal bowl sticks out if may block the hole of the ear (meatus) and create a strange appearance. A deep well defined bowl is ideal, and also important for things such as hearing aids and in ear devices to be worn without difficulty. Using the EarWell device a conchal former can be placed to push the conchal bowl cartilage inwards, deepening the space and creating good definition to this area. This can be done even in late presenting infants, and we have had success in children as old as 3 months.
Constricted Ear
A constricted ear appears crunched and its narrow do the some force that deformed the cartilage in utero. We can use ear molding to help expand the ear and improve the overall shape creating a more appearance, releasing the constriction of the ear.
Cryptotia
Cryptotia or hidden ear is when the cartilage appears hidden within the skin fo the upper ear. It can be manually pulled out to show improvement in the overall ear shape. Using ear molding, we can hold the ear in its corrected shape so that the cartilage will maintain the desired architecture and not retract back under the skin. We have seen success in children as old as 4-5 months with this particular deformity.
