Ear Molding - Non-Surgical Ear Correction | Kids Clinic Singapore
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Ear Molding: Non-Surgical Ear Correction For Newborns

There is a one in three chance that a baby may be born with ear deformities. Majority of these are ear deformations, where the ear is misshapen, but there is no shortage of skin or cartilage. Ear malformations are more severe forms of deformities where there is a deficiency in the ear skin and cartilage, and this makes corrective surgery more complex. Children with ear malformations are more likely to have hearing impairment, as opposed to ear deformations where hearing loss is unlikely. Studies have shown that children with ear deformities are more likely to suffer from psychosocial difficulties compared to children without ear differences.

Ear Deformations And Ear Malformations

With the advent of ear molding, ear deformations and milder ear malformations are now amenable to non-surgical correction, if they can be started shortly after birth, preferably within the first week of life. Although most effective in this early newborn period, ear molding is possible up to 3 months of age. For babies who have missed the window of molding or for babies with ear malformations, surgical correction is done after 5 years of age.

What Causes Congenital Ear Deformities?

The cause for congenital ear deformities is not fully understood. Some possible factors include:
  • Genetic disorders (eg Goldenhars Syndrome)
  • Exposure to toxins
  • An interruption of blood supply to the ear during gestational development
  • Viral infections (eg Rubella)

Types of Ear Deformities

Classification Ear DEformations Ear MALformations Others
Description
Ear is misshapen but does not have shortage of skin or cartilage
Ear deformity with underdevelopment of skin and cartilage
Examples
  • Prominent ear
  • Stahl’s ear
  • Lidding / Lop ear
  • Helical rim deformity
  • Conchal Crus
  • Mixed deformity
  • Cryptotia
  • Constricted ear
  • Microtia
  • Anotia
  • Ear tags
  • Earlobe deformities
Likelihood to have associated hearing loss
Unlikely
Possible
Possible

What is Ear Molding?

Ear molding is most effective in the first 6 weeks of life because a newborn’s cartilage is pliable, thanks to the presence of mummy’s estrogen hormones in their bodies. During molding, a ear mold is worn on the baby’s ear for a few weeks to correct the shape. The ear mold must be kept in place continuously during this period. The duration of treatment is 4 to 6 weeks (longer if the deformity is more severe or if the baby is older).
Earwell
An example of a ear mold (EarwellTM Infant Ear Correction System) worn for a baby with ear deformation.

The success rate of correction in ear deformations is more than 95%, according to a ear molding study carried out by Dr Chia Hui Ling. For ear malformations, the success rate is lower.

Ear Deformities Responsive To Ear Molding

Ear Molding In Kids
Types Of Ear Molding In Kids

Real Life Case Studies

As my experience in ear molding increases over the years, I started ear molding for more complicated malformations, such as cryptotia. Cryptotia is a condition where the top of the ear is buried under the scalp skin. I remembered a mother bringing her baby to see me for cryptotia because she was worried that the condition will affect her child’s ability to wear spectacles. She was concerned because myopia affects every family member and she read that ear deformities may have a negative impact on his psychosocial well-being. She was glad to learn that ear molding is an effective non-surgical method to treat cryptotia. After a few weeks of ear molding, the cryptotia was successfully corrected and she expressed that she is grateful that the simple treatment took away the potential problems that her child might have faced in future.

I met another mother who brought her child very promptly to seek help for prominent ears. In babies, prominent ears are easy to miss and often detected beyond the golden window period of molding. However, this mother spotted the deformation early because she was actively looking out for the condition. She had prominent ears and suffered teasing as a child for many ears. Eventually, she went for otoplasty to correct the deformity. Her baby had her prominent ears successfully corrected by ear molding.

FAQ

Ear molding can treat ear deformities (both deformations and malformations), as long as there is minimal skin and cartilage shortage. Dr Chia has described a 3-step approach to identifying ear deformations, which pictures the ear like a bowl. The 1st step is to examine the ‘rim’ of the bowl (helix of the ear) to look for any abnormal folding or irregularities. The 2nd step looks into the bowl (concha of ear) which should not be too large or have a strut (crus) running across. The 3rd step is to check how high is the bowl, which should not be more than 8mm from the head. This last step will pick up a prominent ear, an easily missed deformation.
The earlier the better. Molding can be started from Day 1 of birth and is best started within the first week. Nonetheless, it is possible to do ear molding up to around 3 months but the effectiveness decreases with age.
Molding does not hurt the child. It is common for the baby to cry when the splint is applied because the baby is held very still, not because it is painful.

Skin rashes and abrasions from the splint wear is a known complication.  This is more common in our local hot and humid climate, but are often self-limiting and resolve within a few days. I recommend all parents to keep their babies cool in an air-conditioned environment. In a small percentage of babies, the ear deformities may not correct fully.

In summary, ear molding is an effective non-surgical treatment for ear deformations, provided it is performed within the golden window of opportunity in the first few weeks of life.
This article is written by Dr Chia Hui Ling, a Consultant Plastic Surgeon at SW1 Plastic Surgery Clinic. Dr Chia is an award-winning doctor with a special interest in women and children plastic surgery, including cosmetic and reconstructive surgery. She was the recipient of two prestigious overseas fellowship awards, which took her training in plastic surgery to Seoul, South Korea, and the UK. Dr Chia is part of Smile Asia, a global alliance of charities that treats facial deformities through surgical missions and education.
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