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Ear Molding in Newborn Infants with Auricular Deformities

Byrd, H. Steve M.D.; Langevin, Claude-Jean M.D., D.M.D.; Ghidoni, Lorraine A. M.D.

Plastic and Reconstructive Surgery: October 2010 - Volume 126 - Issue 4 - p 1191-1200
doi: 10.1097/PRS.0b013e3181e617bb
RECONSTRUCTIVE: HEAD AND NECK: ORIGINAL ARTICLES
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Background: A review of a single physician's experience in managing over 831 infant ear deformities (488 patients) is presented.

Methods: The authors' methods of molding have advanced from the use of various tapes, glues, and stents, to a comprehensive yet simple system that shapes the antihelix, the triangular fossa, the helical rim, and the overly prominent conchal-mastoid angle (EarWell Infant Ear Correction System).

Results: The types of deformities managed, and their relative occurrence, are as follows: (1) prominent/cup ear, 373 ears (45 percent); (2) lidding/lop ear, 224 ears (27 percent); (3) mixed ear deformities, 83 ears (10 percent) (all had associated conchal crus); (4) Stahl's ear, 66 ears (8 percent); (5) helical rim abnormalities, 58 ears (7 percent); (6) conchal crus, 25 ears (3 percent); and (7) cryptotia, two ears (0.2 percent). Bilateral deformities were present in 340 patients (70 percent), with unilateral deformities in 148 patients (30 percent). Fifty-eight infant ears (34 patients) were treated using the final version of the EarWell Infant Ear Correction System with a success rate exceeding 90 percent (good to excellent results). The system was found to be most successful when begun in the first week of the infant's life. When molding was initiated after 3 weeks from birth, only approximately half of the infants had a good response.

Conclusions: Congenital ear deformities are common and only approximately 30 percent self-correct. These deformities can be corrected by initiating appropriate molding in the first week of life. Neonatal molding reduces the need for surgical correction with results that often exceed what can be achieved with the surgical alternative.

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Dallas, Texas

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas; Children's Medical Center Dallas; and the Department of Pediatrics, Baylor University Medical Center.

Received for publication January 18, 2010; accepted March 22, 2010.

Disclosures:Dr. Byrd has a royalty agreement with Becon Medical for his work on the EarWell device; neither of the other authors has any commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article. No funding was received for the work presented in this article.

Supplemental digital content is available for this article. A direct URL citation appears in the printed text; simply type the URL address into any Web browser to access this content. A clickable link to the material is provided in the HTML text of this article on the Journal's Web site (www.PRSJournal.com).

H. Steve Byrd, M.D., Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, 1801 Inwood Road, Dallas, Texas 75390, byrd.plasticsurgery@gmail.com

©2010American Society of Plastic Surgeons