Ear Molding in Newborn Infants with Auricular Deformities

Abstract

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.

Neonatal Ear Molding: Timing and Technique

“…8 Authors on this subject agree that adequate molding material should be delicate enough to reduce the risk of pressure ulcers, should be nonirritating to the skin to reduce risk of dermatitis, should be malleable to achieve the optimal ear shape, and should be readily available without exorbitant expense. 1,3,6 Previous studies report success with a variety of splints, stents, and molds including Reston foam, dental material, lead-free soldering wire, feeding tubes, surgical tapes, wax, and vinyl polysiloxane impression material. 3,5 In our experience, ease of assembly is another important feature, because primary care practitioners should be able to offer this solution to patients without requiring elaborate materials and instruments.…”

“…Three molding forces are needed to correct the majority of deformities: a stent along the retroauricular sulcus that is able to form an antihelical fold, an anterior conformer able to recreate the natural curvature of the helical rim, and a helical rim retraction with arch formation. 6 If significant cupping is present, an additional piece of tape can be used to approximate the pinna to the mastoid. The tools described in our methods are able to perform each of these functions with proper placement, negating the need for expensive molding devices previously described.…”

“…The tools described in our methods are able to perform each of these functions with proper placement, negating the need for expensive molding devices previously described. 5,6 If any concerns arise, instead of the metal splint the patient can be started or later transitioned to a softer custom fit elastomer splint (North Coast Medical, Gilroy, CA) (Fig 3). We have seen excellent results with both splints in this straightforward technique.…”

“…5 Despite its efficacy, uncertainty surrounding the diagnosis of, the indications for, and the timing of treatment has caused auricular molding to not be widely adopted. 2,6 Previous studies demonstrate that early intervention increases the likelihood of achieving optimal cosmetic outcomes while decreasing the duration of therapy. 1,[4][5][6] Here we present the successful correction of an auricular deformity through nonsurgical methods implemented on the first day of life.…”

“…2,6 Previous studies demonstrate that early intervention increases the likelihood of achieving optimal cosmetic outcomes while decreasing the duration of therapy. 1,[4][5][6] Here we present the successful correction of an auricular deformity through nonsurgical methods implemented on the first day of life. The aim of this report is to make pediatric practitioners aware of an effective and simple molding technique appropriate for a correction of congenital auricular anomalies and to stress the importance of instituting therapy early.…”