What is auricular (ear) deformation?
When infants are born with an irregular ear shape, they are said to have congenital auricular deformity. This can range from auricular malformation (no missing tissue, just an abnormally shaped ear) to microtia (external ears are not fully developed).
Auricular malformation can range from shape abnormalities where the top rim of the ear (helical rim) is either folded over, wrinkled or tight -- such as lop, cup or prominent ears.
The causes are not fully defined, but some possible factors include constriction of blood supply to the baby’s ear during fetal development, genetic mutations or inherited conditions, maternal exposure to certain toxins or medications, viral infections (like flu or rubella), external compression and abnormal fetal positioning in the uterus during pregnancy and birth.
Auricular malformation mostly occurs late in fetal development. The good news is this type of auricular malformation can be corrected with non-invasive methods prior to 3 months of age.
How is ear malformation diagnosed?
Congenital auricular malformations are usually noticeable at birth. At Texas Children’s Hospital, the hearing screen technicians (HSTs) are trained by an otologist to identify some of the most common auricular malformations. At the time of the newborn hearing screen, our HSTs examines each baby’s ear and immediately alert the auricular malformation team if one is identified. An appointment is then made to evaluate the ear and provide treatment if necessary.
Also, if your pediatrician detects an auricular malformation, a referral can be made to follow up with our Texas Children’s Otolaryngology team.
What is the treatment for ear malformation?
To achieve the best result, early identification and intervention is essential. The earliest, non-invasive treatment we recommend is ear molding.
This is a treatment technique used during infancy to mold deformed ears into a normal shape. The earlier the ear molding is applied, the higher chance the malformed ear can be corrected with a non-invasive procedure. When your infant is about 6-7 weeks old, their ear cartilage will harden, making ear molding/reshaping more difficult.
Most ears, if treated early, respond to ear molding to improve their shape. In general, the younger your child is when treatment for ear deformities is started, the shorter the duration of therapy.
How does Texas Children's Hospital perform ear molding?
To reshape the ears, a splint is made and modified to a desirable shape. The malformed ears are cleaned, then liquid adhesive and steri strips are used to secure a splint in place. The best part is, ear molding is not painful.
We conduct exams weekly over the course of treatment and take photo documentation at each visit to track your child's improvement. The team will also assess the splint areas and ears for skin integrity.
During your infant’s appointment, we will also update you on the progress and address any concerns you may have. The treatment will continue until the desired result is achieved, which is typically about 4-8 weeks.
What advice do you give to parents?
Don’t wait! Most ear deformities are correctable without surgery.