Updates

Ear Deformities at North Austin Campus

Conditions

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Our specialists at Texas Children’s North Austin Campus are experienced in the full range of external ear reconstruction techniques. Whether your baby born with a folded ear needs us for non-surgical molding of their ear in clinic, or your school-age child born with a missing ear from a craniofacial conditions needs a new ear built, our team is ready to meet their needs.

If your child requires treatment to the ear canal or inner ear, we will coordinate with our ENT / Otolaryngology experts who specialize in those areas.

Our craniofacial plastic surgery team offers the following services:

  • Some babies are born with ears that are formed but have an abnormal shape. The top of their ears can be folded, wrinkled, or tight, known as a “lop ear deformity”. If we can see these babies in the first 6 weeks of life, we can offer a painless, non-surgical treatment in clinic that will correct the ear shape in 5-6 weeks.
  • When a baby is born some of a hormone from their mother (estrogen) is in their blood system. This hormone allows the baby’s ear cartilage to be reshaped with gentle molding using a special device. This is called infant ear molding.
  • In many cases our specialists will use the EarWellTM device to mold the ear. We will apply this soft silicone device to your baby’s ears in clinic and we then see you every two weeks until the correct ear shape has occurred. This gentle molding does not cause your baby any pain or discomfort and usually takes 5 to 6 weeks.
  • Once your baby is two months old, the hormone has left their system and the new ear shape is permanent.
  • Our craniofacial orthodontist also has special skills to create custom molds that can be used if the ear deformity cannot be treated with the EarWellTM device.
  • Some children’s ears stick out farther from the head, known as “prominent ears” or “protruding ears”. This can cause concern to parents and older children. Prominent ears can also make it difficult to wear protective headgear and be more risk from trauma during contact sports later in life. 
  • Our surgeons are experienced in a technique known as “setback otoplasty” that not only makes the ear lie flatter to the head, but it also reshapes the ear to give it a more natural form. 
  • Some families or children want the ear correction as soon as possible, but it is very important not to do the surgery at too young an age. If setback otoplasty is done too early, it will need to be repeated since the result will not be stable. We recommend waiting until at least 6 years of age before your child undergoes this corrective surgery. 
  • This surgery is done through small incisions hidden behind the ear and it corrects the position of the upper ear, but also the natural folds and valleys of the ear and the position of the earlobe. 
  • The surgery only lasts a couple of hours, and your child goes home the same day. They will need to wear a special head bandage for a week after surgery to protect the surgery site, and then wear a head band that looks like a ski-band for five more weeks until the ear is fully healed, and they can return to normal sports and activities. 
  • Some children are born with a small (“microtia”) or missing (“anotia”) ear. This can occur in craniofacial conditions such as Treacher Collins syndrome or Craniofacial Microsomia. Our surgical specialists are experienced in a technique known as “MedPorTM Otoplasty”. 
  • MedPorTM Otoplasty uses a carved framework made from a special plastic called “porous polyethylene”. This plastic is the same material used in chin and cheek implants. The body accepts this plastic under the skin and does not reject it. 
  • The surgery can take 6 hours or longer and your child usually stays overnight.
  • The surgeon inserts the framework through an incision on the side of the head. They will cover the framework with the skin, as well as a special lining called “fascia” that the surgeon finds inside the scalp and gives added protection over the framework. Skin from another part of the body (skin graft) is also required.
  • We can usually do the ear reconstruction with a single surgery, but in some cases may recommend a second surgery (staged reconstruction). 
  • For craniofacial conditions, we may recommend delaying ear reconstruction surgery until after certain jaw surgery procedures are complete. 
  • Our team of reconstructive surgeons has extensive experience in dealing with all types of traumatic wounds including external ear trauma. 
  • Injuries where a piece of the ear is missing may require reconstruction using skin or cartilage moved from another part of the body
  • Torn earlobes from earrings is a common injury we see in clinic. We usually recommend treating these with a day surgery to close the torn lobe and let it heal. It is best not to have a new piercing in the same area to prevent the same problem from happening again.