Expert discusses newborn ear deformities and treatments

Expert discusses newborn ear deformities and treatments
Calvin U. Allen Executive Vice President and Chief Human Resources Officer — Children's Hospital of Philadelphia
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Dr. Cassandra Ligh, a plastic and reconstructive microsurgeon at Children’s Hospital of Philadelphia (CHOP), provides insights into ear deformities in newborns and the process of ear molding. Dr. Ligh is part of CHOP’s Ear Deformities Program, focusing on ear reconstruction.

Ear shapes vary widely, and some variations can be hereditary. Abnormal ears fall into two categories: “An ‘ear malformation’ is when your baby is missing portions of their ear,” while “an ‘ear deformity’ is when your baby has all the parts, but it may be folded, tucked or shaped in a way that is different.” Surgical correction for malformations typically occurs after age four, whereas deformations can often be addressed nonsurgically before six weeks through ear molding.

The likelihood of natural improvement in ear shape remains uncertain. A study involving 1,500 newborns indicated that only 32% of deformities improved by 30 days post-birth. Early intervention with ear molding during the first six weeks is crucial due to the pliability of newborn ears influenced by maternal hormones.

Ear molding involves placing a temporary device on the child’s ear within six weeks after birth. This device stays in place for about six weeks to reshape the ear gently. “It is not painful because the device is placed using medical-grade adhesives or something similar.”

Starting early increases success chances and reduces treatment duration. The procedure takes 2 to 10 minutes per ear, with molds remaining for 6 to 8 weeks. Molds are replaced as needed during this period.

Regarding pain concerns, Dr. Ligh assures: “Absolutely not.” She adds personal experience: “I molded my son’s ear when he was a newborn… he hated having to stay still for the one minute it took the adhesive to dry!”

Molding systems at CHOP do not impact hearing long-term but families should ensure no obstruction occurs in specific systems used elsewhere.

The procedure begins with consultation and application on the same day if agreed upon. Instructions are provided along with a baby bonnet for protection during sleep.

Home removal depends on mold type; CHOP guides families over the phone if feasible.

To prevent skin issues, molds must remain dry throughout treatment without hindering normal activities.

Success rates vary by system; however, CHOP reports high satisfaction: “96% of parents rated their child’s ear outcome as excellent or greatly improved.”

Post-six-week molding isn’t viable due to cartilage hardening as maternal hormones dissipate.

Risks include incomplete shape improvement, skin irritation, infection, erosion, and adhesive allergies.

Nursing or sleeping shouldn’t be affected directly; precautions like hats prevent accidental mold disruption.

Insurance coverage varies; families usually pay upfront then seek reimbursement from insurers.

If unsuccessful molding occurs, surgery remains an option later in childhood when compliance improves with age-appropriate understanding.



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