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Review
. 2019 Dec;128(12):1141-1146.
doi: 10.1177/0003489419865562. Epub 2019 Jul 31.

Clinical Approach After Complicated Ear Mold Fitting: A Case Series of Six Patients and Evaluation of Literature

Cindy van den Boer  1 , Erik van Spronsen  2 , Carlijn T Q Holland  2 , Fenna A Ebbens  2 , Jérôme J Waterval  2
Affiliations
Review

Clinical Approach After Complicated Ear Mold Fitting: A Case Series of Six Patients and Evaluation of Literature

Cindy van den Boer et al. Ann Otol Rhinol Laryngol. 2019 Dec.

Abstract

Objectives: Insertion of mold material into the middle ear is a complication of molding procedure for ear impression. These cases are referred to an ENT specialist. There is no standardized approach to this problem. Literature shows different clinical strategies. The aim of this study is to share our experience and to analyze the adverse outcome of different clinical approaches.

Methods: A case series of six patients with molding material inside the middle ear after complicated molding procedure for swimming earplugs are described. Additionally, available literature was reviewed to analyze results of the clinical approach after iatrogenic molding procedures. Forty-nine ears were included.

Results: In-office removal of the material is associated with a significant risk of adverse outcome if the eardrum cannot be examined. This also accounts for ossicular involvement.

Conclusions: Temporal bone CT is advised in patients after complicated ear mold fitting if the tympanic membrane cannot be examined completely or the middle ear is involved. Blind removal should be avoided. Retroauricular transcanal tympanotomy or transmastoidal tympanotomy with facial recess approach is best practice in case the mold material has entered the middle ear. A clinical treatment algorithm is presented.

Keywords: ear mold impression material; hearing aids; middle ear; middle ear foreign body; otologic surgical procedures; otology.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Intraoperative view of canal wall up approach of mold material in the middle ear, epitympanum, and antrum. A wide canal plasty has been performed for improved middle ear exposure. The chain is intact, however covered with material.
Figure 2.
Figure 2.
Flowchart of clinical approach of attending outpatient ENT patient with ear mold material left in the ear canal. Abbreviation: EAC, external auricular canal.
See this image and copyright information in PMC

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