Ear Molding Therapy: Laypersons' Perceptions, Preferences, and Satisfaction with Treatment Outcome

Abstract

This study investigates laypersons' perceptions of congenital ear deformities and preferences for treatment, particularly with ear molding therapy-an effective, noninvasive, yet time-sensitive treatment.

Methods: Laypersons were recruited via crowdsourcing to view photographs of normal ears or one of the following ear deformities, pre- and post-molding: constricted, cryptotia, cupped/lopped, helical rim deformity, prominent, and Stahl. Participants answered questions regarding perceptions and treatment preferences for the ear. Statistical analyses included multiple linear and logistic regressions and Wilcoxon signed-rank tests.

Results: A total of 983 individuals participated in the study. All deformities were perceived as significantly abnormal, likely to impair hearing, and associated with lower psychosocial quality of life (all P < 0.001). For all deformities, participants were likely to choose ear molding over surgery despite the logistical and financial implications of ear molding (all P < 0.02). Participants were significantly more satisfied with the outcome of ear molding in all deformities compared with control, except constricted ears (all P < 0.002, except P_constricted = 0.073). Concern for hearing impairment due to ear deformity was associated with increased likelihoods of seeing a physician (P < 0.001) and choosing ear molding despite treatment logistics and costs (all P < 0.001).

Conclusions: Laypersons perceived all ear deformities as abnormal and associated with low psychosocial quality of life. Despite logistical and financial implications, laypersons generally desired molding therapy for ear deformities; treatment outcomes were satisfactory for all deformities except constricted ears. Timely diagnosis of this condition is crucial to reaping the benefits of ear molding therapy.

Fig. 1.

Example of a survey form. Each participant viewed one and only survey corresponding to a single type of ear deformity. Numerical values for multiple-choice ordinal responses are the following: questions 3–12 and 16—highly unlikely = 1, highly likely = 5; question 14—highly unsatisfied = 1, highly satisfied = 5.

Fig. 2.

Pairwise comparisons between different ear types with respect to perceived level of abnormality after controlling for participant’s age, parental status, and sex. CI, confidence interval.

Fig. 3.

Pairwise comparisons between different ear types with respect to concern for hearing impairment after controlling for participant’s age, parental status, and sex. CI, confidence interval.

Fig. 4.

Pairwise comparisons between different ear types with respect to predicted psychosocial quality of life after controlling for participant’s age, parental status, and sex. CI, confidence interval.

Fig. 5.

Pairwise comparisons between different ear types with respect to willingness to seek treatment after controlling for participant’s age, parental status, sex, and concern for hearing impairment. CI, confidence interval.

Fig. 6.

Pairwise comparisons between different ear types with respect to willingness to consult a plastic surgeon for treatment options after controlling for participant’s age, parental status, sex, and concern for hearing impairment. CI, confidence interval.

Fig. 7.

Pairwise comparisons between different ear types with respect to participant’s willingness to choose nonsurgical over surgical treatment after controlling for participant’s age, parental status, sex, and concern for hearing impairment. CI, confidence interval.

Fig. 8.

Pairwise comparisons between different ear types with respect to participant’s willingness to choose ear molding given the logistics of treatment after controlling for participant’s age, parental status, sex, and concern for hearing impairment. CI, confidence interval.

Fig. 9.

Pairwise comparisons between different ear types with respect to level of satisfaction with the outcome of ear molding after controlling for participant’s age, parental status, sex, and concern for hearing impairment. CI, confidence interval.

Fig. 10.

Pairwise comparisons between different ear types with respect to willingness to choose ear molding without complete insurance coverage after controlling for participant’s age, parental status, sex, and concern for hearing impairment. CI, confidence interval.

Fig. 11.

Pairwise comparisons between different ear types with respect to willingness to choose ear molding after being informed of the estimated cost of treatment after controlling for participant’s age, parental status, sex, and concern for hearing impairment. CI, confidence interval.