Long-term Outcomes of Infant Ear Molding: A 10-year Single-Surgeon Experience

Abstract

Background: This study assesses long-term results of ear molding and factors associated with improved outcomes.

Methods: Consecutive infants treated by a single surgeon from 2012 to 2023 were reviewed. Photographs before device application (time T0) and within 6 months of device removal (time T1) were collected. Satisfaction responses and long-term photographs (time T2) were collected from parents. Deformity severity at the 3 timepoints was determined by the surgeon and participants recruited via crowdsourcing using a 4-point severity scale.

Results: Of 97 parent respondents, 78 (80%) were satisfied, 15 (16%) were neutral, and 4 (4%) were dissatisfied with the appearance of their child's treated ear(s). Predictors of satisfaction included absence of ear prominence (P = 0.018), InfantEar use (P = 0.002), and longer follow-up (P = 0.047). Thirty patients with 47 deformities had photographs at T1 = 0.2 ± 2.8 years and T2 = 6.5 ± 2.8 years after treatment, which were evaluated by 236 laypeople. From T0 to T1, surgeon severity score decreased from a median of 3.0 [3.0-3.0] to 2.0 [1.0-2.0] (P< 0.001), which further decreased to 1.0 [1.0-2.0] at T2 (P = 0.064). From T0 to T1, layperson severity score decreased from 2.4 [1.8-2.9] to 1.5 [1.2-2.1] (P < 0.001), which further decreased to 1.3 [1.1-1.5] at T2 (P = 0.015). Surgeon and layperson scores differed at T0 (P < 0.001), whereas posttreatment scores were similar (P = 0.958, P = 0.495). Predictors of improved layperson scores at T2 included absence of ear prominence (P < 0.001), earlier treatment (P = 0.043), and longer follow-up (P = 0.005).

Conclusions: The appearance of ear deformities was significantly improved at more than 6 years after treatment and tended to normalize with growth.

Fig. 1.

The 4-point severity scale used for grading the severity of ear deformities is shown with patient examples.

Fig. 2.

Application of the EarWell Correction System (A) and InfantEar Molding System (B) to infant ear deformities.

Fig. 3.

A female patient with bilateral helical rim deformities underwent ear molding therapy with InfantEar beginning at 1 week of age for a total of 4 weeks. She experienced no complications, and her parent expressed extreme satisfaction with the current appearance of her treated ears. Her right ear is shown before treatment (A), 10 weeks after treatment (B), and 7.4 years after treatment (C) with successful correction of the deformity. Surgeon severity scores were 4, 1, and 1, whereas average layperson severity scores were 3.3, 1.5, and 1.0 at the 3 respective timepoints for her right ear.

Fig. 4.

A female patient with a left cup ear deformity underwent ear molding therapy with InfantEar beginning at 1.6 weeks of age for a total of 4 weeks. She experienced no complications, and her parent was satisfied with the current appearance of her treated ear. Her left ear is shown before treatment (A), 14 weeks after treatment (B), and 7 years after treatment (C). Surgeon severity scores were 3, 1, and 1, whereas average layperson severity scores were 2.1, 1.2, and 1.0 at the 3 respective timepoints for her left ear.

Fig. 5.

A female patient with bilateral prominent ears underwent ear molding therapy with EarWell beginning at age 8.8 weeks of age for a total of 5 weeks. She experienced no complications. Her parent was dissatisfied with the current appearance of her treated ears due to the recurrence of protrusion and stated that successful correction was not expected due to her late age at presentation. Her left ear is shown before treatment (A), 11 weeks after treatment (B), and 9.6 years after treatment (C). Surgeon severity scores were 3, 2, and 3, whereas average layperson severity scores were 2.5, 1.7, and 2.6 at the 3 respective timepoints for her left ear.