Non-operative management of ear deformities in the neonate

• congenital ear deformities are common and usually corrected surgically in childhood (1)
  • ear deformities are often first noticed by parents or non-specialist personnel such as midwives, general practitioners, and health visitors
    • true incidence is unknown
    • about 5% of the white population are thought to have prominent ears - however this may be an underestimate as most reports do not include less severe anomalies
  • splinting of ear deformities in the early neonatal period has been shown to be a safe and effective non-surgical treatment - splint is applied with no anaesthesia
    • splinting of ears in the early neonatal period has been advocated as an effective non-surgical treatment often produces better results than surgery (1)
      • best results are achieved and the shortest period of splintage is needed when treatment is started immediately after birth
      • nonoperative management of ear deformities is possible because of the early malleability of cartilage during the neonatal period when the cartilage elasticity is affected by high levels of circulating maternal estrogens. Following 72 hours these levels drop and the cartilage becomes more firm (2)
  • ear splinting may be used in the management of various ear deformities:
    • bilateral constricted ears
      • in this deformity, the rim of the ear looks as if it has been tightened (similar to a purse string that has been pulled closed)
    • Stahl's ear
      • a helical rim deformity characterised by a third crus, flat helix, and malformed scaphoid fossa
    • prominent ear (s)

Reference:

1. Lindford AJ et al. Postpartum splinting of ear deformities.BMJ. 2007 Feb 17;334(7589):366-8.
2. Bauer BS. Nonoperative treatment of congenital deformities of the ear Operative Techniques in Plastic and Reconstructive Surgery 1997; 4 (3):104-108.