My Baby's Ears Look Strange, What Should I Do?

My Baby’s Ears Look Strange, What Should I Do?

www.earsny.com

Parents of newborns are often hypervigilant of their baby. They notice every movement, every noise, and every misplaced hair. As a result, parents are often the first to notice if their baby’s ears look different from the prototypical ear. They might call their pediatrician, ask other parents, or search online for guidance. While these sources may provide some guidance, once parents notice something on their baby that concerns them, they will stop at nothing to find a definitive answer. This definitive answer will come from ear shape specialists like our team at EarsNY whose decades of combined experience treating thousands of ears ensures that you and your baby are in the best hands. 

The most common condition that causes concern, and the one that requires immediate action for the best results, is ear deformity. Simply put, an ear deformity is when an ear is fully formed, but its shape deviates from the shape of a typical ear. Ear deformities can vary greatly in type and severity, but they are completely benign. A typical ear has a shape defined by specific anatomical structures including the helix, anti-helix, tragus, anti-tragus, superior and inferior crus, lobe, triangular fossa, and conchal bowl. The shape of any one of these structures can be distorted in an ear deformity.

Ear deformities are believed to occur because the ear will take on whatever shape it is in while the baby is in the womb. Many ear deformities make the ear appear squished or compressed, which makes sense because babies are tightly packed in the womb. You might be asking, if ears take on their shape based on their position in the womb, why are our ears not constantly changing shape when we sleep on them? The reason for this, is the same reason why ear deformities need to be address as soon as possible – plasticity. Plasticity is defined as “the quality of being easily shaped or molded”. The plasticity of our ear cartilage is very high when we are born, and it decreases rapidly until plasticity is pretty much completely lost by the age of 6 months. It is for this reason that any concerns about your baby’s ear shape should be brought to an ear shape specialist as early as possible. 

Ear deformities come in a wide variety of shapes and severities. Some may be so inconspicuous that only a well-trained eye can spot it. Others are so apparent that they are difficult to not notice. Non-surgical ear molding can benefit patients with any and all ear deformities, provided treatment is initiated early. Here are some of the most common deformities seen in infants: 

Stahl Ear: The upper portion of the ear is pointed causing a “Spock” or “Elf” appearance. Compared to a typical ear the helical rim is not continuous and there is a fold running up from the anti-helix.

Lidding: Rather than being pointed like in Stahl ear or curved as expected, lidding results in downward folding of the upper part of the ear.

Helical Rim Deformity: These deformities vary in appearance; they affect the outer most rim of the ear known as the helix. The rim will often appear compressed or squished.

Cup Ear: This deformity often has a striking appearance where the entire ear appears to be rolling in on itself. The ear often sticks out and the deformity is readily visible.

Cryptotia: The upper part of ear cartilage is tucked under the scalp skin; this can limit the use of eyeglasses in the future because the sulcus where glasses would normally sit is not well defined.

Prominent Ear: This is sometimes referred to as dumbo ear, the ears stick out further than usual and often results in teasing at school. Surgical correction may be the only option if not addressed early.

While these deformities can occur independently, we often see a combination of these deformities that can often be corrected simultaneously with non-surgical ear molding. The key to obtaining the best outcome possible is starting treatment early. However, treatment options exist for older children and adults with concerns about their ear shape.

Ideally, ear molding, which is the gold standard treatment for ear deformities, is started before 3 weeks of age. We have seen parents bring in infants as young as 2 days old for ear molding, but we have also treated patients older than 3 weeks old with success. Before 3 weeks of age ear cartilage plasticity is very high and remains high for the duration of treatment, which is typically 4 weeks when initiated early. Once an infant is older than 3 weeks, treatment duration may need to be longer, or an infant may be ineligible for ear molding. Early initiation of ear molding is ideal for 3 main reasons:

1. Higher likelihood of the desired outcome: As previously mentioned, ear cartilage plasticity is highest at birth and decreases rapidly with age. Research conducted by our own team and other research groups around the world suggests that outcomes are the best when treatment is stared before infants reach 3 weeks of age. However, recent research conducted by our team has shown that parents are happy with even modest improvements in ear shape when treatment is initiated late.
2. Shorter treatment duration: Because cartilage plasticity decreases with age, older infants who are still candidates for ear molding are typically treated for 6 or more weeks instead of the 4 weeks done for younger infants. Extending the treatment can increase the effectiveness of treatment for older infants but may be annoying to keep on for a long time.
3. Easier upkeep for parents: The ear molding device is secured with medical tape and must be kept on 24 hours a day for the duration of treatment. While it can withstand normal brushing up against objects, as infants become older and begin to actively explore the world, they are more likely to pull the device off. While this is not pain for the infant, it does require the device to be put back on, often by the healthcare team that is overseeing treatment. If this happens often, it can be a burden for parents. In our experience, this tends to happen much less with younger infants.

Ear moldings is a safe and effective, non-surgical treatment option for ear deformities that is covered by most insurances. Early identification and treatment initiation increases the efficacy and ease of treatment. While infants under the age of 3 weeks are the ideal candidates for ear molding, older infants still have many options available. Parents who are concerned about their baby’s ear shape should schedule an appointment with an ear shape specialist as soon as possible to maximize treatment ease and effectiveness. While toddlers and adults may be too old for ear molding, other options may be available to those who are concerned about their child’s or their own ears. Our all-star team of ear shape specialists are happy to speak with you and help you explore potential options. Visit www.earsny.com for more information. 

*Disclaimer: The information in this article is not medical advice and should not be used for the purposes of diagnosis or treatment. If you believe you or your loved one has any of the conditions described above, please consult a medical professional.