Newborn Ear Deformities
Most parents are delighted when their child is born with 10 fingers and 10 toes, and have everything else in place: a voice that cries, ears that hear and eyes that see. Heaven knows, with the onslaught of chemicals and hormones in our food and drinking water, that’s a blessing in itself. However, the average expecting parent doesn’t realize that 20-30% of newborns have some kind of external ear abnormality. The most common external ear abnormality would be ears that stick out, called protuberant ears. Next most common would be “Vulcan” ears, in which the ears are pointed. Other deformities include a lack of curvature at the top of the ears; ears that are folded over; and ears in which the round inner part of the ear is pinched or flattened.
These malformations can occur as a result of a baby’s trip through the birth canal or due simply to genetics. There are medical names to identify every type and degree of external ear deformity, but suffice it to say, for parents whose infants have abnormal ears, little correction has been available other than the hope that the deviation would resolve over time. Some ears will self-correct, some won’t, some will worsen; but most troubling is that pediatricians have no way to know in advance.
While external ear deformities certainly won’t diminish a child’s ability to hear or live a fruitful and fulfilling life, untreated ear deformities can create emotional problems for children as a result of teasing on the schoolyard, which can create life-long self-esteem and self-image difficulties. As a board-certified plastic surgeon myself, I would be loathe to think that every small physical deformity is a reason to run to the plastic surgeon. At the same time, as a parent, I recognize that our culture places a certain premium on a normal appearance and, because I desire that my children face as few insurmountable problems in life as possible, I’d be gung-ho to help them look as normal as possible.
The standard treatment for external ear deformities in infants has been for the physician to apply medical tape in various arrangements in hopes of compelling the external ear to remodel itself. Although this has been fairly helpful for ears that stick out (protuberant ears), it’s of little help for children with the above problems. Ultimately, if the child’s parents could afford the expense of the surgical procedure to correct the ears, an otoplasty could be performed when the child was entering elementary school. This surgical treatment is almost never covered by health insurance and runs approximately $2500-4500, depending on where the parents live, as metropolitan areas tend toward higher elective plastic surgery fees.
During the first month or so after birth, a baby’s system has a large reserve of estrogen that begins to diminish almost immediately. This estrogen makes it possible to “remold” the ear cartilage during the first few weeks after birth. That’s why a pediatrician will usually apply tape to protuberant ears at a baby’s first visit—to take advantage of the ear’s capacity to be reshaped. Although the tape technique can help “flatten” protuberant ears, the other deformities are largely unchanged with the use of medical tape.
Fortunately for both babies and parents, a new way to correct ear deformities at infancy has been developed in which a soft plastic “ear muff” placed over the infant’s ears, preferably within the first three weeks after birth. Although created by a plastic surgeon, there’s no surgery involved. In fact, it’s non-invasive and painless. Depending on the deformity, various “conformers” are placed to apply gentle, consistent pressure on the ears to reshape them. A recent Baylor study of 250 infants with ear deformities showed resolution of 98% of anomalies over a period of 6-8 weeks.
If, when you look at your newborn’s ears, you discover that they are protuberant or malformed, please make an appointment with a trained doctor as soon as possible: you have a short window of opportunity during the first 6 weeks of life that does not exist later on.