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Cited by 88Reconstructive Facial Surgery TechniquesCongenital Ear and Nasal AnomaliesCraniofacial Disorders and Treatments

Non-surgical correction of congenital deformities of the auricle: a systematic review of the literature

van Wijk, M.P., Breugem, C.C., Kon, M.·2009·Journal of Plastic, Reconstructive & Aesthetic Surgery
DOI 10.1016/j.bjps.2009.01.020
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Abstract

Background Splinting is an elegant non-surgical method to correct ear deformities in the newborn. Since the late 1980s, many authors demonstrated that permanent correction occurs by forcing the ear into the proper position for several weeks. The external ear anomalies suitable for splinting have a common feature that no skin or cartilage is absent; the protruding, lop and Stahl's ears are good examples of these anomalies. Surprisingly, this technique is relatively unknown to plastic surgeons and is hardly ever communicated to the general public.Purpose of study To review the literature on non-surgical correction of ear deformities, focussing on indications, technique, results and possible complications.Methods A systematic literature search was performed in July 2008 using PubMed. Twenty papers were suitable for review.Results Splinting can be performed in many ways, provided that the ear is permanently kept in the desired shape without distorting it. It is disputable until what age splinting therapy can reasonably be offered--opinions vary from 'newborn only' to well up to 3 or 6 months of age. A rigid fixation seems to allow correction in older children. The time needed to splint for permanent correction depends upon the age at the time of starting the treatment. For a newborn, 2 weeks often suffice, whereas for older children splinting time becomes more variable--up to 6 months. Most patients we treated had lop, Stahl's or prominent ears. In a case series in Japan, cryptotia was the most frequent deformity encountered. Most authors made their own judgement on the results, categorising their outcomes from poor to excellent, or asked a lay opinion. Fair-to-excellent results were reported in 70-100% of the cases. The results tended to be poor in older children. Recurrence was seldom described clearly in the literature and was probably listed as poor result. No serious complications occurred and skin irritation was seen sporadically.Conclusions Ear splinting is an elegant technique that should be practised on a wider scale than is done today. Hopefully this article will challenge authors to perform prospective studies specifically addressing the relation between patient age, degree of deformity, stiffness of the cartilage, the time needed to splint and the treatment outcome.

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Crossref · 10.1016/j.bjps.2009.01.020

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  • Maternal estrogen promotes exceptional cartilaginous plasticity in the neonatal ear, with estrogen levels peaking at day 3 and returning to baseline after a week.

    “In the first few days after birth, maternal estrogen promotes exceptional cartilaginous plasticity in the neonatal ear. However, estrogen levels peak at day 3 and return to baseline levels after a week [11].”

    From Correction of Congenital Auricular Deformities Using the Ear-Molding Technique (2016) · cites this paper as [11]

  • No consensus exists on the maximum age limit for molding therapy, with opinions ranging from neonates to 3-6 months of age.

    “Although most studies agree that earlier molding therapy seems to allow a shorter treatment time and leads to better outcomes, opinions on the maximum age limit range from neonates to 3–6 months of age, and no consensus yet exists [11].”

    From Correction of Congenital Auricular Deformities Using the Ear-Molding Technique (2016) · cites this paper as [11]

  • Earlier molding therapy seems to allow a shorter treatment time and leads to better outcomes.

    “Although most studies agree that earlier molding therapy seems to allow a shorter treatment time and leads to better outcomes, opinions on the maximum age limit range from neonates to 3–6 months of age, and no consensus yet exists [11].”

    From Correction of Congenital Auricular Deformities Using the Ear-Molding Technique (2016) · cites this paper as [11]

  • The main issue noticed in the analysis is the lack of consensus.

    “The main issue noticed in our analysis is the lack of consensus, as mentioned by Van Wijk et al2”

    From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [2]

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Authors
van Wijk, M. P., Breugem, C. C., & Kon, M.
Affiliations
University Medical Center Utrecht (NL)
ORCID
Venue
Journal of Plastic, Reconstructive & Aesthetic Surgery
Publisher
Elsevier BV
Published
2009-06
Volume
62
Issue
6
Pages
727-736
ISSN
1748-6815 (ISSN-L)
DOI
10.1016/j.bjps.2009.01.020
OpenAlex
W2047801299
Cited by
88
References
37
Citations by year
2026: 3 · 2025: 4 · 2024: 7 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 11 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 3
FWCI
0.69
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Plastic Reconstructive & Aesthetic Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
  • Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
Keywords
ear deformity, congenital ear anomalies, non-surgical correction, prominent ears, lop ear, cryptotia, treatment outcomes, recurrence, skin irritation, treatment timing
MeSH terms
Age Factors, Child, Preschool, Ear Cartilage, Elasticity, Equipment Design, Humans, Infant, Infant, Newborn, Recurrence, Splints, Treatment Outcome, Ear Auricle

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