Ear Molding in Children—Timing, Technique, and Follow-up: A Systematic Review
Abstract
Background: Nonsurgical management of congenital ear anomalies using molding devices shows efficacy but lacks standardization of treatment protocols and outcome measures. Learning Objective: To compare ear molding techniques and identify factors related to treatment outcomes. Design Type: Systematic review of the literature (1990–2021). Methods: Studies reporting molding for congenital ear anomalies were assessed. PRISMA guidelines were used. Data extracted included: age at treatment initiation, treatment duration, correction rates, and complications. Data analysis included descriptive statistics and outcomes were compared using the Student t -test. Results: In total, 37 studies with 3,341 patients (mean patients per study, 95; range, 5–488) were included. Infants in whom treatment was initiated at 4.8 weeks (median, 3.7; range, 0.9–8.8 weeks) were treated for 5.1 weeks (median 4.7, range 2.6–7.6 weeks) with 11.0 months follow-up (median 11.4, range 1.4–21.0 months). Individualized devices (physician-customized) were used more (62.2% of studies) than commercial devices. No difference in correction ( p = 0.44) or complication rates ( p = 0.19) was identified between devices. Totally, 70.3% of studies reported complications and 40.5% of studies included long-term follow-up data. Conclusions: The available evidence supports initiating ear molding in the first weeks of life to be most effective, yet outcome data should be standardized in future studies to improve evidence quality.
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Nonsurgical approaches, such as newborn auricular molding, leverage early cartilage plasticity with promising outcomes.
“Nonsurgical approaches, such as newborn auricular molding, leverage early cartilage plasticity with promising outcomes.70–73”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [72]
Cites
Matsuo, K., Hirose, T., Tomono, T., Iwasawa, M., Katohda, S., Takahashi, N., & Koh, B. (1984) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-198401000-00009 · Cited by 303 · see citing works
The relationship between language development and behaviour problems in children with hearing loss
Stevenson, J., McCann, D., Watkin, P. M., Worsfold, S., Kennedy, C., & on behalf of the Hearing Outcomes Study Team (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2009.02124.x · Cited by 183 · see citing works
Ear Molding in Newborn Infants with Auricular Deformities
Byrd, H. S., Langevin, C.-J., & Ghidoni, L. A. (2010) · Plastic and Reconstructive Surgery · doi:10.1097/prs.0b013e3181e617bb · Cited by 178 · see citing works
Porter, C. J. W., & Tan, S. T. (2005) · Plastic and Reconstructive Surgery · doi:10.1097/01.prs.0000161454.08384.0a · Cited by 152 · see citing works
Complications of otoplasty: a literature review.
Limandjaja, G. C., Breugem, C. C., Mink van der Molen, A. B., & Kon, M. (2009) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2008.06.043 · Cited by 151 · cited 1× · see citing works
“7,8 Typically, surgical intervention is delayed until at least 5 years of age, allowing the ear to have completed most of its growth.”
Psychological and social outcome of prominent ear correction in children
Bradbury, E. T., Hewison, J., & Timmons, M. J. (1992) · British Journal of Plastic Surgery · doi:10.1016/0007-1226(92)90165-t · Cited by 145 · see citing works
Ear deformities: social and psychological implications
MacGregor, F. C. (1978) · Clinics in Plastic Surgery · doi:10.1016/s0094-1298(20)32138-6 · Cited by 99 · see citing works
The Newborn Butterfly Project: A Shortened Treatment Protocol for Ear Molding
Doft, M. A., Goodkind, A. B., Diamond, S., DiPace, J. I., Kacker, A., & LaBruna, A. N. (2015) · Plastic and Reconstructive Surgery · doi:10.1097/prs.0000000000000999 · Cited by 93 · see citing works
A splint for correction of congenital ear deformities
Tan, S. T., Shibu, M., & Gault, D. T. (1994) · British Journal of Plastic Surgery · doi:10.1016/0007-1226(94)90144-9 · Cited by 92 · see citing works
Psychosocial Adjustment and Craniofacial Malformations in Childhood
Pertschuk, M. J., & Whitáker, L. A. (1985) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-198502000-00005 · Cited by 86 · see citing works
Daniali, L. N., Rezzadeh, K., Shell, C., Trovato, M., Ha, R., & Byrd, H. S. (2017) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000003150 · Cited by 82 · see citing works
Early nonsurgical correction of congenital auricular deformities.
Ullmann, Y., Blazer, S., Ramon, Y., Blumenfeld, I., & Peled, I. J. (2002) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-200203000-00013 · Cited by 77 · see citing works
Nonsurgical correction of congenital ear abnormalities in the newborn: case series
Smith, W., Toye, J., Reid, A., & Smith, R. (2005) · Paediatrics & Child Health · doi:10.1093/pch/10.6.327 · Cited by 49 · see citing works
Chan, S. L. S., Lim, G. J. S., Por, Y. C., Chiang, M. F., Ho, S., Saffari, S. E., & Chia, H.-L. (2019) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000006057 · Cited by 45 · see citing works
van Wijk, M. P., Breugem, C. C., & Kon, M. (2012) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2011.08.021 · Cited by 45 · see citing works
Correction of Congenital Auricular Deformities Using the Ear-Molding Technique
Woo, T., Kim, Y. S., Roh, T. S., Lew, D. H., & Yun, I. S. (2016) · Archives of Plastic Surgery · doi:10.5999/aps.2016.43.6.512 · Cited by 40 · cited 1× · see citing works
“7,8 Typically, surgical intervention is delayed until at least 5 years of age, allowing the ear to have completed most of its growth.”
Newborn ear deformities: early recognition and novel nonoperative techniques
Schultz, K., Guillen, D., & Maricevich, R. (2017) · Seminars in Plastic Surgery · doi:10.1055/s-0037-1603958 · Cited by 34 · see citing works
Petersson, R. S., Recker, C. A., Martin, J. R. K., Driscoll, C. L. W., & Friedman, O. (2012) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2012.06.011 · Cited by 33 · see citing works
A simplified nonsurgical method for the correction of neonatal deformational auricular anomalies.
Chang, C. S., & Bartlett, S. P. (2017) · Clinical Pediatrics · doi:10.1177/0009922816641368 · Cited by 30 · see citing works
Zhang, J.-L., Li, C.-L., Fu, Y.-Y., & Zhang, T.-Y. (2019) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2019.06.001 · Cited by 29 · see citing works
Nonsurgical Management of Congenital Auricular Anomalies
Lennon, C., & Chinnadurai, S. (2018) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2017.09.001 · Cited by 28 · see citing works
Guidelines for the Ethical Publication of Facial Photographs and Review of the Literature
Bennett, K. G., Bonawitz, S. C., & Vercler, C. J. (2018) · The Cleft Palate-Craniofacial Journal · doi:10.1177/1055665618774026 · Cited by 26 · see citing works
Otoplasty in children younger than 5 years of age
Songu, M., & Adibelli, H. (2010) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2009.12.010 · Cited by 25 · see citing works
Comparison of 2 Ear Molding Systems for Nonsurgical Management of Newborn Auricular Deformities
Xiong, H., Wang, X., Li, G., Xu, J., Zhai, J., Chen, S., Lu, Y., Chen, Y., Zheng, Y., & Yang, H. (2020) · Ear Nose & Throat Journal · doi:10.1177/0145561320901398 · Cited by 21 · see citing works
Nigam, M., Kotha, V. S., Barra, C., & Baker, S. B. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000006473 · Cited by 20 · see citing works
Efficacy and Timing of Neonatal Ear Correction Molding
Zhuang, Q., Wei, N., Zhou, Q. D., Wang, H., Wu, Y., Chen, Z., Yu, D., Wang, P., & Shi, H. (2020) · Aesthetic Plastic Surgery · doi:10.1007/s00266-019-01596-y · Cited by 19 · see citing works
Assessing outcomes of ear molding therapy by health care providers and convolutional neural network
Hallac, R. R., Jackson, S. A., Grant, J., Fisher, K., Scheiwe, S., Wetz, E., Perez, J., Lee, J., Chitta, K., Seaward, J. R., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-97310-7 · Cited by 17 · cited 1× · see citing works
“56 Several studies did include blinded ratings of posttreatment photographs that can offer strength to the reported judgments and minimize bias.”
Using Ear Molding to Treat Congenital Auricular Deformities
Chen, Y., Wang, W., Wang, Y., & Mao, X. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.752981 · Cited by 15 · see citing works
Ear Molding Therapy: Laypersons’ Perceptions, Preferences, and Satisfaction with Treatment Outcome
Vu, G. H., Azzolini, A., Humphries, L. S., Mazzaferro, D. M., Kalmar, C. L., Zimmerman, C. E., Swanson, J. W., Taylor, J. A., & Bartlett, S. P. P. (2020) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000002902 · Cited by 15 · see citing works
Non-surgical correction of cryptotia
Chia, H.-L., & Sim, N. H. S. (2020) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2020.08.133 · Cited by 14 · see citing works
Effectiveness of ear splint therapy for ear deformities.
Woo, J. E., Park, Y.-H., Park, E. J., Park, K. Y., Kim, S. H., & Yim, S.-Y. (2017) · Annals of Rehabilitation Medicine · doi:10.5535/arm.2017.41.1.138 · Cited by 14 · see citing works
Efficacy of Classic Ear Molding for Neonatal Ear Deformity: Case Series and Literature Review
Kim, J.-H., Jo, T., Choi, J., Kim, J., & Jeong, W. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11195751 · Cited by 12 · see citing works
Long-Term Effectiveness of Ear Molding and Factors Affecting Outcomes
Chen, L., Li, C., He, A., Tong, H., Yu, J., Cui, C., Fu, Y., & Zhang, T. (2024) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000010678 · Cited by 12 · see citing works
One-Year Outcomes of Ear Molding for Infants with Constricted Ear
Chen, P., Yang, J., Yang, L., Liu, Y., Gao, M., Li, S., Wang, D., & Zhao, S. (2022) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000009781 · Cited by 12 · see citing works
Study on application of ear correction model to infantile cryptotia
Zhou, Z., Chen, C., Bi, J., Jiang, A., Dai, J., Chen, W., & Fu, Y. (2018) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2018.12.022 · Cited by 12 · see citing works
Zhong, Z., Zhang, J., Xiao, S., Liu, Y., & Zhang, Y. (2021) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000008293 · Cited by 12 · see citing works
Splintage for correction of congenital ear deformities
Schönauer, F., Fera, G., Rusca, I. L., & Molea, G. (2003) · European Journal of Plastic Surgery · doi:10.1007/s00238-003-0553-2 · Cited by 12 · see citing works
Congenital anomalies of the external ear
Liaw, J., Patel, V. A., & Carr, M. M. (2017) · Operative Techniques in Otolaryngology-Head and Neck Surgery · doi:10.1016/j.otot.2017.03.012 · Cited by 11 · see citing works
Ear Molding for Congenital Auricular Deformities: Efficacy and Factors Affecting Outcomes
Hui, L.-B., Li, M.-H., & Liu, Y. (2023) · Ear, nose, & throat journal · doi:10.1177/01455613231181192 · Cited by 10 · see citing works
Congenital Ear Malformations: Effectively Correcting Cryptotia with Neonatal Ear Molding
Rozanski, C., & Rousso, J. J. (2017) · Ear Nose & Throat Journal · doi:10.1177/014556131709600905 · Cited by 8 · see citing works
Dinis, J., Junn, A., Long, A. S., Phillips, S. M., Reategui, A. A., Kaplan, A., & Alperovich, M. A. (2021) · Aesthetic Plastic Surgery · doi:10.1007/s00266-021-02610-y · Cited by 8 · see citing works
Non-surgical correction of cryptotia and the analysis of treatment time and other influence factors
Wang, D., Jiang, H., Yang, Q., Liu, X., He, L., Pan, B., & Lin, L. (2019) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2019.109771 · Cited by 7 · see citing works
A Novel Nonsurgical Technique for Correcting Congenital Auricular Anomalies
Duvdevani, S. I., Knoller, H., Rozendorn, N., Alon, E. E., & Madgar, O. (2022) · Facial Plastic Surgery · doi:10.1055/s-0041-1735976 · Cited by 7 · cited 1× · see citing works
“14,18,23,24,53 Initiation of molding after 6 weeks of age has also shown good outcomes in some cases 32,44,51,53 but has also been associated with lower rates of parental satisfaction, longer length of treatment, and an increased rate of device failures necessitating replacement.”
Congenital anomalies of the auricle: correction using external splints
Oroz, J., Pelay, M. J., Col�s, C., P�rez, M., & Rabell, J. (1995) · European Journal of Plastic Surgery · doi:10.1007/bf00178542 · Cited by 7 · see citing works
Nonsurgical correction of auricular deformities
Millay, D. J., Larrabee, W. F., & Dion, E. R. (1990) · The Laryngoscope · doi:10.1288/00005537-199008000-00020 · Cited by 6 · see citing works
Fraser, L., Starritt, N. E., Melia, L., & Kubba, H. (2013) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2012.12.033 · Cited by 6 · see citing works
Stahl's ear deformities treated with auricular splinting
Schönauer, F., Pezone, G., Pensato, R., & D’Andrea, F. (2020) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2020.10.081 · Cited by 6 · see citing works
Olshinka, A., Ad‐El, D., & Yaacobi, D. S. (2021) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000008301 · Cited by 4 · see citing works
Neonatal ear splinting for congenital ear deformities✰
Javed, M. U., Lazarou, M., Kyle, A., & Jones, N. W. (2020) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2020.05.064 · Cited by 4 · see citing works
Matic, D. B., & Boyd, K. U. (2010) · Plastic and Reconstructive Surgery · doi:10.1097/prs.0b013e3181ea91cf · Cited by 4 · see citing works
Evaluation and Nonsurgical Treatment of Neonatal Ear Anomalies
Moss, C. R., & Gargaro, C. (2022) · Advances in Neonatal Care · doi:10.1097/anc.0000000000000999 · Cited by 3 · see citing works
Hazkour, N., Palacios, J., Gray, R., Pessino, K., Rivera, R., & Bastidas, N. (2022) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000008758 · Cited by 3 · see citing works
Consultation with the Specialist
Spinelli, H. M. (1993) · Pediatrics in Review · doi:10.1542/pir.14.12.473 · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 7
- Naumann A. Otoplasty—techniques, characteristics and risks. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2007; 6:Doc04.
- Mohammadi AA, , Imani MT, , Kardeh S, et al. Non-surgical management of congenital auricular deformities. World J Plast Surg. 2016; 5(2):139–147.
- Ainuz B, , Grant J, , Scheiwe S, et al. Clay ear molding treatment protocol for infants: Description and outcomes. Cleft Palate-Craniofac J, 2021; 58(4):113.
- Brown S, , Wetz E, , Grant J, et al. Neonatal ear molding: A PRACTICAL HANDS-ON INSTRUCTIONAL COURSE. Cleft Palate-Craniofac J, 2019; 56(1):7–8.
- Gray R, , Bastidas N, , Abraham H, et al. Successful nonsurgical correction of late-presenting infant ear deformities. Cleft Palate-Craniofacial J, 2019; 56(1):80.
- Leonardi A, , Bianca C, , Basile E, et al. Neonatal molding in deformational auricolar anomalies. Eur Rev Med Pharmacol Sci. 2012; 16(11):1554–1558.
- Tan S, , Wright A, , Hemphill A, et al. Correction of deformational auricular anomalies by moulding–results of a fast-track service. N Z Med J. 2003; 116(1181):U584. Published 2003 Sep 12.
Cited by
Sorted by citations
Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review
Kaleeny, J. D., & Janis, J. E. (2026) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000007404
“70–73 Although auricular deformities are not physiologically harmful, they can cause significant psychosocial distress, particularly in children.”
Optimizing Neonatal Ear Molding: Are Commercial Systems Superior to Classic Methods?
Marcus, K. S., & Scott, A. R. (2026) · The Laryngoscope · doi:10.1002/lary.70426
Gonzales, J. J., Hollier, P., & Hollier, L. H. (2026) · The Journal of craniofacial surgery (Print) · doi:10.1097/scs.0000000000012871
Yang, Q., Yang, K., Liu, Y., Wang, J., & 冯国平 (2026) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2026.112992
- Authors
- Sulibhavi, A., Reddy, S. P., Butts, S. C., & Schmalbach, C. E.
- Affiliations
- Temple University (US)
- SUNY Downstate Health Sciences University (US)
- Corresponding author
- Schmalbach, Cecelia E.
- Venue
- Facial Plastic Surgery & Aesthetic Medicine
- Publisher
- SAGE Publications
- Published
- 2024-11-01
- Volume
- 26
- Issue
- 6
- Pages
- 730-739
- ISSN
- 2689-3614 (ISSN-L)
- 2689-3622
- OpenAlex
- W4400318969
- Semantic Scholar
- af4e8f9aaa8bfbb3570969003a07ee2212bdb83b
- Cited by
- 4
- References
- 53
- Citations by year
- 2026: 4
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Facial Plastic Surgery & Aesthetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- 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
- congenital ear anomalies, children, treatment timing, treatment outcomes, complications, long-term follow-up, correction rate
- MeSH terms
- Child, Ear, External, Humans, Infant, Infant, Newborn, Time Factors
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