Classification of newborn ear malformations and their treatment with the EarWell infant ear correction system.
Abstract
BACKGROUND: A single practice's treatment protocol and outcomes following molding therapy on newborn ear deformations and malformations with the EarWell Infant Ear Correction System were reviewed. A classification system for grading the severity of constricted ear malformations was created on the basis of anatomical findings. METHODS: A retrospective chart/photograph review of a consecutive series of infants treated with the EarWell System from 2011 to 2014 was undertaken. The infants were placed in either deformation or malformation groups. Three classes of malformation were identified. Data regarding treatment induction, duration of treatment, and quality of outcome were collected for all study patients. RESULTS: One hundred seventy-five infant ear malformations and 303 infant ear deformities were treated with the EarWell System. The average age at initiation of treatment was 12 days; the mean duration of treatment was 37 days. An average of six office visits was required. Treated malformations included constricted ears [172 ears (98 percent)] and cryptotia [three ears (2 percent)]. Cup ear (34 ears) was considered a constricted malformation, in contrast to the prominent ear deformity. Constricted ears were assigned to one of three classes, with each subsequent class indicating increasing severity: class I, 77 ears (45 percent); class II, 81 ears (47 percent); and class III, 14 ears (8 percent). Molding therapy with the EarWell System reduced the severity by an average of 1.2 points (p < 0.01). Complications included minor superficial excoriations and abrasions. CONCLUSION: The EarWell System was shown to be effective in eliminating or reducing the need for surgery in all but the most severe malformations. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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Virtually all studies evaluating ear molding efficacy have focused on short-term results, with follow-up limited to less than a few years.
“Virtually all studies evaluating ear molding efficacy have focused on short-term results, with follow-up limited to less than a few years.7,9–16”
From Long-term Outcomes of Infant Ear Molding: A 10-year Single-Surgeon Experience (2025) · cites this paper as [14]
Prominent ears showed most difficult to correct.
“Prominent ears showed most difficult to correct.6,29,31,35,37 (Tables 3, 5).”
From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [31]
Daniali et al measured a significant improvement for treated malformations (P < 0.01).
“Daniali et al measured a significant improvement for treated malformations (P < 0.01).”
From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [31]
Daniali et al reported more than a single deformity in 102 ears and 91 ears having a mixed deformity; only 88% of mixed deformities had a successful outcome, whilst single deformities showed a success rate of 97%.
“Daniali et al reported more than a single deformity in 102 ears and 91 ears having a mixed deformity. Only 88% of mixed deformities had a successful outcome, whilst single deformities showed a success rate of 97%.31”
From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [31]
Two articles reported on the treatment of malformations, including constriction and cryptotia as malformations.
“Two articles reported on the treatment of malformations,30,31, including constriction and cryptotia as malformations.”
From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [31]
Difficulty in correcting prominent ears could be attributable to them being overlooked, an unnoticed conchal crus, or genetic predisposition.
“This could be attributable to them being overlooked, an unnoticed conchal crus, or genetic predisposition.6,31.”
From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [31]
Daniali et al stated that even in the case of severe constriction, results of ear molding were still better than the contours after surgical repair.
“They also stated that even in the case of severe constriction, results of ear molding were still better than the contours after surgical repair.”
From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [31]
Daniali et al noticed more complications in malformations than in deformations.
“Daniali et al noticed more complications in malformations than in deformations.31”
From Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature (2020) · cites this paper as [31]
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- Authors
- Daniali, L. N., Rezzadeh, K., Shell, C., Trovato, M., Ha, R., & Byrd, H. S.
- Venue
- Plastic & Reconstructive Surgery
- Published
- 2017-03
- Volume
- 139
- Issue
- 3
- Pages
- 681-691
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W2589712013
- Cited by
- 82
- References
- 13
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 8 · 2023: 14 · 2022: 15 · 2021: 11 · 2020: 9 · 2019: 7 · 2018: 1 · 2017: 4
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive Surgery (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
- cryptotia, severity classification, treatment outcomes, complications
- MeSH terms
- Congenital Abnormalities, Ear, External, Humans, Infant, Newborn, Retrospective Studies, Plastic Surgery Procedures
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