PLASTIC SU RGERY An Easy Fix for Misshapen Infant Ears Any adult who was born with large, misshapen or prominent ears can tell you that “funny-looking” ears rarely escape the attention of others. In childhood, misshapen ears are an easy target for taunts, and it's not unusual for older children, and even adults, to seek reconstructive surgery to put an end to the teasing. Much of that angst could be avoided if misshapen ears are identified shortly after birth and parents are referred to an expert. Today’s procedures include a gentle device that can be fitted to a child’s ear to reshape it in only six weeks, says Justine C. Lee, MD, PhD, the Bernard G. Sarnat, MD, Endowed Chair for Craniofacial Biology in the UCLA Division of Plastic & Reconstructive Surgery. The catch is that the procedure works best if the infant is treated in the first few weeks of life, while the cartilage is malleable. “Misshapen ears are a common problem and may be under diagnosed,” Dr. Lee says. “There are several types of ear anomalies. Some defects, such as microtia, are related to congenital issues and are linked to problems with hearing. Patients with microtia are frequently deficient in the quantity of cartilage and would require ear reconstruction with cartilage grafts.” Other anomalies, she explains, are related to an abnormal shape of the cartilage; these ear anomalies are amenable to cartilage reshaping. company about coverage. Prior to the new reshaping system, doctors used soft material to create an ear mold that was taped on an infant's ear. Parents needed to change the tape often, and it was difficult to keep the device properly affixed to the ear. “It worked OK, but because it's a bit of a nuisance, there is a higher chance of the parents giving up and letting it go,” Dr. Lee says. The newer procedure, which is performed by Dr. Lee and other surgeons in the UCLA Division of Plastic & Reconstructive Surgery, consists of a silicone device that is securely affixed to the child's ear. The device is removed and re-taped at two- week intervals so the physician can monitor progress. While the device may minimally muffle hearing, it’s not painful and it does not interfere with a baby’s learning and development. The device is highly effective in reshaping ears if used in the first three weeks of life, but it's only about 50 percent effective in an infant who is two months of age, Dr. Lee says. “With any type of procedure, even though this is non-invasive, the best results come from surgeons who have extensive amounts of experience with external ear anomalies including misshapen ears, prominent ears and microtia,” Dr. Lee says. To view a video about ear molding, go to: uclahealth.org/earmolding Misshapen ears are not a significant issue for a baby, “but when these children get older and are around peers, it may cause problems with self-esteem,” Dr. Lee says. “I've had patients who come to see me later in life and say, ‘I've been teased all my life, and I've wanted to have reconstructive surgery for a long time.’” A simple, non-surgical procedure in infancy is far preferable to expensive reconstructive surgery in adulthood, she says, adding that parents should contact their insurance Vital Signs Fall 2016 Vol. 72 11