Congenital and acuired ear deformities; treatment modalities

Abstract

Each year around 2500 people in the Netherlands have their protruding ears operatively corrected. Deformed baby ears can be reshaped using splints. This appealing technique was already reported on in the eighties, but literature was not conclusive on until what age this therapy was effective. Our research showed a reasonable chance of success if started before the age of six weeks. Duration of treatment rises with age. As early referral is vital, we posed the question if ear splinting should be actively suggested to parents. This was ethically debated; by splinting perfectly healthy baby ears we cross the border between treatment and enhancement. Making molding part of the official national screening program therefore fails based on WHO criteria. It is reasonable to educate midwifes, maternity nurses, general practitioners, pediatricians and plastic surgeons to recognize deformed ears and offer splinting. The flaw being that it does not fit in any one’s daily practice. This thesis also addresses ear deformation after perichondritis in high earpiercings. Literature suggested some piercing methods give excessive damage to the ear cartilage. But we found the same extent of damage for all common piercing methods in our histologic study. Rib cartilage is a useful source for spare ear parts; whether for correction of a sunken ear after mastoidectomy, reconstruction after a spider bite necrosis or antihelical support for a lop-ear. Tanzers classification of lop-ears (1975) should be reclassified because of improved techniques developed in ear reconstruction. The more severe deformities should be treated as concha type microtia.