Constricted ears refer to a variety of ear deformities where the top rim of the ear (helical rim) is either folded over, wrinkled, or tight. This condition can range from mild to severe.
In the mild form, the rim of the upper ear (helix) alone may be folded — this form is sometimes called lop ear. In the severe form, the cartilage of the helix and scapha (the curved depression below the rim of the upper ear) may be constricted, forming a tight roll.
It is unknown what causes constricted ears. There may be a shortage of skin or cartilage, or both.
Nonsurgical ear molding
Newborns with constricted ear deformities may respond to non-operative molding while their ear cartilage is still soft. Ear molding uses a combination of a commercially available ear molding systems and orthodontic molding materials to reshape the ear.
Infant ears have very high levels of maternal estrogen (estrogen which crossed from mother to baby while in the womb and during the birthing process). This makes them very soft and pliable, and responsive to molding.
If ear molding is started early enough (ideally in the first few weeks of life), surgery can often be avoided. Results are less successful if treatment is delayed longer than three weeks as maternal estrogen levels fall to normal by six weeks of age.
Because some ear deformities will self-correct over time, we typically monitor your child for the first 7 to 10 days of life before starting treatment. If the ear deformity noted at birth is still present, then your child’s doctor will place the ear molding appliance.
Most ears, if treated early, respond to ear molding to improve the shape of the ear. In general, the younger your child is when treatment is started, the shorter the duration of therapy.
Nonsurgical ear molding of constricted ears
Left: Infant with constricted ear deformity before treatment. Right: Application of EarGear velcro component.
Left: Application of molding device. Right: Three months after completion of ear molding.
Surgical treatment of constricted ears
Constricted ear deformity, before and after surgery.
Once the ear cartilage has stiffened, surgery is necessary to correct the constricted ear deformity. Depending upon the severity of the condition, it may be possible to work with the ear cartilage already present to achieve a better shape of the ear.
In more severe cases of constricted ears, a rib cartilage graft may be necessary to replace wrinkled helical cartilage from the ear.
If there is a tight band of skin that pulls the helix down, your child’s surgeon may add additional skin and cartilage from the normal ear to match the other side.
Some children have bilateral constricted ears, in which both ears are affected. Your child’s surgical team will discuss options with you to determine whether to repair both ears at the same time, or in stages.