Australian Doctor Australian Doctor 28th July 2017 | Page 26

Therapy Update
Figure 1.
Figure 2.
Figure 3 A.
Figure 3 B.
from previous page
Figure 4.
tubing can be very effective.
Used with tapes, this tech-
nique is straightforward and
easily taught to parents in
one to two sessions.
For more complex defor-
mations, silicone conform-
ers may be required.
Adhesive
is
applied
behind the ear, and the
mould is applied both pos-
teriorly and anteriorly to
allow the ear to be moulded
both internally and in an
antero-posterior dimension.
While the technique is
usually painless, there can
be complications associated
with the use of ear moulding
devices.
The most common com-
plication is skin excoriation
from the use of adhesive
glues and tapes, which usu-
ally resolves with cessation
of treatment.
Deeper tissue injury and
pressure-related necrosis of
the skin and cartilage have
been reported, but usually
result from incorrect use of
an appliance — highlighting
the importance of specialist
referral.
These systems are not
straightforward to apply
or to monitor. However, if
properly used, they have the
capacity to selectively shape
targeted areas of the exter-
nal ear, including the heli-
cal rim, scapha, antihelix,
superior crus, concha and
lobule. 3
A US study demonstrated
good to excellent results
for all deformations after
using one such system. They
were also able to show good
results for all but the most
severe malformations.
In these instances, the
authors note they were able
to achiev