Two characteristics of Cup Ear that distinguish it as a malformation:
1) A shortage of helical rim tissue resulting in a “purse string” around the scapha, folding it forward into a “cupped” position. This constrictive ring differentiates Cup Ear from the Prominent Ear deformity, making it significantly more difficult to treat.
2) The perimeter of the concha vertical wall and its junction with the antihelix is deficient (Cup Ear DX). The constriction around the concha causes it to fold forward and inward, frequently bringing the lobule into an overly prominent position.
The video below demonstrates the use of a Retractor to stretch the helical rim, and also a modification of a Bottom Retainer Tape to stretch and adhere a lobule that has been curved and forced forward.
Other steps that may be taken include:
- Sequential repositioning of the Retractor(s) throughout the treatment to fully expand the helical rim.
- The rigid helical rim cartilage may require anchoring of the Retractor to the helical rim and to the Posterior Cradle with the assistance of a medical-grade cyanoacrylate adhesive.
- Constriction around the concha bowl may require expanding the circumferential dimension of the bowl, in addition to flattening the mastoid angle and any possible conchal cruz.
- During reapplications, foam may be added to both the vertical shaft and the horizontal top of the Conchal Former to introduce both lateral and downward pressure on the conchal bowl.
- Parents should be apprised that this is an aggressive correction technique that may result in skin abrasion.
- The child should be seen after a week to monitor this possible occurrence. Abrasion can be overcome by removal of components for several days before reapplying.