Microtic ear

What is microtia?

The term microtia refers to a congenital small external ear. It is a type of ear deformity due to the incomplete development of ear during the fetal stage. The defect can be either unilateral, affecting only one ear, or bilateral, affecting both. With bilateral microtia, there is a greater risk of hearing loss. In most severe cases, there is no development of the external part of the ear. This condition is known as anotia (“no ear”). Children with anotia may have inner ear abnormalities. These children should see the otolaryngologist for early detection and management of hearing problems. In case of anotia, hearing aids might be needed. Also, self-esteem can be affected in children who are very concerned about these problems.

There are four basic degrees of microtia:

Grade I: A slightly small ear with identifiable structures. A small external canal may be present or not.


Grade II: Some features of a normal ear are missing.


Grade III: A very small portion of cartilage with nearly absence of external ear.


Grade IV: Absence of the total ear or anotia.

These deformities may be different in each patient and treatment can only be determined by a medical examination.

At what age can the microtia correction be performed?

Patients with microtia may suffer from psychological and emotional problems. That is why children with microtia should have surgery early to avoid possible emotional stress. Many patients often wear their hair in ways that it hides the affected area to deal with this problem. Although most patients with microtic ear are children, many adult patients with microtia consider ear reconstruction.

The ideal age for ear reconstruction is over the age of 4-7 when children have sufficient cartilage in the rib cage to allow reconstruction of an adult ear. However, the physician is who can determine the appropriate moment for reconstruction.

Consultation

What to expect during your consultation?

During consultation you may express your reasons to consider ear reconstruction and also your expectations. It is important that patients do a good research about ear reconstruction surgery.


This may help you to understand how the treatment will be developed, as you save time asking appropriate questions. Your doctor will address your questions and any specific concerns you may have. Also, your surgeon will show you photographs of comparable ear reconstruction procedures on other children to give you a realistic idea of what to expect from surgery.

Ear reconstruction is not an easy process for children. The patient and parents should understand that total ear reconstruction surgery takes place over the course of different stages at two to three month intervals. Also, microtia treatment may cause some postoperative discomfort with a prolonged recovery period and the patient may need to use protective dressings during treatment. Since a piece of cartilage is removed from the child´s rib cage, patient is usually most comfortable spending one or two nights in the hospital following the surgery.

It is important that you discuss the potential risks and complications of ear reconstruction surgery with your doctor. Although, the treatment of microtia involves a complex process, ear reconstruction may have significant psychological lifelong benefits for the affected child.

Preoperative evaluation

The preoperative evaluation is essential for the patient seeking ear reconstruction. The surgeon will thoroughly examine head and neck. Preoperative evaluation involves facial asymmetry, malocclusion and other characteristics of the hemifacial microsomia condition, in which the lower half of one side of the face is underdeveloped and does not grow normally. Also, surgeon estimates position and size of the opposite ear. The use of cartilage from the rib to reconstruct the external ear is also considered. Ear reconstruction surgery success depends on the preoperative evaluation, planning and appropriate treatment. Photos of the patient´s ears are taken to determine the appropriate shape and position.

Preoperative planning

The success of ear reconstruction basically depends on surgical planning. The following steps are required to ear reconstruction:

* Mold:

The surgeon creates a silicone mold as an exact copy of the opposite normal ear in case of unilateral microtia. When bilateral microtia exists, the surgeon may use the ear from another child or family parent of similar age, as a template.


* Later, the area for graft insertion is delimitated.