Microtia indicates a small, abnormally shaped or absent external ear. It can be unilateral (occurring on one side) or bilateral (occurring on both sides).
Aural atresia is the absence or incomplete formation of an external ear canal. Microtia is almost always accompanied by aural atresia. Clients with microtia and aural atresia do not have normal hearing on the affected side but may have completely normal hearing on the unaffected side. In most cases, microtia and aural atresia occur as an isolated condition. In some, however, the ear deformity occurs in conjunction with other facial deformities.
The most common syndrome in which microtia accompanies other anomalies is called hemifacial microsomia which is a variable deformity that can involve the ear, the bones of the face, the fullness of the cheek and other soft tissue, and the function of the facial nerve. If your child is diagnosed with microtia, the first priority during infancy is to ensure that there is sufficient hearing for language development. An accurate hearing test, also called an audiogram, is recommended as early as possible to establish the need for a hearing aid. If the deformity is unilateral (occurring on one side), and the opposite ear functions normally, a hearing aid will not be necessary. This is the case in the majority of patients. If the deformity involves both ears, a hearing aid will be necessary.
Surgery to restore hearing may not be recommended for several years. Surgery to correct the deformity is typically performed after the age of six and is coordinated with the surgical reconstruction of the ear canal. It is important that the first stages of external ear reconstruction be performed prior to reconstruction of the ear canal. The external ear reconstruction usually involves three to four stages. In the first stage a cartilage framework is carved from pieces of rib cartilage and inserted under the skin on the side of the head where the new ear will be. This procedure takes approximately four hours and requires a general anesthetic and a minimum overnight stay in the hospital. The second, third and fourth stages are short, "touch-up" type procedures which can often be performed on an outpatient basis. In the second stage of reconstruction, the earlobe is rotated into the correct position. The third stage involves deepening of the conchal bowl (the central portion of the ear) and construction of the tragus. In the final stage of reconstruction, a skin graft is inserted behind the ear to lift it off the head so that it more closely resembles a "normal" ear. Please contact me with any questions you may have.
wdf cosmetic and reconstructive plastic surgery 515.421.4299
2600 Grand Avenue Suite 125
Des Moines, Iowa 50312