Microtia

Microtia, which means "small ear," is a deformity acquired while a baby is developing in the womb; it is usually not hereditary. In most cases, only one ear is affected (unilateral microtia) but in about 10 percent of cases, both ears are affected (bilateral microtia). Approximately one in 6,000 to 8,000 babies are born with microtia. The chance of having more than one child with microtia is thought to be less than six percent.

Parents, particularly mothers, often feel as though they are responsible for their baby being born with microtia and are concerned that they may have done something wrong during the pregnancy. Though there is an extremely rare tendency for microtia to run in families, there is no known dietary, pharmaceutical or physical cause for the condition and it is understood that the condition occurs during the earliest stages of pregnancy.

Diagnosing Microtia

Microtia is easily diagnosed because the ear abnormality is readily apparent. What is not easily known is the child's ability to hear. A newborn hearing test is administered after birth, but a more sophisticated test by an audiologist may be necessary. A computed tomography (CT) scan at 2-1/2 to 3 years of age may be necessary to determine if ear canal reconstruction is an option.

Types of Microtia

Microtia patients may range from having only a small ear to having no ear at all. The ear canal and the ear drum (tympanic membrane) may be partially formed or completely absent. The severity of the microtia is measured on a scale of Grade I to Grade IV.

  • Grade I: Small abnormalities when compared with the opposite ear which require only minor ear reconstruction
  • Grade II: Typically, the upper half of the ear is severely affected and the lower half appears quite normal
  • Grade III: The ear is small and peanut-shaped, often with a partial earlobe, and there is no external ear canal or ear drum. Often referred to as "microtia with aural atresia," this is the most common form of microtia.
  • Grade IV: The most severe form of microtia where there is no ear at all, also known as "anotia."

Treating Microtia

There are three primary options for reconstructing a patient's ear, each offering distinct advantages and disadvantages over the others. Understanding these differences, and selecting the appropriate procedure and medical team to perform them, is critical for these very young patients.

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