Microtia Ear Reconstruction
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.
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."
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.
- MEDPOR Ear Reconstruction: A synthetic material is used as a framework that is covered by the body's own tissue
- Rib Cartilage Ear Reconstruction: Uses the patient's rib cartilage to create an ear that is covered by the body's own tissue
- Silicone Prosthetic Ear Reconstruction: Sculpting an artificial "plastic" ear that attaches to the body either with an adhesive glue or with a device that is surgically implanted into the bone (called an osseointegrated implant)