What is Microtia?

Microtia is an incompletely formed external ear and can present on a spectrum. The ear malformation can be unilaterial (occuring on one side) or bilaterial (occuring on both sides). Microtia occurs more commonly in boys and on the right side. It is present in 1 in 6,000-12,000 births and most commonly exists as an isolated issue. The exact cause of microtia is unknown.

Issues to Consider

Occasionally, microtia is diagnosed before birth on ultrasound, but most of the time the diagnosis comes as a surprise to parents. Fortunately, significant advances have occurred in the field of ear reconstruction that have improved the development and overall health of children affected by microtia. Early evaluation is important for several reasons:

  1. Hearing may also be impaired
  2. If hearing impairment is left untreated, the child is likely to develop a speech delay
  3. Microtia can be linked to genetic syndromes such as Goldenhars, Hemifacial Microsomia, or Treacher Collins

Accordingly, a “team-approach” that includes an audiologist, an otologist (or ENT), and a geneticist is often important in optimizing your child’s overall health.

How is Microtia Treated?

There are two options for the treatment of microtia. For traditional rib cartilage reconstruction, the age is 6-7 years, when the child is of a sufficient size. This time frame allows for a more sizable rib cartilage graft and allows the unaffected ear to serve as a model for the reconstruction. The reconstruction is performed in three stages. The first stage is the most involved of the three stages, and includes taking cartilage from the rib and constructing a framework for the ear. The new cartilage is placed under the skin where the ear would normally be located. Patients stay in the hospital for 1-2 days to ensure a good recovery and to monitor two small drains from the surgical site that maintain the contour of the ear framework. The second and third stages entail smaller surgical procedures, and involve creating an earlobe and then elevating the ear away from the head. These are both same-day surgeries, meaning that your child usually does not need to stay in the hospital overnight. If he or she is a candidate for ear canal reconstruction, an otolaryngologist can perform a fourth surgery that opens the ear canal itself.

Another option for reconstruction is known as the Medpor ear reconstruction, which uses a synthetic material instead of the patient’s cartilage. We can typically begin reconstruction as early as 4-5 years since it is not dependent on rib cartilage being a sufficient size. Reconstruction is performed in two stages, and the initial stage is the longest in procedure duration.

Why choose Wellspring for your child with microtia?

Very few surgeons treat microtia in the United States today. Dr. Hobar and Dr. Cone devote themselves to this patient population and actively work to incorporate the latest advances in this area of surgery. We pride ourselves not only in excellent outcomes for our patients, but also in individual, personalized care for each patient and his or her family.