Ear Reconstruction for Microtia

Microtia is a birth deformity of the ear that has been reported to occur once in every 6,000 births. It is characterized by underdevelopment of the pinna (outer ear or visible part of the ear). The abnormality may vary from an ear that is slightly smaller than the normal to the complete absence of the outer ear. Ear reconstruction surgery can be an effective option to resolve this congenital deformity and to recreate cosmetically appealing ears.

The exact reason for microtia is still unknown, especially regarding the role of genetic and environmental factors. Changes happening at times of fetal development such as neural crest cells disturbance, vascular disruption, and altitude are cited as some of the reasons, though not proven scientifically. Since the reasons for microtia are not clear, prevention is therefore difficult.

Microtia is almost always accompanied by another condition atresia, which is characterized by the absence or underdevelopment of the ear canal and middle ear structures. This can affect the hearing capacity of the child and cause facial nerve weaknesses.

Surgery for ear reconstruction can correct a lot of conditions such as:

* Anotia or non-existence of the whole ear

* Incomplete ear with a stenotic (closed off) external ear canal, that can cause conductive hearing loss

* Small ear with recognizable structures and a small external ear canal

* The existence of a small peanut-like vestige structure when the external ear, ear drum, and external ear canal are not present

Ear Reconstruction Surgery

Ear reconstruction to resolve microtia can be done with a lot of procedures, out of which ‘Rib Cartilage Graft Reconstruction’ is the most popular one. The method uses a living sculpture from the patient’s own tissues (rib cartilage) to create the external ear. The surgery is carried out in two stages.

* In the first stage, the cartilage is extracted from the ribs and carved, molded, and reshaped to form a new ear in the right position

* The second stage, performed after four months, involves the creation of the fold and projection behind the ear to lift it in to a position similar to the opposite ear.

Advantages of this method include:

* The rib graft ear will continue to grow as the body of the child continues to grow

* As the patient’s own tissue is used for reconstruction there is less chance for rejection and infection

* Exposure of the cartilage after injury is salvageable without the loss of the entire framework

Ear reconstruction for microtia should be performed by a craniofacial plastic surgeon. Only surgeons experienced in reconstructive procedures can provide the best cosmetic and functional results with minimal risk of complications.