Microtia – Causes, Types & Treatment

Microtia is a medical term used for congenital deformity in which a child is born with an under developed ear. The severity can range from being partially formed ear to a lump of a tissue or ear being absent altogether. Microtia can affect one ear (Unilateral Microtia) or both ears (Bilateral Microtia)

Causes of Microtia

Microtia is a congenital disorder (Present at birth), hence the exact cause is not known. In some cases, Mircrotia occurs due to an abnormality of a single gene that can cause a genetic syndrome. Few cases have also been related to intake of some drugs/medicines during pregnancy that leads to a pattern of birth defects like microtia.

Types of microtia

Type I. The ear is slightly smaller than normal with most normal features present.

Type II. The ear is partially formed with a closed-off external ear canal, causing hearing loss.

Type III. The ear appears as a small, peanut-shaped formation of cartilage. In this condition, the external ear canal and the ear drum are usually absent.

Type IV. The ear is completely missing, known as “anotia.”

Treatment

Ear reconstruction surgery is one of the most challenging operations to perform, due to the complex shape that must be created for the ear to look natural. Only highly skilled & experienced Microtia surgeons can perform the surgery to get consistent results.

RIB Cartilage Ear Surgery

The basic principle of Rib Cartilage Ear Surgery is to reconstruct the contours of a normal ear. As the ear is complex in shape, a firm-supporting framework has to be used in order for these contours to be properly reproduced.

It is one of the most commonly used techniques for ear reconstruction. The surgery involves removing a portion of the patient’s rib cartilage and carving it to create a framework for a new ear. This framework is then placed in a pocket under the scalp skin. Rib Cartilage ear surgery might need 2-4 surgeries for the optimum results, but highly skilled surgeons are able to achieve optimum results in least number of surgeries.

This surgery is age dependent and the patient needs to be at least8 years of age, as the surgery cannot be carried out without the patient having developed sufficient rib cartilage. The surgery might be delayed if there is not enough cartilage at their disposal to create a symmetric ear. Once the chest circumference of child reaches 60cm, irrespective of the age, we can perform the surgery.

Procedure

The procedure involves harvesting the rib cartilage from the patient. This leaves a scar of some 6-8 cms in length but it does not deform the patient’s chest, nor does it hamper the playing of sports.

The new ear is sculpted from the patient’s own cartilage and skin and therefore is alive, grows with a child, and heals without problems. This allows a person to resume normal sports, swimming, and PE activities 4-6 weeks after surgery with no particular concerns.

First Operation

During the first operation, the rib cartilage is harvested and a framework is prepared that is then implanted beneath the skin. In this stage of the surgery, all the contours of the ear will be reproduced, but there will be no space behind the ear. The ear appears normal from the side profile but will not stand out like the other one.

Second Operation

To make the ear look symmetrical to the other ear, second operation is done to create postauricular sulcus (space behind the ear) that makes sure that both ears match when they are viewed face-on. The interval to be observed between these two operations ranges from three to six months, depending on the particular patient’s situation.

If your child is suffering from Microtia, consult Dr. Rajat Gupta, a highly skilled board certified plastic surgeon specializing in ear reconstruction surgery.