About Facial Deformities

Microtia

What is microtia?

Microtia means a small, abnormally shaped or absent external ear. It can occur on one side of the head (unilateral) or on both sides bilateral). The unilateral form is much more common, occurring in approximately 90 percent of patients, mostly males, and on the right side more often than on the left. Microtia occurs once in every 4,500 births in the general population; bilateral microtia occurs once in every 18,000 birth

Microtia may appear as an isolated deformity, although it often occurs along with other defects, such as astresia (lack of an external auditory canal), hemifacial microsomia, and Teacher-Collins syndrome. Because microtia is associated with these other conditions, patients with microtia might consider having a genetic evaluation, which would make parents aware of any increased risk of these conditions in future children.

What causes microtia?

The causes of microtia are difficult to define. Some theories point toward a decrease in blood supply to the developing ear in utero. Others involve certain medications taken by the mother during pregnancy, such as Accutane, Thalidomide, and retinoic acid. Environmental factors have also been considered.

What surgical solutions are available for the treatment of microtia?

The traditional surgical approach for microtia ear reconstruction, which has accounted for more than 90 percent of these corrective treatments to date, involves three operations during which rib grafts are taken from the patient to form an outer ear. A newer surgical solution, developed by Dr. Thomas Romo III, eliminates the need to extract rib cartilage from the child's chest. The technique uses an ear framework constructed of porous polyethylene, which has a normal appearance and is readily accepted by the child's body. It also reduces the number of days spent in the hospital, as well as the number of operations needed to form the outer ear. Another advantage of this method is the fact that the ear reconstruction can be performed at a younger age (three years of age). It is important to discuss the best option for your child with a qualified plastic surgeon who is familiar with both techniques.

Another state-of-the-art technique that produces cosmetic results equal to, and often better than, rib grafts involves the placement of a prefabricated, detailed prosthetic ear on the child's head. This ear is supported in place by magnets or connecting hooks, which allow for removal and cleaning at bedtime.