Microtia
Microtia is a condition where the outer ear is incompletely formed, being either absent entirely or partially. Most of the time, this condition isn’t genetic and cannot be detected via prenatal ultrasound, making it a surprise for the new parents. This condition sometimes affects only one ear (unilateral) or may affect both (bilateral). It may or may not affect hearing.
If your child was born with microtia, you may be wondering what options are available, how this condition will impact their future, and what you can do to support them.
At UVA Health Children’s, we’ve helped many children with microtia. With pediatric facial plastic specialists, ENTs, audiologists and a full team of specialists, we can provide complete care for this condition and its complications.
Does Microtia Affect Hearing?
Many parents are equally concerned about whether or not their child will be able to hear. Sometimes, microtia is accompanied by a lack of an ear canal. This is a separate condition called aural atresia that can occur with or without microtia.
As part of newborn screening, all babies are given a hearing test. Additionally, if your child is born with microtia, we’ll consult with pediatric ENT specialists and audiologists to determine if their hearing has been affected.
If your child has aural atresia, then we are one of the few children’s hospitals with specialty-trained surgeons (Otologists) who can help to repair this condition. Even in cases when the ear canal can’t be surgically fixed, our experts have options to improve your child’s hearing through different kinds of hearing aids.
Types of Microtia
Microtia is based on the parts of the ear that are affected.
Grade 1- All parts of the ear are formed, but small.
Grade 2- The ear is missing some key features.
Grade 3- A majority of the ear did not form, leaving only a small earlobe or ridge of skin.
Grade 4- No ear is visible.
Treatment for Microtia
Rebuilding an outer ear can require several surgeries. It is helpful to wait till your child is a little older, physically larger, and more mature. Typically, we wait until a child is around 6-7 years old to begin talking about surgery.
Rib Cartilage Method
The rib cartilage method is used most frequently and is considered the standard approach. Using cartilage from their rib, your surgeon can craft an outer ear. For this approach, we need to make sure your child’s rib has matured enough to provide a strong graft.
Because this graft is made with your child’s own living tissue, their body accepts this graft and can be expected to survive the duration of your child’s lifetime. It also holds up better to trauma than the implant method.
This procedure requires more than one surgery to produce the best shape and position of the ear. This first surgery is under general anesthesia and requires your child to spend a few nights in our children’s hospital for recovery. Future surgeries to elevate and refine the ear are also performed with anesthesia, but your child can go home the same day.
Implant Method
For some patients, an authentic external ear cannot be made, and a prosthetic ear will have to be considered. This can be discussed with your surgeon. Some centers use a plastic material instead of your child’s rib. While this can be done in fewer stages, some feel the longevity may be less predictable.
What Method Is Right for Your Child?
At UVA Health Children’s, we have a multidisciplinary team that cares for your child and can review all options in great detail, including the hearing specialists.