Detailed Information on Microtia

Microtia is an abnormally small external ear (auricle). It can be unilateral (one side only) or bilateral (affecting both sides). Microtia is thought to be a “non-inducible” type of congenital malformation, which means that it is not typically the result of the mother’s behavior during the pre-natal period (such as the use of caffeine or alcohol). Microtia can occur in defined syndromes such as Treacher Collins Syndrome, hemifacial microsomia and other associated syndromes. In most cases, only one ear is affected. In that case, it is called Unilateral Microtia. If both ears are affected, it is called Bilateral Microtia.

Microtia can cause difficulties with wearing headphones and glasses. It is also occasionally associated with syndromes that can cause balance problems, kidney problems, and jaw problems, and more rarely, heart defects and vertebral deformities. There are 4 distinct grades of microtia, ranging from mild to moderate. Grade I microtia results when a child develops an almost normal looking ear that is smaller than normal, but functioning. Grade II microtia involves developing a partial external ear, resulting in partial loss of hearing. Patients with grade II microtia may have a closed external ear canal, allowing them to hear only muffled sounds.

Grade III microtia, the most common form of microtia, involves the lack of an external ear and ear canal, as well as eardrum. Patients with Grade III microtia frequently have a small nub or piece of skin where the external ear should reside. Grade IV microtia is the most severe form of the defect, where patients have no ear and accompanying anatomical structures of the ear.  Microtia and Atresia usually occur together. Microtia occurs more often in boys than girls. There are various options to help the hearing status on children with microtia and Artesia.

The two major ways for repairing microtia depend upon the material used for the ear framework. One method employs a living sculpture from the patient’s own tissues (rib cartilage) and the other uses a framework of firm synthetic plastic. This spells out the main difference between the two techniques: one type of ear is created from your own bodily tissues whereas the other is an ear of foreign material. In addition, children with microtia should be evaluated by ultrasound for renal or urinary tract anomalies for potentially treatable anomalies. Cognitive delay is not typical for isolated microtia.