There are different entities and severities of ear deformities. This introduction details congenital absence of the ear, microtia.

Purpose

To correct deformities and to re-create absent parts of the affected pinna to achieve a near normal appearance.

Details

There are 2 broad approaches to creating an absent ear:

a)         Using the patient's own tissues - A series of staged operations are done. A first operation is performed to harvest costal cartilage carved appropriately to resemble the shape of the auricular features which are then imbedded into a skin pocket at the site of the absent ear. After a period of 9 to 12 months, when the transplanted cartilage has gained a secure blood supply, the cartilage with the overlying skin intact is elevated from the side of the head and kept there. The back of the ear is usually reconstituted with local transposed fascia and skin grafted.

b)         A prosthetic ear modelled on the opposite normal ear is tailored-made and put on using osseo-integration techniques.

Result

Reconstruction using autologous tissue is a lengthy procedure and further touch ups after the initial 2 stages are often necessary. Patients should be realistic in their expectation of the final appearance.

Caution

Parents of affected children are usually keen to seek medical remedy. The generally recommended age for surgery is when the child's head has grown sufficiently to approximate an adult's head size, i.e. at least 8 to 10 years old. Creation of the pinna does not restore hearing in the ear if that sensation is also defective. The ENT specialist may be involved with creation of an ear canal if the latter is absent and the inner ear is intact.