What is microtia? Children who have microtia have an ear or ears that are not fully or normally formed at birth. In mild cases, a child’s ear may be partially formed and they may be able to hear. In severe cases of microtia, there can be very little ear tissue and a child may not be able to hear. The severity of the condition ranges and depends on each specific case.

While experts do not yet know what exactly causes microtia, some studies show that women who have diabetes before getting pregnant are at higher risk. In the same study, there was also a connection to women who eat a diet lower in carbohydrates and folic acid, as well.

Each Case Is Labeled As A Specific Grade Level In Order To Determine Severity

When one ear is affected, it is called unilateral microtia. When both ears are affected, it is called bilateral microtia. Healthcare providers determine a diagnosis based on a number of factors. There are four “grades” they must choose from.

• Grade 1: The child’s ear could be small, but the ear canal is usually open. The outer ear has most of the features of a normally formed ear.
• Grade 2: The child’s ear might be small and might be missing some features. The child’s ear canal could be open or closed.
• Grade 3: The child’s ear canal is usually closed. A small bud of cartilage might be present in place of a normally formed ear. The child might have an ear lobe, but the lobe might not appear in a normal position or shape.
• Grade 4: Most of the child’s ear is completely missing.

Regardless of grade level, children have reported reduced hearing, frequent ear infections and trouble figuring out which direction a certain sound is coming from.

Many parents and caregivers find themselves asking, “can microtia be correct?” The good news is that it is usually diagnosed right away at birth after a physical exam. Then, a treatment plan can be created.

Deciding When Surgery Is Necessary With The Help Of An Experienced Surgeon

For children with milder cases, minimally invasive surgery may be an option. In more severe cases, reconstruction is not done until a child is between six and nine years old. The reason healthcare professionals wait is because the ear needs to grow as close to its adult size as possible.

Two to four procedures are completed depending on the surgeon and what kind of reconstruction is performed. By using a patient’s existing tissue, a new ear structure is built.  If microtia ear surgery using the patient’s existing tissue isn’t the best option, an ear prosthetic might be used and offers realistic results, as well. For children who use a prosthetic ear, most prosthetics are held on by strong magnets or posts which are surgically implanted.

While these options may not bring hearing back, it addresses the visual deformity in one or both ears. As always, a child’s healthcare provider will discuss each treatment plan in order to determine what is right.

At Gillette Children’s, patients get the benefit of having multiple team members help a child and their family navigate this process. Experts in audiology, plastic surgery, speech and language therapy, ear, nose and throat, and radiology and imaging all work together to get the best possible result.