Microtia is a condition present at birth with which a person’s ear is small and underdeveloped. Most patients with microtia also have a condition known as atresia that causes the ear canal to be closed or very narrow. This can lead to a significant hearing loss on the particular side.
Microtia and atresia occur in approximately 1 in 6,000 children and the cause is not fully known. Microtia can occur with other congenital syndromes, but most often it is an isolated abnormality where cartilage and tissues do not fully develop.
Surgery is not always needed for every case. Available treatments include ear reconstruction and help with hearing. Our renowned ear reconstructive surgeons are also experts in hearing support.
Children with aural atresia, or ear canal deformities, can have conductive hearing loss which makes it difficult to understand speech or identify where noises are coming from. Hearing loss in one of the ears may lead to speech and language delays, attention and concentration difficulties, and academic issues. Our ultimate goal is to have the child hear well out of both ears.
The first step improving a patient’s hearing is accurate hearing testing. At Texas Children’s Hospital, the pediatric audiologist can provide the best possible hearing evaluations and hearing device care. Hearing support occurs as a team between families, the audiologist, and surgeons.
Hearing Devices
Children with microtia and atresia are often candidates for hearing aids known as bone-anchored hearing aids (BAHAs). BAHAs can be used soon after birth without surgery by using them with a band around the head known as a soft band. Later in life a BAHA device can be implanted through a surgical procedure that improves the quality of sound.
Ear Canal Surgery
Some patients with small and absent ear canals may have the canal opened through surgery called atresiaplasty or canalplasty. A CT scan of the ear bones can help determine if someone is a good candidate for this procedure.
Reconstructive Treatments
Ear Reconstruction with 3D Porous Implant
This ear reconstruction technique is sometimes called Supor or Medpor surgery and has been in use since the 1980s. It can be performed in one outpatient surgery without pain before a child begins school. A bio-compatible, customized porous ear implant is used by surgeons and covered with the patient’s own tissue and skin. The 3D implant is permanently positioned to complete the procedure. The pores in the ear implant allow for human tissue and blood vessels to grow into the implant.
Most patients are also candidates to improve their hearing during the same surgery. Our global expert in microtia reconstruction surgery, Dr. Gabriel Gomez, has developed a cutting-edge technique in implant reconstruction to improve blood flow to new ears.
Ear Reconstruction with Rib Cartilage
Ears can be reconstructed using a person’s own cartilage. In the first surgery, surgeons will harvest cartilage from the rib cage and shape it into an ear and then implant it on the side of the head. During a second surgery, the ear is raised from scalp.
This surgery takes immense experience and skill to perform. Dr. Carol Liu is a highly regarded cartilage reconstructive surgeon who is widely published and a speaker at numerous international microtia conferences.
