Microtia Ear Reconstruction Houston

Microtia / Ear Reconstruction Houston What is microtia?

What are some other names of microtia?

What causes microtia?

What else is microtia associated with?

Will my child with microtia be able to hear?

What are the important considerations for my new baby with microtia?

What can I expect for surgery to reconstruct the ear?

WHAT IS MICROTIA? Microtia literally means “little ear”. It is a congenital malformation where the pinna (portion of the year that is visible), does not develop fully.

WHAT ARE SOME OTHER NAMES OF MICROTIA? Microtia is also called aural atresia or ear atresia. It is sometimes called anotia, though anotia literally means “no ear”. True anotia is rare as mostly there is some ear remnant.

WHAT CAUSES MICROTIA? The cause of microtia is unknown. There are several theories, but the true cause remains allusive. Some of the theories include failure of development or loss of circulation is the stapedial artery in the fetus, genetic causes as some of the syndromes are inheritable, and environmental causes. What is important to know is that there is nothing you may have done to cause microtia in your child.

WHAT ELSE IS MICROTIA ASSOCIATED WITH?

Microtia is often isolated, i.e. not part of a larger syndrome. It also may be associated with a syndrome. The most common one is craniofacial microsomia. This is also called hemifacial microsomia, first and second branchial arch syndrome, and otomandibular syndrome. Other syndromes it is associated with are Treacher Collins syndrome, Goldenhar syndrome, Nager syndrome.

WILL MY CHILD WITH MICROTIA BE ABLE TO HEAR? Yes! Microtia is a malformation of the outside of the ear. In most people, the nerve on the inside of the ear is normal. Furthermore, the contralateral ear, if not involved, will allow for adequate hearing for normal speech and language development. Typically, people with microtia have a conductive hearing loss. That means, the nerve can interpret sound, but the sound has a difficult time reaching the ear. In order to help this, hearing aids that amplify sound directly to the bone can be used. They fall into two categories, the first are aids that are held against the bone with straps. The second are aids that are attached directly to the bone (BAHA, Bone Anchored Hearing Aid) Many, but not all, patients with microtia are candidates for reconstruction of the ear canal. This allows sound to travel directly to the nerve. In order to be a candidate, the middle ear space must have air. You will need evaluation with a CT scan to determine if you are a candidate for this type of surgery.

WHAT ARE THE IMPORTANT CONSIDERATIONS FOR MY NEW BABY WITH MICROTIA? The most important thing to remember for your new child with microtia is that the future is bright. With proper care, microtia is completely treatable. You or your child will have a completely normal life and no adverse sequelae. Considerations for unilateral cases (people with one microtic ear and one fully developed ear) include observation of the other ear. People with one microtic ear depend on the other ear for hearing. Ear infections can decrease hearing and therefore should be taken seriously. Your pediatrician should take any signs of infection seriously and begin prompt treatment at any signs of infection. For bilateral cases (both ears are microtic) early hearing assist devices are critical. These allow for sound input which is critical for speech and language development. Early operations are best avoided for either hearing or reconstruction of the ear. Surgery for reconstruction of the ear should be delayed until the child is large enough to allow for enough rib cartilage to create a properly sized ear. This is typically

between 5 and 7 years of age, but most often around six years. The surgery to reconstruct the canal is best delayed until the reconstruction of the outside of the ear is complete.

WHAT CAN I EXPECT FOR SURGERY TO RECONSTRUCT THE EAR? Microtia ear reconstruction surgery can be performed at any time after the child is large enough to allow for enough cartilage to be taken. In general, reconstruction is accomplished with two procedures. The first procedure builds a new ear in the correct position and the second procedure raises that ear off the side of the head. In the first procedure, cartilage is taken from the ribs. The tissue around the ribs is closed and often, some portion of the ribs will reform. This cartilage is carved, reshaped, and molded to look like an ear. This cartilage is placed underneath the skin where the ear should be. The skin takes the shape of the cartilage and a natural shape is formed. The ear surgery takes approximately 5 hours and the recovery is approximately 3 days. The ear is fully formed.

It is however, flat against the head and there is no space behind the ear. The second procedure takes place approximately four months after the first. After four months, the ear is completely healed and can withstand a second surgery. In this procedure, the fully formed ear is simply elevated from the side of the head and a skin graft is used, along with a small block of cartilage that has been placed in a pocket under the skin, to project the ear off the side of the head and hold it in that position. A third procedure is sometime needed for piercing the ears for wearing of earrings. This small procedure is done in the office with local anesthesia in cooperative patients. Ear reconstruction surgery is divided into two general types, reconstruction with natural, living cartilage or reconstruction with artificial materials. At HPCS, we do not use artificial materials in ear reconstruction. Artificial materials, no matter what new devices or technology is used at the present time, are not alive and have no ability to withstand trauma or heal. Artificial materials are more prone to infection. Artificial materials do not last forever and every artificial material used in the past has been associated with long term problems. Though reconstruction with cartilage does require more work, a life time of a natural appearing ear with minimal risk of problems is well worth the effort.

Houston Plastic and Craniofacial Surgery Dr Sean Boutros

6400 Fannin, Suite 2290 Houston, TX 77030 Tel: 713-791-0700 Fax: 713-791-0703 http://www.drseanboutros.com Related Links: Houston Plastic Surgery Houston Plastic Surgeon Breast Augmentation Houston Breast Reconstruction Houston