Microtia - Atresia

What is Microtia - Atresia?

Aural Atresia is the medical term that refers to the absence of the ear canal. It can also involve other structural abnormalities of the middle ear, such as the absence of an ear drum and the small bones of the middle ear. The function of the middle ear is to transmit the sound to the inner ear or cochlear.

Patients who have Microtia usually also have aural atresia. In fact, 95% of all aural atresia cases occur in microtia patients. The two conditions are closely related because the middle and outer ear develop from one common block of tissue at approximately 6-10 weeks gestational age.

Hearing Restoration

It is usually possible to restore hearing in Microtia patients with aural atresia, as long as the inner ear is present. Patients should have regular monitoring of their hearing and a high resolution 3-D CT scan of the temporal bones to show if the middle ear structures can be surgically corrected. This important test determines if the patient is a candidate for hearing correction surgery in addition to the reconstruction of the outer ear.

The surgery is either done prior to or after the outer ear reconstruction surgeries. This depends on the type of outer ear reconstruction surgery done. With an implant, most surgeons recommend having the middle ear surgeries first. With rib graft cartilage technique, the atresia surgery is performed after outer ear reconstruction.

Microtia correction with the rib cartilage method using autologous (patient's own) cartilage is preferable in patients wishing to also have atresia repair surgery. Because the tissue used to construct the new ear is the patient's own, it has its own blood supply, is more durable and is also less subject to infection.

Revision Surgery

Another factor to consider is that 15-20% of children (see Children and Microtia) who have atresia surgery will require a revision operation due to narrowing of the opening (stenosis), new bone growth in ear canal, chronic moisture or infection or loss of previously experienced excellent hearing. If revision surgery because necessary the rib cartilage ear performs better than an implant which might be subject to exposure, extrusion and infection.

Contact our office today to schedule a consultation with Dr. Mark Mitchell Jones.