Microtia Ear Surgery

Staged Surgical Total Ear Reconstruction

Microtia is a congenital deformity of one ear, and occasionally both ears, where the middle ear containing the small bones of the ossicular chain and the external ear with its cartilagenous framework do not fully develop. This condition almost always results in a severe hearing loss and an external ear structural deficit. Only some rudiments of the external ear remain. They are often deformed and malpositioned. Microtia reconstruction is one of the most challenging surgeries faced by a reconstructive surgeon.

Common Approaches to Ear Reconstruction

Various methods to reconstruct ears have been introduced, but none have stood the test of time as well as the sculptured rib graft technique. Natural tissue, such as sculptured rib, has several advantages over artificial implants, plastic glue-ons, or snap-on ears. First of all, natural tissue is acceptable to the patient under many circumstances where the body would reject an artificial ear. Silastic ear implants are notorious for not only rejections, but also for infections healing problems. In addition, glue-on or snap-on artificial ears can be pulled off. Can you imagine the embarrassment of your child, if the class clown yanked off the ear, holding it up to the classmates? Due to the risk of the ear coming off, sports participation with artificial ears may be limited.

Advantages of Natural Grafts

Once implanted, a rib graft ear retains some sensation on the skin, whereas a plastic ear has no sensation at all. Natural skin changes color in various situations. While a plastic ear may match the adjacent skin color well most of the time, it does not blush or flush as one’s face normally does when excited, cold, or embarrassed. Nor does an artificial ear suntan. Finally, while a plastic ear color may be matched well for photography, it becomes artificial looking in the real world due to its inability to change color naturally.