microtia | Ana Plastics - Center for Custom Prosthetics

Microtia, translated from the original Greek means, ‘little ear.’ It’s the medical term used to describe a small or missing ear, which can be from birth or from other causes such as cancer. Some known syndromes that cause microtia are Goldenhar syndrome, hemifacial microsomia or Treacher-Collins syndrome.

Microtia can affect a single ear (unilateral), or both of them (bilateral). Bilaterial microtia affects around 10% of those born with microtia and is by far the rarest form. Overall, it’s estimated that 1 in 7000 children are born with microtia, and seems to affect boys more than girls and right ears more than left ears. Microtia also seems to be more prevalent in Asian children than other races, for reasons that are still unknown.

As well as the physical differences, those with microtia can also suffer some level of hearing loss. The middle ear, which contains the eardrum and tiny bones is often affected as well as the outer ear that we see. Sometimes the ear canal can be blocked, deformed or absent altogether which means sounds cannot reach the ear drum.

Those with bilateral microtia can have significant hearing difficulties that might necessitate hearing aids. There are operations available to open up the ear canal and reconstruct a middle ear, but they currently have very low success rates. For those with bilateral microtia, the fitting of a bone conduction hearing aid is often the best course of action. This device transmits sound through the bones in the skull so it reaches the middle ear. It’s a very effective hearing aid, but isn’t suitable for young children. A permanent bone anchored hearing aid might be useful for older patients.

The treatments for microtia are all cosmetic. As stated above, the operations that can rebuild the inner ear do not have a high enough success rate to be viable in the majority of cases. In most cases there are three ways of tackling the situation.

The first is doing nothing and leaving the ear as it is. It can be covered by hair and depending on the severity of the case might not be noticeable in normal daily life. The second is to have reconstruction using a rib graft, which takes time, as a new ear is “grown” in the body. The process is in two stages and involves using cartilage from the ribs to give the new ear structure. This is only suitable for those patients aged 10 or over. Finally is prosthetics, or false ear. This is a popular method that takes two operations, but daily maintenance to keep the ear healthy. The prosthetic will need to be changed every two years if the patient is a child, and less often when fully grown.

Microtia is a rare condition, one that doesn’t need to impact life too greatly. The advances in hearing aids and prosthesis have made living with the condition much more bearable for the vast majority of suffers in the last 20 years. That said, there is still much to do, especially with regards reconstruction of the inner ear and the restoration of hearing. Fortunately there are some of the greatest scientific minds in the world working on just that, so watch this space.