Microtia Repair
What is Microtia?
The microtia is defined as the congenital smallness, deformity or absence (Anotia) of the auricle. The ear consists of the outer, middle and inner ear structures. The congenital inability or underdevelopment of the outer ear (auricle) is called as the “Microtia”.
The microtia can be unilateral or bilateral. It is unilateral in most patients. The reason for this formation depends on many factors. Some medications (such as thalidomide) or infections (such as rubella) used by the mother during the pregnancy can cause this condition.
In most patients, there is no external auditory canal, it is closed. Since the auricle and external auditory canal develop from the same structures in the womb, the people having the microtia usually do not have an external auditory canal. In the absence of the external auditory canal, hearing is reduced in the ear on that side.
The structures in the middle ear (eardrum, middle ear ossicle, hammer, anvil, stirrup) do not develop in those who do not have an external auditory canal. The lack of the development of these structures also prevents hearing. There is no problem in the inner ear except in rare cases.
What is the Surgical Treatment of the Microtia?
The aim is to reconstruct the deformed or incompletely formed outer ear structure. It is not possible to perform the outer ear canal or inner ear surgery with this surgery.
At What Age Should the Microtia Be Done?
It is easier to perform the surgeries performed at an early age with the rib cartilages that have reached adequate development. Usually around the age of 8 years, the thorax and normal ear development are considered suitable for this surgery.
How to Perform the Microtia Surgery?
The correction of the microtia cannot be done with a single surgery. According to the surgical technique used; 2, 3 or 4 sessions of the surgery can be required for those who have no auricle.
The microtia operations are performed under the general anesthesia and certain periods are left between the operations.
In order to create a natural ear, the cartilage skeleton of the ear should first be prepared. The rib cartilage is used for this. The cartilage removal from the rib does not cause any health problems or appearance disorders in later life.
In the first session of the surgery, the cartilage taken from the patient’s own ribs is shaped with the help of the various sutures and a normal ear roof is formed. Then, a subcutaneous socket is opened in the extra-ear region and the ear skeleton is placed there. During this session, the earlobe can be shifted to the area where it is required to be.
The second surgery session is done a few months after the first. The aim is to form the back of the ear tissue, which is attached to the skull. The ear mold placed in the first session is slightly separated from the skull, although there is skin tissue in front of it. A thin skin graft (patch) taken from the groin is also transplanted here to form behind of the ear.
If necessary, in other session surgeries, it can be made to create the earlobe, adjust the location of the earlobe, create the ear hole protrusion in front of the ear hole and create the collapsed ear hole. These corrections can also be made in the first 2 sessions of the surgery, depending on the patient and surgical technique. Three or four sessions of the surgery can also be required.
