Microtia Repair

Before & After

When a child is born with either no ear or a very small rudimentary one, it is termed microtia and may be associated with hearing loss. The repair of this is occurs in four separate stages, spread out over a year. The framework for the new ear comes from the child’s rib cage and is done at the first stage. Most procedures are done between the ages of 5 and 7 years to allow adequate rib cartilage growth and also ensure the child’s understanding, cooperation, and motivation. It is also desirable to complete this before beginning school.

Understanding the Procedure

Microtia is performed in a series of four operations spread out over one year. Because of the young age, each procedure is performed under general anesthesia. The first procedure is the primary one where cartilage is harvested from the child’s ribcage and carved into the framework of an ear. It is then implanted into its final site. The subsequent stages involve small alterations including the creation of an ear lobule and lateralizing the ear. The first procedure is usually associated with a 3-4 night hospital stay and subsequent procedures are performed on an outpatient basis.

What to Expect After Surgery

There are two small drains placed under the ear after the first procedure. These drains are removed on the 3rd or 4th day following surgery. There is usually a large bandage around the head placed to protect the ear. A second incision is along the ribcage where the cartilage was harvested. The subsequent stages are significantly more minor and well tolerated. The end result is an ear that is less conspicuous than the original deformity and resembles a normal ear. It is important to recognize that the ear will not be perfectly like the other side in terms of appearance or the way it feels.

Frequently Asked Questions?

What is the appropriate age for my child to receive this type of surgery?
Most microtia repairs begin around 6 years.

What about my child’s hearing?
The hearing restoration procedure is an entirely separate operation performed after the external reconstruction. This sequence of procedures has proven to provide the optimal outcome. Not all children are good candidates for the hearing restoration surgery. Our neurotologist performs this surgery and can determine his/her candidacy based on a CT scan.

Does insurance cover this procedure?
This is considered a significant birth defect, and insurance carriers usually recognize it as such. Many insurance carriers will initially deny with the argument that it is elective and cosmetic and this often requires letters of appeal and photographs in order to rectify.