What is Microtia?

Microtia, meaning “small ear,” is a rare congenital condition affecting the external portion of the ear. Children with this condition may have unilateral microtia (only on one side) or bilateral microtia (on both sides.)

Hearing ability may vary. Some children will have no hearing, while others may have partial hearing. Aural atresia refers to microtia in which both ears are hearing-impaired due to the lack of an ear canal, eardrum, and ear bones. 

mother comforting her son

What are the effects of microtia?

In addition to hearing difficulties, which can cause learning problems and even speech impediments, children with microtia may lack self-confidence regarding their appearance. They may encounter bullying and harassment at school that can be difficult to deal with. Ear reconstructive surgery in Palo Alto can help children affected by microtia regain self-esteem, form positive relationships, and fit in socially. Dr. Graw is a compassionate, skilled provider who delivers natural-looking results that blend seamlessly with the child’s anatomy.

The technique will be selected to achieve the result you envision based on your skin quality, age, and other considerations. All methods involve incisions, but the length of the incisions varies based on the corrections to the skin and tissue needed.

What are the different types of microtia?

Microtia is divided into 4 types, ranging from small ears to virtually non-existent ears. 

  • Grade 1 – Grade 1 involves ears that appear too small, often characterized by a missing ear canal.
  • Grade 2 – Grade 2 involves a poorly developed outer ear characterized by a missing ear canal.
  • Grade 3 – This grade is the most common with microtia and involves abnormal outer ear development with a missing ear canal.
  • Grade 4 – With Grade 4, also called anotia, the ear, and the ear canal are missing.
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What causes microtia?

While no one has determined the exact cause of microtia, it is important to note that children do not get microtia because of factors related to the mother’s pregnancy. Many parents worry that they did something wrong to cause the condition. 

The truth is that it is very rare and difficult to detect microtia in an ultrasound and the condition is not genetic. So there is little parents can do to control it. Microtia affects around one in every 5,000 babies born in the country. 

What are the treatment options for microtia?

There are several treatment options; Dr. Graw will explain them in detail. The oldest reconstruction technique uses rib cartilage to recreate the ear structure. Tissue is harvested from the child’s chest and then used as the raw material for a new ear.

Children typically need to be at least eight years old to undergo this surgery technique. The other option is to use a biocompatible polyethylene implant and a skin graft to form the outer ear. Dr. Graw focuses on creating natural-looking outcomes to help children become less stressed and self-conscious.

What happens after treatment?

While some patients will attain their desired results with a single surgery, there are cases where multiple procedures will be required to produce a well-proportioned, lifelike ear. During your private consultation for microtia surgery in Palo Alto, Dr. Graw will walk you through your personalized treatment plan.

Your child must wear a protective cup over the ear for around three weeks. Swelling and redness are expected, as with any surgery, but these symptoms last just a few weeks. Skin grafting scars may also be apparent. The new ear will look natural, balanced, and fully developed within six months.

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Medium shot of Dr. Graw in red pantsm white shirt, and gray jacket.

Why choose Dr. Graw?

Dr. Graw’s elite training at Stanford, Johns Hopkins, and Harvard instilled in her a passion for aesthetic excellence and an unwavering commitment to patient safety. Dr. Graw is a natural perfectionist and precision-minded visionary who tailors her results to the individual’s goals and wishes. Choosing Dr. Graw for reconstructive ear surgery in Palo Alto, Menlo Park & Atherton is ideal due to her artistry and painstaking attention to detail. When working with children, Dr. Graw is patient, kind, and comforting, as she is a mother herself and understands how daunting a surgical procedure can be at a young age. 

Microtia Surgery FAQs

Will my child be able to hear properly?

How do I discuss the surgery with my child?

Why didn’t microtia show up on my ultrasound?

Did I do something wrong to cause the microtia?

Why should I make my child go through a reconstructive procedure?

Will my child be able to hear properly?

In some cases, microtia can lead to problems identifying the direction that sounds are coming from and distinguishing sounds in a noisy environment. The child should be given a seat in the front of the classroom to best understand the teacher. If hearing loss has occurred in both ears, a bone-conduction hearing aid like BAHA can be beneficial and can be installed before the child reaches 6 months of age.

How do I discuss the surgery with my child?

Parents are usually the ones carrying the brunt of the stress from surgery. Children tend to be resilient and bounce back easily after challenges. Dr. Graw can counsel you on the best way to approach surgery and provide support every step of the way.

Why didn’t microtia show up on my ultrasound?

Ultrasound technicians tend to focus on critical organs. The ears are not routinely investigated during ultrasounds, as they can be difficult to access. Newer high-definition 3D ultrasounds today do a better job assessing the ears.

Did I do something wrong to cause the microtia?

Genetic causes account for only 5% of microtia cases. To date, there is no evidence to support the idea that microtia is caused by anything the mother did or didn’t do. Parents should release any personal guilt for their child’s condition and focus on the available treatments that can improve their child’s life and confidence.

Why should I make my child go through a reconstructive procedure?

Reconstructing the ears can accomplish several goals, including balancing the facial features. Improving hearing through a BAHA implant or atresiaplasty. Improving the child’s social life. Improving the fit and comfort of glasses. Preventing bullying and harassment at school.

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