Microtia is a congenital malformation of the ear which results in the presence of a small ear or even the total absence of an ear and an external auditory canal. What are the causes of ear microtia? Symptoms and consequences? The lighting of Dr Anne-Sophie Hue, ENT specialist in cervicofacial surgery.
Definition: what is a microtia of the ear?
Microtia corresponds to a rare malformation of the ear in which the external part, called pavilion, has developed poorly. There are different stages in microtia, depending on the degree of development of the pavilion: it can go of a small ear which is not very well hemmed but which includes the necessary cartilage (stage I) up to absence of ear and external auditory canal (stage IV) called anotia. The ear then looks like a small cluster of soft tissue.
What is the cause of ear microtia?
Microtia is a congenital malformation, i.e. present from birth. Most of the time, it is an isolated malformation of the outer ear that has occurred at the time of embryogenesis: the tissues are poorly joined. Most often, microtia affects only one ear, but it happens that the attack is bilateral and associated with other malformations in the face. “Microtia can be of genetic origin when it is part of syndromes and there are other abnormalities. Certain factors could also favor microtia, such as exposure during pregnancy to isotretinoin, thalidomide and alcohol. gestational diabetes could also constitute a contributing factor”, says Dr Anne-Sophie Hue.
What are the symptoms and consequences of microtia?
Microtia results in the presence of a smaller than normal ear or even the absence total ear canal. This implies conductive hearing loss in the ear.
The diagnosis is clinical and must be made by an ENT doctor. This one goes observe the malformation : does it only affect the outer ear or also the middle ear and the inner ear? In case of associated malformation of the middle ear, there is often a malformation of the eardrum and the ossicles. A complete assessment must be carried out in order to determine if the microtia is part of a more complete malformation syndrome. “Sometimes microtia can be associated with a cleft lip, heart abnormalities, kidney abnormalities, etc. Imaging examinations (scanner, MRI) will make it possible to specify the damage to the ear“, details the ENT specialized in cervicofacial surgery.
The treatment of microtia is based on the surgery. “We generally wait until the child is 8-9 years old to make a ear reconstruction. Being a rather complicated surgical technique, it is necessary to consult a specialized ENT“, indicates our interlocutor. This is done in two stages. During the first intervention, the surgeon removes cartilage from the ribs and will resculpt it to make it look like an ear. He then puts it under the skin behind the ear. Six months later, the second part of the operation takes place, which consists of recreate a furrow behind the ear. “For this, the surgeon uses the top skin which will mold the cartilage, then he frees the back of the ear by making a kind of small flap which will allow the ear to take off again. This is a major surgery that can only be performed in a specialized center. When surgery is not desired, theinstallation of an epithesis (plastic ear) can be proposed“she continues.
When to consider an operation in case of microtia?
Surgery in case of microtia can be considered when the child expresses discomfort, whether aesthetic or functional in case of deafness.
Thanks to Dr Anne-Sophie Hue, ENT specialist in cervico-facial surgery.