MICROTIA EAR RECONSTRUCTION - Robert Morin MD

MICROTIA
EAR
RECONSTRUCTION

Microtia is a congenital deformity that
occurs in 1 out of 8,000 – 10,000
births. Microtia can affect one
(unilateral microtia) or both
(bilateral microtia) ears.
The right ear is most often affected
in unilateral microtia.

Microtia is a congenital deformity that occurs in 1 out of 8,000 – 10,000 births. Microtia can affect one (unilateral microtia) or both (bilateral microtia) ears. The right ear is most often affected in unilateral microtia.

Located in the center of the face, the nose is one of the most prominent features on our bodies. It is also one of the first things people notice when they meet you. As a result, even millimeter irregularities are noticeable. Therefore, why not give the world the best representation of yourself? With a nasal reconstructive surgery by Dr. Robert Morin, you will be excited to show off the new and improved, best version of you.

How it Works

Nasal reconstruction following cancer can only be performed after all of the cancer has been successfully removed. This part of the procedure is often performed by a Mohs dermatologist or a surgical oncologist. Once negative surgical margins are confirmed by a finalized pathology report, the reconstructive process can begin. The process is intended to restore the form and function of the nose, often by borrowing tissue from other parts of the body. Cartilage from the ribs or skin from the forehead may be necessary depending upon what anatomic structures within the nose are missing. Using small, strategically placed incisions Dr. Morin will expertly re-arrange skin, cartilage and bone in order to successfully re-shape the nasal bridge, tip, and nostrils. Nasal reconstruction following trauma is performed in a similar.

Children born with microtia will have a severely undeveloped external ear structure. There are four grades of microtia, which are classified based on the severity of underdevelopment. These grades are:

  • Grade I: Identifiable structures of the external ear are present, but are not completely developed. The external ear canal is present, but smaller than normal.
  • Grade II: External ear is underdeveloped and the external ear canal is closed, which causes hearing loss.
  • Grade III: Structures of the external ear, ear canal, and eardrum are all absent. A small knob-like structure is present in place of the typical ear structure. This is the most common type of microtia.
  • Grade IV: Complete absence of the entire ear. This grade is called anotia.

Once the healing process is complete, the ear becomes a living part of the patient’s body for life, which is why this approach is preferable for younger patients.

At this time, scientists have not pinpointed an exact cause of microtia.

Pediatric microtia surgery has a very high success rate. For young patients, Dr. Morin typically recommends rib cartilage graft reconstruction, which involves harvesting the patient’s own rib cartilage and using it to constrict the new ear. In order to construct the new ear, there must be enough rib cartilage available. As such, the surgery is usually performed on children who are at least 9 years old. The procedure is performed in two stages, spaced 6 months apart.

MICROTIA EAR RECONSTRUCTION - photo

Surgical Ear Reconstruction

Stage 1 of pediatric microtia surgery

Dr. Morin carefully removes rib cartilage from the patient and expertly shapes it into the framework of an ear. He then inserts the cartilage framework beneath the skin. The position of the reconstructed ear is based upon the position of the normal ear on the other side. When both ears are absent, Dr. Morin uses his extensive knowledge of pediatric facial anatomy to determine the best location of the ears.

Stage 2 of pediatric microtia surgery

During the second operation, the back of the ear is elevated and a skin graft is used to give it the appropriate amount of projection. Once the healing process is complete, the ear will continue to grow with the child for life, which is why this approach is preferable for younger patients.