WHAT IS MICROTIA? Symptoms, Causes & Treatment

Microtia is easily diagnosed at birth during the physical examination. There are really no symptoms that occur with microtia except hearing loss because most microtia patients also lack an ear canal (aural atresia). It is rarely seen on the prenatal ultrasound. A hearing screening is performed prior to the discharge from the hospital and a follow-up hearing test, called an ABR (auditory brainstem response) is highly recommended. A CT scan is usually recommended around 5 years of age to evaluate the anatomy of the outer, middle and inner ear. This will determine the hearing options available if the child undergoes surgery to reconstruct the ear.

The causes of most infants born with microtia is usually unknown. Microtia may appear alone or alongside syndromes like Goldenhar Syndrome, Treacher Collins Syndrome and hemifacial microsomia. It is thought to be the anatomy of the ear partially due to a pinch in the blood vessel giving circulation to the ear. Certain medications taken by the mother during pregnancy such as isotretinoin, thalidomide and others could attribute to microtia. As previously stated, the cause is unknown and usually occurs as a one-time event and other new siblings are rarely affected.

There are four options to manage the outer ear: 1) No surgery. It is very important to note that because this is not a life-threatening disorder, a nonsurgical options should always be available 2) Natural Cartilage which is the gold standard worldwide. This is the most common technique performed worldwide and involves sculpting three small pieces of rib cartilage 3) Medpor Polyethylene Plastic. This is an ear implant made of plastic porous material that requires a flap under the scalp to cover it, along with a skin graft 4) Prosthesis. This is usually a last resort option. Hearing options include 1) No hearing aid 2) Softband BAHA 3) Bone-conduction implant requiring surgery 4) Ear canal surgery (atresiaplasty)

Dr. Bonilla has been treating children with microtia for nearly 30 years. He is the only exclusive pediatric microtia surgeon in the world and has evaluated thousands of children with microtia. Having had initial training as a Pediatric Otolaryngologist gives him the expertise as a hearing specialist as well. This combination of experience of reconstruction of the ear combined with the background in pediatric hearing gives him a unique perspective in treating the whole condition of microtia and aural atresia.