How Is Microtia Treated?
Treatment for microtia involves both hearing and reconstructive approaches. Here is a comprehensive overview.
Microtia treatment is typically divided into two areas: hearing restoration and cosmetic ear reconstruction. Treatment is usually staged over several years.
Hearing treatment:
- Bone-anchored hearing aid (BAHA or Ponto):
- A small titanium implant is placed in the bone behind the ear
- A sound processor attaches to the implant
- Sound travels through bone directly to the inner ear
- The normal hearing ear provides directional hearing
- Usually placed around age 5
- Middle ear surgery (atresia repair):
- Attempts to create an ear canal and reconstruct the middle ear bones
- Less commonly recommended (results are variable)
- May be an option in select cases
Cosmetic ear reconstruction:
- Rib graft reconstruction (autologous):
- Performed at age 6β10 (when the rib cage is large enough)
- Cartilage is harvested from the rib cage (one side)
- The cartilage is carved into the shape of an ear
- It is placed under the skin on the affected side
- 2β4 surgeries over several months
- The result is a natural-feeling, living ear made of the child's own tissue
- Medpor implant:
- A synthetic implant made of porous polyethylene
- Covered with the child's own tissue
- Can be done earlier than rib graft (age 3β5)
- One-stage procedure
- Does not require rib harvesting
- Prosthetic ear:
- A lifelike silicone ear attached with magnets or adhesive
- No surgery needed
- Requires daily care and replacement every 1β2 years
Treatment Timing
- Hearing assessment: at birth
- Hearing aid fitting: as early as 3β6 months (for bilateral)
- Ear reconstruction: ages 6β10
- BAHA: around age 5
Clinical Guidance
Microtia treatment involves bone-anchored hearing aids for hearing and surgical ear reconstruction (rib graft or Medpor) for appearance. Treatment is staged over childhood, and the best approach depends on the grade of microtia and the family's preferences.