What is Microtia?
Microtia is a birth deformity of the ear that occurs about one in 5000 – 7000 births, depending on varying statistics in different countries and in different ethnic races.
- Grade 1 - Microtia is a minimally deformed ear.
- Grade 2 - Microtia is a less form and often looks like a miniature ear.
- Grade 3 - looks like a little sausage shaped wrinkle of skin.
What is Atresia?
Atresia is absence or underdevelopment of the ear canal and middle ear structures.
Microtia is almost always accompanied by atresia because the outer ear and the middle ear develop from one common block of tissue.
What cause microtia and did the parents do anything to cause microtia in their child?
The exact cause of microtia is somewhat obscure, but one sure thing is that the parents did not cause it and should not feel guilty. Children with microtia are great kids who can lead normal lives with support of their parents, family and friends.
What other medical problems are associated with microtia?
- The majority of patients with microtia have no other problems aside from Ear.
- Some are involved with Hemifacial microsomia and facial nerve weakness.
- Other abnormalities such as cleft lip, cardiac problems are much less.
At what age can microtia be repaired?
Children with microtia can be repaired usually after the age of 6yrs when their Chest circumference at Xiphisternum is 60cms. ( The rib cartilage should grow enough for carving ).
This is the most important thing to undergo the microtia repair surgery.
What are the current methods being used to correct microtia?
The two methods used for repairing microtia are : Rib Cartilage And Medpor.
The gold standard method used for microtia repair is using the costal rib cartilage to make the framework. Another method is using Omnipor – Medpor which is an artificial material.
What are the advantages of correcting microtia with Rib - Cartilage?
The new ear is sculpted from patients own rib cartilage. We have reconstructed more than 1500 patients with microtia. Ears constructed by this method retain their form throughout the life.
How much discomfort is there after using rib cartlilage to reconstruct ears?
The discomfort is not much and it well handled with intravenous medications.
Can one use the parents rib cartilage or another person cartilage for microtia repair?
Tissue other than your own is a foreign material, in future the body can reject the material,so it is better to use patients own tissue for microtia reconstruction.
Does the microtia patient have hearing problem?
Sometimes patients have one normal ear and are born adjusted to monaural hearing.
I have been doing Hearing Improvement Surgery along with Microtia Repair in One Single Stage. It is Important to just get a CT Scan Temporal Bone done to see the hearing parts.
How does a person with Microtia hear?
A person with microtia – atresia hears by conduction of sound through bone to reach the inner ear which is almost always normal in microtia since it develops from a tissue source separate from the middle and outer ear.
How soon after birth can hearing be determined in a child with microtia and atresia?
Within the first few days of life and certainly within couple of weeks a BERA – (Bone Stem Evoked Auditory Evoked Response ) can be performed on the child with microtia. But occasionally I have seen unilateral microtia cases with abnormal hearing in the opposite side even though the outer ear appears normal. A child with normal hearing may or may not require hearing aid or amplification but needs to be kept on close treatment for speech assessment.
What are the other tests that should be performed in the child with microtia?
CT Temporal Bone , CT Chest Rib Study & Pure - Tone Audiogram (PTA) are the most important tests to be done before undergoing microtia reconstruction surgery.
Who can benefit from a BAHA?
Microtia-Atresia patients who have very good Bone Conduction thresholds benefit very well from BAHA. Also patients who cannot be fitted with a conventional hearing aid, with recurrent ME infections eg : discharging ear have very good outcomes from BAHA.
Few cases with SSD ( Single Sided Deafness) help with BAHA.
What is BAHA?
The Bone Anchored Hearing Aid ( BAHA) is a surgically implanted device designed for patients with hearing loss. The majority of the conventional hearing aids transmit sound through the medium of air conduction.BAHA stimulates the cochlea by transmitting the sound waves through the bones in our skull or bone conduction, therby bypassing the outer and middle ear.Once the cochlea receiving the sound signals,the information is converted into neural signals and transferred to the brain,where it is perceived as sound, thereby by passing the outer and middle ear.