Microtia is a congenital condition where the outer ear is underdeveloped or absent. It can affect one or both ears and may be associated with hearing loss, depending on the severity of the deformity. While the condition does not usually affect overall health, it can have cosmetic and social implications. Treatment options, including reconstructive surgery and hearing aids, can help improve both appearance and hearing function, with early intervention offering the best outcomes.
What Is Microtia?
Microtia is a condition where the outer part of the ear, called the pinna, is smaller than normal or misshapen. Some children with microtia may have normal hearing, but in other cases, hearing loss can occur if the inner ear is affected. Treatments are available to help reshape the ear if necessary.
Signs & Symptoms of Microtia
Microtia typically affects only one ear, though it can affect both. The ear may appear small or have an unusual shape, and in some cases, it may look like a small bump. If the internal ear structures aren’t formed correctly, a child may experience hearing loss. In rare cases, the external ear may be completely absent, a condition called anotia.
What Causes Microtia?
The exact cause of microtia is usually unknown. It occurs early in pregnancy while the baby’s ear is developing. Some cases of microtia are linked to gene mutations. Microtia is more common in babies whose mothers:
- Have diabetes
- Took certain medications (like isotretinoin, brand name Accutane®) or drank alcohol during pregnancy
- Had a diet low in folic acid and carbohydrates during pregnancy
Some children with microtia also have a genetic condition (such as Treacher Collins syndrome) or other developmental issues affecting the face, heart, kidneys, or limbs.
How Is Microtia Diagnosed?
Microtia is usually noticeable at birth, and doctors may sometimes detect it on a prenatal ultrasound. After birth, doctors will examine the baby for any other health concerns and perform hearing tests and genetic tests if necessary. Imaging studies, such as a CT scan, may also be ordered.
How Is Microtia Treated?
In mild cases, treatment may not be necessary. However, if treatment is needed, options include:
- Ear molding: A silicone mold can be used in the first few months of life to reshape the ear.
- Surgery: Two types of surgical procedures are commonly used to reconstruct the ear:
- Cartilage from the ribs: Surgeons use the child’s rib cartilage to create a framework for the ear, covering it with tissue from the scalp or a skin graft. This surgery is usually done when the child is 6–10 years old and may require several stages.
- Plastic implant: A plastic implant can be used as a framework for the ear, also covered with scalp tissue or a skin graft. This surgery can be done as early as 3 years old, sometimes requiring one or two surgeries.
If the child has hearing problems, specialists such as a pediatric otolaryngologist (ENT) and audiologist can help. A geneticist can assist families in understanding whether microtia could be passed down genetically.
What Else Should I Know?
Most children with microtia can benefit from available treatments if needed. If your child has other medical conditions or hearing issues, follow your doctor’s guidance for care. As your child grows, they may feel concerned about their ear’s appearance. Speaking to a counselor can help them navigate these feelings.
Talking to your doctor about the best treatment options for your child can ensure they get the care they need.