Pinna Reconstruction
Pinna Reconstruction
For patients born without external ears or with microtia (small ears), which occurs in approximately 1 in 8,000 newborns.
What is microtia (congenital small ear)? How to help your child feel confident?
Microtia, derived from the Latin word meaning "small ear," refers to a developmental abnormality of the ear that occurs during fetal development. This results in the ear being smaller than normal or having a deformed shape. Most often, only one ear is affected (approximately 90%), and the right ear is more frequently impacted than the left.
Severity levels of microtia.
In medicine, the severity is divided into four levels.
To plan appropriate treatment.
Level 1: The ears are slightly smaller than normal, but still have a complete basic structure.
Level 2: Partial absence of the ear, usually leaving only the lower part or earlobe, with the upper part curled up.
Level 3: (Most common) The ear appears as a small, bean-shaped growth and usually lacks an ear canal (Aural Atresia).
Level 4: Absence of outer ears (Anotia)
What is the cause?
Currently, the exact cause cannot be identified with 100% certainty.
However, medical data indicates that it is not the mother's fault during pregnancy. Factors that may be involved include:
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Blood flow to the ear area is disrupted during the first 7-12 weeks of gestation.
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Genetic factors (very rare, only 5%).
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Exposure to certain medications or chemicals during pregnancy.
Impacts that need to be addressed.
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Hearing: Because patients with level 3 microtia often lack an ear canal, sound does not reach the inner ear, affecting hearing and development.
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Confidence and self-esteem: When children start school, they may receive comments about their appearance, which can affect their self-confidence.
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Facial structure: In some cases, hemifacial microsomia (slight facial asymmetry) may also be present.
Pinna
Microtia
What is microtia?
Treatment and cosmetic surgery guidelines.
Caring for children with microtia requires a multidisciplinary medical team, including ENT specialists and plastic surgeons, with the following main options:
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Hearing aids: For children with hearing problems, to prevent delayed language development.
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Ear reconstruction surgery: This is usually performed on individuals aged 6-10 years and older (depending on their physical condition and the technique used), and there are two main methods:
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Using the patient's own rib cartilage: This method is highly safe because it uses the patient's own tissue, but requires waiting until the child is old enough to have sufficient cartilage.
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Using a skeletal framework (Medpor): This can be done at a young age (approximately 3-5 years old) and avoids the pain of rib surgery.
Advice for parents if they notice this condition in their child: "Don't panic."
The first thing you should do is take your child for a hearing test with a specialist to check if their inner ear is functioning normally and to plan treatment with a plastic surgeon early on, so that your child can have the best possible quality of life.
The appropriate age for surgery is 6-7 years old.
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Measure the Medpor to match the size of the existing ear.
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Remove the primary meningeal layer (TPF) and use it to cover the Medpor framework. Also, remove skin from the groin or the lateral chest area and use it to cover the framework.
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After surgery, two drainage tubes will be placed to drain blood and to suction the skin to create a groove around the ear. These will be left in place for 7 days, followed by a head bandaging surgery.
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Remove the stitches after 7-14 days.
In the case of using Medpor, the ear structure will be visibly raised immediately after surgery. However, if cartilage is used, the protrusion will become visible after 6 months (after step 3 of the surgery).