Microtia is a malformation of the ear that is seen at birth. The severity of the deformity can range from a small ear with minimal structural abnormality, to no ear at all. The most common form of microtia is what is called a “class III deformity.” These patients have a very small lump in the area where the ear should be, but it does not have the shape and contours of a normal ear. There is usually a nubbin of cartilage with a small amount of fibrofatty tissue that resembles an earlobe. These ears usually do not have an ear canal.
This type of microtia is repaired with surgery in several stages. In the first stage, Dr Rodman harvests cartilage from the patient’s rib. This cartilage is used to carve a new ear. The new ear cartilage is placed under the skin where the small ear was. A drain is used to create suction that holds the skin onto the new ear cartilage. This surgery takes at least 6 hours and patients need to spend at least one night (sometimes two) in the hospital to make sure their pain is controlled and they are able to walk around and take deep breaths. The chest area, where the rib was taken, can be sore for several weeks after the surgery.
Dr Rodman generally recommends that children have the surgery around the age of 5-10 years. The exact age when it is best to perform the surgery varies from child to child, because it depends on how much the child has grown. Kids need to be grown so that they have rib cartilage big enough to make a full sized ear.
In the second stage of the surgery, the ear cartilage is raised off the side of the head. This creates an ear that sticks out of the side of the head, the way a normal ear does. A skin graft is usually placed behind the new ear. This surgery is much shorter than the first, and patients can go home the same day.
In the third and fourth stage of the surgery, a new tragus and and new earlobe is created. Sometimes these steps can be combined together, or with the first or second stage, depending on the patient. These are the final touches that help make the ear look as natural as possible. These are also short surgeries and the patient goes home the same day.
Dr Rodman also works with several otologists, (inner ear surgeons), to help the patient hear in the small ear. To restore hearing in the small ear, there are two options. One is a surgery to help recreate the middle ear. The other option is a short procedure to place a BAHA, or bone anchored hearing aid. This is a permanent hearing aid that works very well to help microtia patients hear normally.
Dr Rodman also does this surgery on adults of all ages. Many of her adult patients had a surgery as a child, but are unhappy with the results. Dr Rodman is able to help revise or recreate these ears as well. It’s never too late to make a change!