Microtia NYC: What Are the Different Treatment Options?

Microtia NYC: What Are the Different Treatment Options?
Microtia NYC: What Are the Different Treatment Options?

Microtia NYC: What Are the Different Treatment Options? Microtia is an ear abnormality where the external part of a child’s ear is usually malformed or underdeveloped. This can affect one or both ears, and in about 90% of the cases, it occurs unilaterally. The estimated source of microtia NYC is about 1 in 10,000 live births per year, while bilateral microtia occurs only in 1 to 25,000 live births per year.

Microtia NYC: What are the causes of microtia?

Microtia NYC occurs in 4 different grades or levels, which include the following:

  • Grade 1 – In this level, a child has an external ear that appears small. And while this is mostly normal, the ear canal is either narrowed or missing.
  • Grade 2 – In this level, the bottom of the child’s ear, as well as the earlobe, look normally developed. However, the top two-thirds are malformed and small, and the ear canal is either narrowed or missing.
  • Grade 3 – This is the most common type that is observed in children and infants. The child has underdeveloped ears, with small parts of an external ear present. With grade 3 microtia, the ear canal is usually missing.
  • Grade 4 – This is the most severe case of microtia, and is also known as anotia. In this level, a child has no ear or ear canal present and can be either unilaterally or bilaterally.

But what causes microtia?

Microtia doesn’t seem to be genetically-inherited for the most part. Mostly, children with microtia don’t have any family members with the same condition. It just happens randomly. And while this condition isn’t hereditary, in the small percentage of inherited microtia, this condition can skip generations. Plus, mothers who have one child born with microtia can have another child with the same condition.

Microtia NYC usually develops during the first three months of the mother’s pregnancy. The causes are mostly unknown, but sometimes, they’re linked to alcohol or drug use during pregnancy. They’re also linked to environmental triggers, genetic changes, folic acid, and a diet low in carbohydrates.

One identifiable risk factor is the use of Accutane (isotretinoin) during the mother’s pregnancy. This medication has been associated with multiple abnormalities, including microtia.

Microtia NYC: What are the different treatment options?

Some families prefer not to intervene with the condition with surgical approaches. For infants, it wouldn’t be a great idea to go for reconstructive ear canal surgery. So, if your child was born with microtia, and you’re not comfortable with surgical options, you can wait until your child is a little older. Microtia NYC surgeries tend to be a lot easier for older children, especially since there’s more cartilage available to graft.

Some children born with microtia may resort to using non-surgical hearing devices. Depending on the level or grade of the child’s microtia, they may be a candidate for this type of device, especially if they aren’t old enough for surgery yet, or if the parents are postponing it. If an ear canal is present, then hearing aids may be used.

Hearing devices

Children may benefit from a cochlear implant if their condition affects their hearing. With this, the attachment point is implanted into the bone, just above and behind the ear. Once it’s healed, children will receive a processor that will be attached at the site. This processor stimulates the nerves in the inner ear, which helps children hear sound vibrations.

Vibration-inducing hearing devices can be very helpful in enhancing a child’s hearing. They are worn on the scalpand connect to surgically placed implants magnetically. These implants are connected to the middle ear – they send vibrations directly into the inner ear.

While hearing devices that are surgically implanted require minimal healing at the implantation site, children may experience the following side effects:

  • Hearing loss
  • Leaking of the fluid that surrounds the brain
  • Nerve injury or damage
  • Tinnitus (ringing in the ears)
  • Vertigo

Children may also be at risk of developing skin infections around the implant site.

Medpor graft surgery

Medpor graft surgery can be done on children as young as 3 years old. This procedure is a type of re-construction that involves implanting a synthetic material instead of rib cartilage. It can be completed in one procedure and uses scalp tissue as a covering to the implant material.

The results of this surgery are more consistent than rib graft surgeries. However, some pediatric surgeons don’t offer or perform this type of surgery because the risk of infection is high. And since it isn’t incorporated into the surrounding tissue, there’s a higher risk of loss of the implant due to injury or trauma.

Prosthetic external ear

Prosthetic external ears can look very real. Children can wear them with an adhesive or through a surgically-implanted anchor system. The procedure to implant anchors is minor, and the recovery time is minimal. This is a good option for children who haven’t been successful with ear re-construction, or for those who haven’t undergone re-construction at all.

While this may be a better option for some children, some may find it difficult to have a detachable prosthetic. Some children may experience skin sensitivity to medical-grade adhesives.

Rib cartilage graft surgery

Rib graft surgery is best for children aged 8 to 10 years old. This surgery involves four procedures in a span of up to 12 months. In this surgery, the rib cartilage is removed from the child’s chest – this is used to create the shape of an ear. And then, it’s implanted under the skin at the site where the ear would be located. After the new cartilage is incorporated at the site, more surgeries and skin grafts will be necessary to position the ear better.

Rib cartilage is durable and strong, and the tissue from the child’s own body is less likely to be rejected. However, this surgery may involve possible scarring at the graft site and pain. Also, the rib cartilage that is used for the implant may feel firmer and stiffer, compared to the ear cartilage.

Children who are born with microtia can lead full lives, especially if they have the needed lifestyle modifications and appropriate treatment. If your child has this condition, talk to your medical care team about the best course of action.






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