What is Microtia and What Can Be Done About It?

Microtia also known as little ear is a birth defect that occurs in as many as one out of every 12 births in the United States. Microtia is referred to as little ear because the outer ear is deformed and often just resembles a nub. In this condition both the outer and middle ears are underdeveloped, and as a result the majority of children with this condition will experience some degree of hearing loss or deafness.

Little ear affects boys more than girls, and is more common among Hispanics and Asians and Caucasians or African-Americans. This condition also is generally found on the right side more than on the left side and only rarely affects both ears.

One of the causes of little ear is known to be the mother taking a drug called Accutane during pregnancy. Accutane is a cancer treatment drug that is also used to treat severe skin conditions such as acne. Accutane works by killing off rapidly dividing cells, which can be fatal in the pregnancy. Between 1982 and 2003 two thousand women who were using Accutane became pregnant with the majority of pregnancies either terminated or ending in a miscarriage. Of the babies that were born, 160 were born with little ear. This prompted a widespread crackdown of the use of Accutane with women who could become pregnant during the treatment process. But Accutane is not the only cause of little ear.

The only way to correct Microtia is surgery. Unfortunately surgery is not an option until the child is at least three years old but preferably 8 to 10 years old. There are three different ways for the surgeon to correct this defect. The first method requires a rib cage graft reconstruction which cannot be done until the child is at least eight years old although some surgeons will do the surgery when the child is at least six years old.

Another reconstructive method is to remodel the ear with a plastic implant which can be done as early as age 3. And finally a third method which is reserved for severe defects or patients who were unsuccessful with the other surgical methods and that is in an ear prosthesis which is made out of silicon and attach with titanium screws to the skull. The prosthesis ear resembles a real ear, even matching skin tone and is virtually indistinguishable from a natural ear.

Because one of the main symptoms of little ear is deafness as a result of the middle ear being underdeveloped, patients are often tested for deafness or hearing loss as early as two weeks of age with a hearing test called BAER which stands for brain stem auditory response test. If the child is experiencing a hearing loss and the condition is left untreated or undiagnosed, the child will likely fall behind in school and require supplemental services as they repeat grades. However children born with this birth defect are able to lead productive lives as long as they get the services they need initially need.