Microtia

What is microtia?

This is a medical name for a poorly developed ear. The ear may be very small, folded over or deformed. Sometimes the ear canal is very narrow or missing altogether. It can occur in one or both ears.

How will it affect my child?

Microtia affects your baby's appearance and you may feel shocked or disappointed that your baby does not look perfect. This is a normal feeling. When children are older they may sometimes become self-conscious about the appearance of their ears. They may ask for the ear to be fixed.

In most cases there is poorer hearing in the ear with microtia. If your child has no ear canal there is at least a moderate degree of deafness in that ear i.e. at least a 60 decibel hearing loss. If both ears are affected your child will usually require a hearing aid.

What causes microtia?

In most children who have microtia we cannot find any cause. It is not due to carelessness or neglect by the mother during pregnancy.

Will my child have other problems?

In many cases the ear is the only part of your child that has not developed perfectly. In a few cases, the microtia may be part of a syndrome such as Goldenhaar's Syndrome in which other abnormalities are present. It is important for your child with microtia to be examined carefully after birth so that any problems in other areas can be picked up quickly.

Is microtia hereditary?

In most cases this is not so. In a few genetic syndromes microtia may be inherited. Discussion with a genetic specialist is recommended if there are concerns about inheritance.

Ear Abnormalities in Microtia

In almost all cases of microtia the ear lobe, the outer ear canal and the middle ear are all affected.

What is the Microtia Clinic?

The Microtia Clinic was established at the Children's Hospital at Westmead to help parents gain appropriate advice about this problem. The clinic provides assessment by both a plastic surgeon and ENT surgeon. They will advise on current treatment options to improve your child's hearing and appearance. Usually the surgery for this condition is not done until your child is over 8 years of age. Families are offered appointments every 2 years to check your child's progress and provide updated advice on treatment. The clinic is coordinated by a paediatrician who also checks the child for other problems. An education consultant who is a teacher of the deaf is able to offer educational advice when needed. A social worker is also available if families are experiencing particular stress.

Appointments can be made by phoning: (02) 9845 2139

What treatment is available?

Surgery

Plastic surgery is frequently available to improve the appearance of the ear lobe once your child is over 8-10 years of age and has clearly indicated that he/she wants to undergo this surgery.

Occasionally a narrow ear canal can be widened but the surgery is difficult and is rarely undertaken if there is good hearing in the other ear. Surgery on the middle ear is rarely undertaken unless the problem is very mild and there is good access to the middle ear.

Not all parents or all affected children want to have surgery for this condition. Others may want it very much.

Hearing

If a child has microtia affecting both ears, he or she will probably require a hearing aid. This may be a bone conductor hearing aid or a bone-anchored hearing aid.

IT IS ESSENTIAL TO TEST THE CHILD'S HEARING IN BOTH EARS IF AN EAR ABNORMALITY IS NOTED AT BIRTH.

Can microtia affect a child's speech or learning?

This can happen if your child is not hearing adequately. Children with hearing loss in one ear often hear poorly if there is background noise and may miss things said to them in the classroom or at home .A child who misses a great deal of what is said may have difficulties with schoolwork. There are precautions you can take to prevent this problem (see Fact Sheet Deaf in One Ear: The School Child).

If a child with microtia gets many ear infections in the normal ear there may be long periods of poor hearing, and speech may not develop properly.

Help for other problems

Some children with microtia have other problems such as jaw problems, eye problems, orthodontic problems etc.

They may need to attend other clinics as well, such as the Craniofacial Clinic, Dental Clinic etc to enable the best possible approach to the problem.

• Do not hesitate to ask questions so that you are sure about treatment available for your child.