Timescale and Diagnosis

The treatment of microtia and atresia is divided into three stages: early hearing rehabilitation, definitive hearing rehabilitation and the plastic reconstructive surgery of the ear.
Hearing rehabilitation is at the forefront and should occur in every case because speech and general development depend on the ability to hear.

Early Hearing Rehabilitation

Zeitplan & Dignostik - FrÅhe Hîrrehabilitation

The function of the middle and inner ear of children with microtia or atresia must be tested within the first weeks of life by a specialist practice or department in the hospital. This area is called “paediatric audiology”. In the first four years of life children wear a bone conduction hearing device on a headband. These hearing devices pick up sound and convey it via the skull to the inner ear.

Definitive hearing rehabilitation

From the second year of life definitive hearing rehabilitation is possible. The ideal time for treatment depends on the severity of the malformation and the chosen method. Reconstructive surgery on the ear canal and middle ear is possible in selected cases. Furthermore, a range of hearing technology is available. This includes bone conduction hearing aids and implants.

Imaging Methods

There are different methods of examination which involve making images of organs or bones. Computer tomography (CT) in radiology is an example of this. Naturally a radiological examination should only be performed if it is necessary for the treatment. We do not recommend a routine radiological examination straight after birth. A CT scan is necessary before an implant operation, for example. Magnet resonance imaging (MRI), on the other hand, is only used in special cases.

Ear Reconstruction

For many microtia sufferers the lack of external ear is very damaging for their self-esteem and their relationships with other people. But there are just as many sufferers who don’t feel restricted by this defect and don’t wish ear reconstructive surgery. The decision for or against treatment must be taken personally by each patient. It is very important to us to discuss this aspect with you in detail beforehand.

Should you decide to have plastic reconstructive surgery of the external ear, there are three different methods that can be used. The external ear can be reconstructed using your own rib cartilage. As an alternative to rib cartilage a special synthetic material from Polyethylene can be used. Furthermore, artificial Silicon ears, known as prosthesis, are available. They give the appearance of a whole ear and are held in place on the head by magnets.

All three methods have pros and cons. We will advise you about these in detail during the consultation.

Syndromes & Further Diagnosis

Microtia and atresia can occur separately or as part of a syndrome. A syndrome is described as different symptoms occurring simultaneously. Known syndromes with ear malformations include Goldenhar syndrome (oculo-auriculo-vertebral dysplasia) and Treacher Collins syndrome (also known as Franceschetti syndrome). In these cases genetic counselling is useful. At the same time the internal organs should be checked for defects in a preliminary paediatric examination, because these must be treated first in any event.
The eyes, jaw and spine are also probably affected and require examination and treatment as appropriate by a specialist ophthalmologist, oral and maxillofacial surgeon or a paediatric orthopaedic surgeon.