Types of Microtia Treatment
Microtia is a condition that’s present at birth and affects your child’s outer ear. Children with microtia have an irregularly shaped outer ear. Most children with microtia don’t have hearing loss because their inner ear usually develops as expected. However, some children with microtia have abnormalities of their ear canal and inner ear, which can cause hearing loss. It is important for a microtia specialist to evaluate your child so you can learn more about their diagnosis.
There are several treatment options to correct microtia:
- Prosthesis placement—We create a custom-fit prosthetic (artificial) ear. We attach the prosthesis to a baby’s or young child’s head with a special adhesive material. We may place a permanent post for the prosthetic ear to attach to when your child’s ear stops growing around ages 5–7. Prostheses don’t last forever and need replacements every few years.
- Autologous rib reconstruction surgery—We take pieces of your child’s rib cartilage to create an outer ear. This involves two separate surgeries. We generally wait until your child is at least 8 years old for these surgeries so that their rib cartilage is big enough to use for the reconstruction.
- Medpor reconstruction surgery—A surgeon uses a 3D-printed implant to create an outer ear. Some surgeons offer this procedure to children as young as 3–4 years. We’ll refer you to a surgeon who performs the procedure if you’re interested in Medpor reconstruction.
When Is Surgery Needed for Microtia?
Surgery isn’t always necessary for microtia. You may choose not to correct your child's microtia if they aren't bothered by it. But your child may still need surgery to treat hearing loss if they have both microtia and ear canal abnormalities.
What to Expect During a Microtia Surgery Consultation
Our specialists will discuss your child’s medical history, perform a physical exam, and help you figure out which treatment options are uniquely best for your child. During this visit, we evaluate your child for hearing loss, examine them for signs of other craniofacial syndromes, and review a timeline of treatment options.
We don’t recommend any ear reconstruction surgery until children are 3 years or older. But it’s still helpful to have a consultation within your child’s first year of life.
Your child’s multidisciplinary care team helps you understand the pros and cons of each treatment. They also provide personalized recommendations for your child’s needs.
Is Microtia Surgery Covered by Insurance?
Many insurance plans cover microtia surgery. Ear reconstruction surgery costs can vary depending on several factors, including your insurance plan. Our team will help you understand your insurance coverage and costs before surgery.
Find a Microtia Specialist
Ear Reconstruction Surgery for Microtia
What to expect during ear reconstruction varies. You can help prepare your child for surgery by explaining what will happen and answering their questions. Your child’s experience depends on whether they have an autologous rib reconstruction or a Medpor reconstruction. Our surgeons help you understand each procedure.
Autologous Rib Reconstruction
An autologous rib reconstruction is a two-stage surgery. The first procedure takes 6–10 hours. Your child receives general anesthesia so they’re asleep during the procedure.
Stage One Surgery
- The surgeon begins by removing pieces of your child’s rib cartilage.
- The surgeon shapes the cartilage into an ear-like structure.
- The surgeon removes any abnormal cartilage from your child’s outer ear.
- The surgeon places the newly shaped rib cartilage beneath your child’s skin where the ear should be.
- The surgeon places additional rib cartilage back under the skin of the rib incision to be used at the next stage of surgery.
Your child typically spends several days in the hospital afterward. We take care of a drain placed along the back of your child’s ear and manage any postoperative pain. As your child heals, the new ear made from rib cartilage grows into your child’s tissues. Healing takes several months.
Stage Two Surgery
The second procedure happens about 6–12 months later. Your child is also asleep under general anesthesia during this surgery.
- The surgeon makes incisions (cuts) behind the new ear to create space to lift it from the head.
- The surgeon positions and elevates the new outer ear.
- The surgeon places additional rib cartilage collected from the first surgery behind the ear. The rib cartilage is taken from the skin pocket of the rib incision that was created in stage one surgery.
- To complete the surgery, the surgeon uses a skin graft to cover the back portion of the ear.
This second procedure takes around 3–4 hours. Your child may be able to go home the same day.
Medpor Reconstruction
Medpor reconstruction involves one procedure. Your child’s surgeon creates the 3D-printed Medpor implant before the surgery. They customize the implant to match the size and shape of your child’s other ear.
Your child receives general anesthesia to remain asleep. During the operation, your child’s surgeon will perform several steps:
- The surgeon makes an incision over where the ear should be.
- They remove any abnormal cartilage from the area.
- They create a tissue flap underneath the scalp to wrap around the implant.
- They place the Medpor implant beneath the area and wrap this in the tissue flap.
- They use a skin graft to cover the implant and tissue flap.
The procedure takes around 12–16 hours.
What to Expect After Ear Reconstruction Surgery
Your child’s surgeon will place a surgical dressing over your child’s ear after either type of reconstruction. Your child will have to stop intense activity for about three weeks after an autologous rib reconstruction. Recovery recommendations after Medpor surgery will depend on your surgeon’s preference.
Your child will have multiple follow-up appointments over the next several weeks and months to ensure the surgical sites are healing well. Your child will also need to avoid contact sports for several months while their ear heals.
Why Choose University of Utah Health?
Our microtia clinic includes a multispecialty team of board-certified specialists:
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Anaplastologists (facial prosthesis creators).
These experts offer comprehensive treatment for microtia and its associated conditions, including hearing loss.
Our work with U of U Health providers means your child has easy access to all the specialists they need. Your child receives care in our world-class pediatric hospital. We offer all the resources for managing any other conditions and complications.
Make an Appointment
Your insurance determines whether you need a referral to schedule an appointment with the microtia clinic. We recommend checking with your insurance provider before coming to the clinic.
Call 801-587-2173 to schedule an appointment.
