Microtia – congenital absence of ear

Microtia is the congenital absence of an auricle or part of the ear. It is a very rare disease. Since the external ear canal is closed, it is possible to experience hearing loss. Since the middle ear development is in another region, the middle ear is completely healthy in these patients.

Microtia treatment is not done as soon as the child is born. Because rib cartilage is used in the construction of the auricle and it is necessary to wait for a while for the rib cartilage to develop. However, the treatment of congenital auricular absence should be done before school age so that it does not reveal psychological causes in the child. Therefore, the best average age for this treatment is 5-6. By opening a canal in the middle ear, the tissue in the middle ear region is matured. Then, an artificial hearing aid is placed in the inner ear area and the surgery is completed. It is important to complete the outer ear reconstruction before starting middle ear aesthetics. Microtia treatment is safe. It has been applied for about 20 years and has reached a certain standard. The results are excellent. Microtia surgery should only be performed by specialist doctors. The rib is used to take a piece of the ear cartilage. Therefore, a surgical incision must be made in the chest.

General or local anesthesia is applied according to the procedure to be performed in the treatment. If the ear is to be completely rebuilt from the beginning, it may require 2 or 3 surgeries. The treatment that needs to be done is to transfer the cartilage taken from the rib to the ear. Artificial substances are sometimes used in these processes, but this is not recommended. The tissue of the person is the most natural and healthy.

There are different methods used to create the skin tissue of the auricle. Tissue expansion is one of these methods. In this method, a silicone balcony is placed under the skin of the area where the ear will be formed and the balloon is inflated at certain intervals. Thus, the skin gradually expands. The expansion process takes about 1.5-2 months. When it reaches the desired size, the balloon is removed in the second surgery. The prepared ear skeleton is placed in it.

In another method, the skin of the area where the ear will be made is removed and a pocket is created under it. The cartilage skeleton is placed in the pocket. In the surgery to be performed 2-3 months later, the skin and cartilage are removed together and the back side of the auricle is created by placing a skin patch on the back.

In another method, a vascular membrane structure called temporal fascia located under the scalp on the ear is removed and wrapped on the cartilage skeleton. Skin cover of the auricle is provided by wrapping a skin patch taken from another part of the body.
The temporal fascia provides nourishment to both the inner cartilage and the outer skin patch. After a while, both tissues begin to bleed from the temporal fascia with neovascularization. Of course, the creation of ear folds on such complex three different tissues is a very dexterous process, and despite all the meticulousness, there is a risk that the folds formed due to the previously unmeasurable factors of the patient may be lost as a result of partial or complete melting of the cartilage. All these reasons make ear reconstruction one of the most difficult issues. The aesthetic plastic surgeon decides which method will be applied by discussing all these possibilities with the patient’s family.

It is not recommended to lie on the ear for the first two weeks after the operation. After this time, you can sleep on a soft pillow. At first, there may be some swelling in the operation area. This amount is decreasing day by day. The shape gradually falls into place. The surgery does not consist of a single stage. Since there is a period of about two months between them, it may take a year for the surgery to be completed. Microtia and Anotia surgeries are operations that require patience since the ear is almost absent. Treatment should be continued patiently until the ear takes the desired shape.

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