Ear reconstruction

Earreconstruction may be necessary when the patient is born with some deformity in the region or when the ear undergoes some type of trauma that alters its original formation. This reconstruction can be partial or total, depending on the microtia, that is, the deformity or trauma. 

This anomaly can be uni or bilateral. In most cases, it is one-sided! Only 10% and 20% of patients have the anomaly in both ears. In about 50% of patients, the external auditory canal exists, however, the hearing disorder occurs in only 25% of patients.

How is ear reconstruction surgery performed?

It’s a complex procedure. It is a surgery performed in three main surgical stages, the first of which consists of removing three cartilages from the rib, modeling and sculpting the costal cartilage and including it in the mastoid region. 

The second time is summarized in the placement of a cartilage to increase the position (shim). 

In the third stage, the ear release is reconstructed in order to provide projection and restoration of the angle formed between the ear and the skull.

 When to have the surgery?

Unlike non-syndromic and syndromic craniosynostosis , the ear should not be operated on in the first months of the patient’s life. 

We perform ear reconstruction surgery fromthe age of 10, but this has more to do with the size of the costal cartilages than the size of the ear itself. If we do it with the youngest child, there is a possibility that we will have to collect more than 3 costal cartilages.

This waiting time is because before this period the ear is still growing. That way, any attempt at reconstruction will not be accurate.

When surgery involves total ear reconstruction, in which reliefs must be created, the procedure should be performed after 9 or 10 years of age (depending on the patient’s height and body development).

It is important to wait until the appropriate age to ensure that the ear has fully developed, allowing enough cartilage to be removed.

Is hearing function affected?

It is normal that in cases of ear malformation, the concern with hearing is great. A frequent question is whether the child who is born with the anomaly or the person who acquires it will be completely deaf on the affected side. The answer to these questions is: it depends. The auditory system is complex, consisting of three parts of the ear (outer, middle and inner) and the auditory pathways in the central nervous system.

In fact, in some cases, the ear canal can be affected. When it is the case of total ear reconstruction, this area may be partially or even completely absent.

It is rare to have patients without hearing on the affected side. It’s only 10% of cases!

Generally, people who have these anomalies have at least some hearing. This is because the inner ear, called the receptive ear, is derived from an embryological tissue different from the tissue of the outer and middle ear (conductive portion). therefore, the inner ear is rarely involved. 

When both ears are affected by these anomalies and the ear canals are absent, it will be necessary to wear a device to help the patient hear normally and recover.