Chapter
2:
Microtia
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Chapter
2: |
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Ear Reconstruction
Microtia
Ear Reconstruction
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The treatment of microtia involves surgical
reconstruction of the external ear framework. Ear reconstruction
requires a carefully planned, staged reconstruction that involves 3-4
operative procedures. The first procedure involves the construction of
the cartilage framework for the ear. Under general anesthesia, donor
cartilage for the frame is obtained en bloc from the rib area
contralateral to the ear being reconstructed to take full advantage of
the cartilage's natural curvature. Working from pre-surgical templates
that have been drawn as well as from photographs, the surgeon then
carves the cartilage into its new shape and carefully positions the
graft into position. The overlying skin then redrapes to the newly
carved cartilage framework. Subsequent operations are required to rotate
the lobule and to elevate the framework into its final position.
It is of significance to note that if there is normal hearing in one ear, surgery to improve hearing in the abnormal ear is not recommended. Almost 90% of all patients with microtia have only unilateral involvement and quickly adjust to this condition following birth. Potential gains from working on the middle ear are outweighed by the inherent risks of the surgery itself. Therefore, middle ear surgery should be performed only on the true bilateral microtia patient or the patient with significant hearing loss in both ears.
The Tennessee
Craniofacial Center, part of the Erlanger Health System, is located in
Chattanooga, Tennessee. The Center, led Larry A. Sargent, M.D.,
specializes in the evaluation and treatment of patients of all ages with
craniofacial deformities. Location: 975 East Third Street. Chattanooga,
Tennessee 37403 |
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