Microtia Workup

  • Author: Samuel J Lin, MD; Chief Editor: Deepak Narayan, MD, FRCS   more...
 
Updated: Jul 22, 2011
 

Imaging Studies

  • Thorough workup includes an evaluation of the kidneys and collecting system via ultrasound.
  • Evaluation of the cervical, thoracic, and lumbar spine by plain radiographs rules out occult malformations.
  • In patients with craniofacial microsomia, 3D CT scans aid in surgical planning.
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Diagnostic Procedures

  • Infants should have baseline audiology evaluation of the affected and unaffected ears. Address hearing deficits promptly to prevent speech problems.
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Samuel J Lin, MD  Attending Surgeon, Plastic Surgery, Division of Otolaryngology-Head and Neck Surgery, Beth Israel Deaconess Medical Center, Associate Staff Physician, Otolaryngology, Division of Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School

Samuel J Lin, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, and Triological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Bruce S Bauer, MD  Clinical Professor of Surgery, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine; Director of Pediatric Plastic Surgery, NorthShore University HealthSystem

Bruce S Bauer, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Pediatric Plastic Surgeons, American Association of Plastic Surgeons, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society of Maxillofacial Surgeons, and American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Julia Corcoran, MD, FACS  Department of Surgery, Division of Plastic Surgery, Assistant Professor, Children's Memorial Hospital, Northwestern University

Julia Corcoran, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Cleft Palate/Craniofacial Association, and American College of Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Lawrence Ketch, MD, FAAP, FACS  Head, Program Director, Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Colorado Health Sciences Center; Chief, Pediatric Plastic, The Children's Hospital of Denver

Lawrence Ketch, MD, FAAP, FACS is a member of the following medical societies: American Academy of Pediatrics, American Association for Hand Surgery, American Association of Plastic Surgeons, American Burn Association, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Plastic Surgery Research Council

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jaime R Garza, MD, DDS, FACS  Consulting Staff, Private Practice

Jaime R Garza, MD, DDS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, Texas Medical Association, and Texas Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Deepak Narayan, MD, FRCS  Associate Professor of Surgery (Plastic), Yale University School of Medicine; Chief of Plastic Surgery, West Haven Veterans Affairs Medical Center

Deepak Narayan, MD, FRCS is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Indian Medical Association, Plastic Surgery Research Council, Royal College of Surgeons of Edinburgh, and Royal College of Surgeons of England

Disclosure: Nothing to disclose.

References

  1. Melnick M, Myranthopoulus NC, eds. External ear malformations: epidemiology, genetics and natural history. In: Birth Defects. Vol 15. 1979.

  2. Brent B. The correction of mi-rotia with autogenous cartilage grafts: I. The classic deformity. Plast Reconstr Surg. Jul 1980;66(1):1-12. [Medline].

  3. Poswillo D. Otomandibular deformity: Pathogenesis as a guide to reconstruction. J Max Fac Surg. 1974;2:64-72.

  4. Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg. Aug 1993;92(2):187-201. [Medline].

  5. Firmin F. Controversies in autogenous auricular reconstruction. Presented at: Ear Reconstruction '98: Choices for the Future;. March 4-6, 1998;Lake Louise National Park, Alberta, Canada.

  6. Tolleth H. Artistic anatomy, dimensions, and proportions of the external ear. Clin Plast Surg. Jul 1978;5(3):337-45. [Medline].

  7. Yang SL, Zheng JH, Ding Z, Liu QY, Mao GY, Jin YP. Combined Fascial Flap and Expanded Skin Flap for Enveloping Medpor Framework in Microtia Reconstruction. Aesthetic Plast Surg. Oct 7 2008;[Medline].

  8. Romo T 3rd, Morris LG, Reitzen SD, Ghossaini SN, Wazen JJ, Kohan D. Reconstruction of congenital microtia-atresia: outcomes with the Medpor/bone-anchored hearing aid-approach. Ann Plast Surg. Apr 2009;62(4):384-9. [Medline].

  9. Pierce GW. Reconstruction of the external ear. Surg Gynecol Obstet. 1930;50:601.

  10. Converse JM. Reconstruction of the auricle - Part I. Plast Reconstr Surg. 1958;22:150-163.

  11. Converse JM. Reconstruction of the auricle - Part II. Plast Reconstr Surg. 1958;22:230-249.

  12. Tanzer RC. Total reconstruction of the external ear. Plast. Reconstr. Surg. 1959;23:1-15.

  13. Oyama A, Fujimori H, Funayama E, Yamamoto Y. Intraoperative simulation device using negative pressure for construction of framework in microtia reconstruction. Plast Reconstr Surg. Mar 2008;121(3):129e-130e. [Medline].

  14. Helling ER, Okoro S, Kim G 2nd, Wang PT. Endoscope-assisted temporoparietal fascia harvest for auricular reconstruction. Plast Reconstr Surg. May 2008;121(5):1598-605. [Medline].

  15. Aase JM, Tegtmeier RE. Microtia in New Mexico: evidence for multifactorial causation. Birth Defects Orig Artic Ser. 1977;13(3A):113-6. [Medline].

  16. Adamson JE, Horton CE, Crawford HH. The growth pattern of the external ear. Plast Reconstr Surg. Oct 1965;36(4):466-70. [Medline].

  17. Llano-Rivas I, Gonzalez-del Angel A, del Castillo V, et al. Microtia: a clinical and genetic study at the National Institute of Pediatrics in Mexico City. Arch Med Res. Mar-Apr 1999;30(2):120-4. [Medline].

  18. Poswillo DE. Discussion of Bennun RD, Mulliken JB, Kaban LB, Murray JE. Microtia: A microform of hemifacial microsomia. Plast Reconstr Surg. 1985;76:864-865.

  19. Snively SL. Plastic surgery of the ear. Select Read Plast Surg. 1994;7:1-26.

  20. Takahashi H, Maeda K. Survey of the familial occurrence of 171 microtia cases. Jpn J Plast Surg. 1982;15:310.

  21. Tanzer RC. Total reconstruction of the auricle. The evolution of a plan of treatment. Plast Reconstr Surg. Jun 1971;47(6):523-33. [Medline].

  22. Thomson HG, Winslow J. Microtia reconstruction: does the cartilage framework grow?. Plast Reconstr Surg. Dec 1989;84(6):908-15. [Medline].

  23. Tolleth H. A hierarchy of values in the design and construction of the ear. Clin Plast Surg. Apr 1990;17(2):193-207. [Medline].

 
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Lobular type microtia.
Conchal remnant type microtia.
Auricular dystopia definition.
Cartilage framework construction, Bauer technique (left) and Nagata technique (right).
Reconstruction of microtia.
Reconstruction of microtia.
Reconstruction of microtia.
Dissection of auricular remnant.
Dissection of auricular remnant.
First stage – lobular type.
Conchal remnant type.
Second stage.
Second stage.
Second stage.
Construction of tragus.
Reconstruction of microtia.
Vestige with meatus and canal.
Reconstruction of auricular dystopia.
Reconstruction of auricular dystopia.
Reconstruction of auricular dystopia.
Augmentation of skeletal support.
Integrating auricular reconstruction with distraction osteogenesis.
Integrating auricular reconstruction with distraction osteogenesis.
Integrating auricular reconstruction with distraction osteogenesis.
Integrating auricular reconstruction with distraction osteogenesis.
Auricular structure.
Dimensions and proportions of the external ear.
 
 
 
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