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Ear Reconstruction Workup

  • Author: Joseph L Leach, Jr, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
Updated: Apr 08, 2015

Laboratory Studies

Unless indicated by the patient's overall medical condition, no particular laboratory studies are obtained routinely.


Imaging Studies

Aural atresia repair requires a fine cut noncontrast axial and coronal CT scan of the temporal bones. The timing of this study is not critical and may be deferred until the otologic procedure is anticipated.


Diagnostic Procedures

For microtia repair, no routine diagnostic procedures are necessary, unless a thorough history and physical examination reveal that particular studies are necessary.


Histologic Findings

Because microtia consists of malformed cartilages and skin appendages, no routine histologic examination is indicated. In fact, no pathologic specimen is obtained under normal circumstances.



Meurmann staged microtia as follows:

  • Grade 1: Malformed auricle of smaller than normal size but retaining characteristic features
  • Grade 2: Rudimentary auricle consisting of a low oblong elevation hook formed at the cranial end corresponding to the helix
  • Grade 3: A more defective auricle with a malformed lobule and the rest of the pinna being totally absent

Grade 3 is the abnormality most commonly encountered in patients desiring reconstruction. Note that anotia is not considered under the above classification.

Contributor Information and Disclosures

Joseph L Leach, Jr, MD Associate Professor of Otololaryngology, University of Texas Southwestern Medical School

Joseph L Leach, Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Cosmetic Surgery, Triological Society, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, Texas Medical Association

Disclosure: Nothing to disclose.


Michael J Biavati, MD, FACS, FAAP Clinical Assistant Professor of Otolaryngology, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School; Private Practice, ENT Care for Kids, Dallas, TX

Michael J Biavati, MD, FACS, FAAP is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Society of Pediatric Otolaryngology, Society for Ear, Nose and Throat Advances in Children, American Academy of Pediatrics, American Cleft Palate-Craniofacial Association, American College of Surgeons, The Triological Society, Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dominique Dorion, MD, MSc, FRCSC, FACS Deputy Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Université de Sherbrooke, Canada

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Additional Contributors

John C Li, MD Private Practice in Otology and Neurotology; Medical Director, Balance Center

John C Li, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Neurotology Society, American College of Surgeons, American Medical Association, American Tinnitus Association, Florida Medical Association, North American Skull Base Society

Disclosure: Received consulting fee from Synthes Power Tools for consulting.

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Grade 4 microtia (anotia). Note the absence of cartilage.
Grade 3 microtia: the most common type.
Grade 2 microtia.
Grade 1 microtia.
Framework components of porous polyethylene.
Cartilage framework carved and assembled for stage 1.
Appearance at completion of stage 1, rib technique.
Incisions for stage 2.
Postoperative appearance, stage 3. A bolster is in place over the skin graft.
Appearance after stage 4.
Early result after stage 1 reconstruction with porous polyethylene.
Early result after stage 2 reconstruction with porous polyethylene.
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