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.
Staging
Meurmann staged microtia as follows:
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Grade 1: Malformed auricle of smaller than normal size but retaining characteristic features
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Grade 2: Rudimentary auricle consisting of a low oblong elevation hook formed at the cranial end corresponding to the helix
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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.
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Grade 4 microtia (anotia). Note the absence of cartilage.
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Grade 3 microtia: the most common type.
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Grade 2 microtia.
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Grade 1 microtia.
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Framework components of porous polyethylene.
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Cartilage framework carved and assembled for stage 1.
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Appearance at completion of stage 1, rib technique.
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Incisions for stage 2.
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Postoperative appearance, stage 3. A bolster is in place over the skin graft.
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Appearance after stage 4.
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Early result after stage 1 reconstruction with porous polyethylene.
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Early result after stage 2 reconstruction with porous polyethylene.