Small Ear Canal Problem or Microtia is a birth defect that affects an ear or both of a baby. If a baby gets affected by Microtia during their birth, the external part of their ear remains malformed or underdeveloped. It can be unilateral or bilateral, depending on the number of ears getting affected. In almost 90% of the cases of Microtia, only one ear gets affected.

If your child has a small ear canal or an underdeveloped ear, they may have fallen victim to Microtia. You might want to know what are the problems your child will face due to this and how can this condition be treated. We will talk about all that in this article.

Microtia usually develops in an unborn child during the first trimester of the pregnancy period. Even though the causes of this condition getting developed is unknown, there is some stuff that can be linked to the development of this birth defect. Microtia can occur in four different grades, types, or severity, and depending on the grade, there are several treatment options available for this condition.

Let’s get to know more about the levels, causes, and treatment methods of this condition.

Different Levels of Microtia

The four levels of Microtia are-

Grade I

The affected child might have a small but normal external ear, but the ear canal might be missing or narrowed.

Grade II

The bottom third of the affected child’s ear might be normally developed, including their earlobe. But the top two-thirds will appear to be malformed and small. The ear canal might also be missing or narrow.

Grade III

The most common type of Microtia that’s observed in children is Grade III. This level occurs when the affected child might have an underdeveloped or small external ear, including the beginning of a lobe. It can also have some part of cartilage at the top, but there will be no ear canal.

Grade IV

This is the most severe form of the condition, and there will be no ear canal or ear present in this grade.

Causes of Microtia

Even though the causes of Microtia getting developed in the early weeks of pregnancy is mostly unknown, there are some things that can be linked to it, such as specific genetic conditions, environmental triggers, taking alcohol or drugs during pregnancy, and having a diet that’s low in folic acid and carbs.

Among other possible risk factors, one is the use of isotretinoin medications during pregnancy, which are used for acne. These medications have been associated with several birth defects, including microtia. If the pregnant mother has diabetes, it can also work as an underlying reason.

This condition isn’t a genetically inherited one, and it is seen to be appeared at random. However, if a mother has one child with this condition, the chance of having another child with microtia increases by 5%.

Diagnosing Process of Microtia

Pediatricians can diagnose this condition by observing the state of the ear. But for determining the severity, a child will have to go through hearing tests with pediatric audiologists, and other specific tests with an ENT (ear, nose, and throat) specialist. The severity can also be determined through CAT scans, but they are conducted with older children.

While the presence or absence of the ear canal in an affected child will be confirmed by an ENT specialist, the level of hearing loss will need to be evaluated by an audiologist. If the child should go for either reconstructive surgery or hearing assistance, will need to be determined by the ENT specialist.

It is also important to rule out other diagnoses while diagnosing a child with microtia, as this condition can occur alongside other birth defects or genetic conditions.

Treatment Methods of Microtia

Since this condition occurs in infants as birth defects, many families opt to not go for surgery. Also. surgeries for microtia are easier for older kids, so it’s best to wait until a child is older before conducting reconstructive surgery on them.

It’s also possible to deal with conditions by using nonsurgical hearing devices, like cochlear implants or hearing aids. Especially if ear canals are present, hearing aids can be used so that they can listen better. Other hearing devices can be used too if the child is too young for surgery, or the parents are postponing the surgery.

Here are some of the treatment methods of Microtia-

Rib Cartilage Graft Surgery

This surgery is conducted through two to four procedures over a period of several months to a year. For this surgery, rib cartilage will be removed from the chest of the child and will be used to form the shape of an ear. Then it’ll be implanted at the area where the ear would have been placed.

When the cartilage will get completely incorporated at the site of the surgery, additional skin grafts and surgeries might be needed to position the ear better. Rib cartilage is durable and strong. Since tissue from the child’s own body is used, it’s less likely to get rejected as an implant. This surgery is recommended for 8-10 years old children.

Medpor Graft Surgery

Medpor graft surgery is suitable for much younger children, as a 3-year old child can also undergo this safely. For this surgery, synthetic material is used as an implant instead of rin cartilage. The implant is covered by using scalp tissue, but there is a risk of losing the implant due to injury or trauma, as the implant is not incorporated into the tissue of the surrounding area. The surgery can be done within one procedure, and the results have more consistency than the rib cartilage graft surgery.

Prosthetic External Ear

Prosthetic external ears can be a good option for children that weren’t able to undergo reconstruction surgeries, or whose reconstruction surgery wasn’t successful. Prosthetic ears can be either worn through an anchor system that’s surgically implanted, or with an adhesive. These prosthetic ears can look really authentic. The procedure of placing anchors is minor, and the time for recovery is minimal. However, this procedure can be problematic for children with skin sensitivities. Also, the prosthetics will need to be changed from time to time.

Hearing Devices

If the ear canal is present in the affected child, the condition is of one of the lower grades, and their hearing is affected due to microtia, then mini cic hearing aids can be used to deal with the issue.

But if the former two are not the case, then the child can benefit from using cochlear implants. These devices are implanted into the bone above and behind the ear. There will be a processor that can be connected at the site, which will help the child hear sounds by stimulating the hearing nerves of the cochlea or the inner ear. There are other surgically-placed vibration-inducing devices that can help to enhance the hearing of children that are affected by microtia. These devices send sound vibrations to the inner ear by connecting to the middle ear.

Final Words

Children who experience microtia can easily lead a normal life after going through a treatment method that’s appropriate for them. If a child is affected by one of the lower grades, and their main concern is hearing loss, then they can easily start listening better by using hearing assistive devices like hearing aids or cochlear implants.

But if a child is affected by one of the higher grades of microtia, then it’s best to go undergo surgical procedures like rib cartilage graft or medpor graft surgery. No matter what treatment procedure you choose, make sure that your child is safe from any kind of side effects that might occur due to the surgeries.