Facial Plast Surg
DOI: 10.1055/s-0044-1785454
Original Article

Contemporary Treatment of Microtia–Atresia

Thomas Romo III
1   Department of Otolaryngology-Head and Neck Surgery, Northwell Health, New Hyde Park, New York
2   Department of Otolaryngology-Head and Neck Surgery, Lenox Hill Hospital, New York, New York
,
Sylvia Horne
1   Department of Otolaryngology-Head and Neck Surgery, Northwell Health, New Hyde Park, New York
2   Department of Otolaryngology-Head and Neck Surgery, Lenox Hill Hospital, New York, New York
,
2   Department of Otolaryngology-Head and Neck Surgery, Lenox Hill Hospital, New York, New York
› Author Affiliations

Abstract

Microtia–atresia is a congenital deformity affecting the external ear and ear canal that can present with varying degrees of severity and morbidity. Treatment occurs along a spectrum and primarily centers on improving aesthetic appearance. Many cases of microtia will not be effectively treated with conservative measures and will require some form of reconstruction. There are several options available, including porous polyethylene implants, autologous rib grafting, and autologous chondrocyte frameworks. Equally significant is the treatment of hearing loss, as many patients with microtia–atresia will have a component of conductive hearing loss. This article aims to comprehensively review contemporary treatment modalities for microtia–atresia and discuss the advantages, disadvantages, and practicality of each. Treatment and reconstruction often take a multidisciplinary and multistaged approach to achieve optimal results, with ideal management determined by each patient's individualized needs.



Publication History

Article published online:
08 April 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Tsang WSS, Tong MCF, Ku PKM. et al. Contemporary solutions for patients with microtia and congenital aural atresia - Hong Kong experience. J Otol 2016; 11 (04) 157-164
  • 2 Andrews J, Kopacz AA, Hohman MH. Ear microtia. In: StatPearls. StatPearls Publishing; 2023. . Accessed December 28, 2023 at: http://www.ncbi.nlm.nih.gov/books/NBK563243/
  • 3 Chauhan DS, Guruprasad Y. Auricular reconstruction of congenital microtia using autogenous costal cartilage: report of 27 cases. J Maxillofac Oral Surg 2012; 11 (01) 47-52
  • 4 Ali K, Mohan K, Liu YC. Otologic and audiology concerns of microtia repair. Semin Plast Surg 2017; 31 (03) 127-133
  • 5 Olshinka A, Louis M, Truong TA. Autologous ear reconstruction. Semin Plast Surg 2017; 31 (03) 146-151
  • 6 Ali K, Trost JG, Truong TA, Harshbarger III RJ. Total ear reconstruction using porous polyethylene. Semin Plast Surg 2017; 31 (03) 161-172
  • 7 Romo III T, Fozo MS, Sclafani AP. Microtia reconstruction using a porous polyethylene framework. Facial Plast Surg 2000; 16 (01) 15-22
  • 8 Pierce G. Reconstruction of the external ear. Surg Gynecol Obstet 1930; 50: 161-172
  • 9 Tanzer RC. Total reconstruction of the external ear. Plast Reconstr Surg Transplant Bull 1959; 23 (01) 1-15
  • 10 Brent B. Auricular repair with autogenous rib cartilage grafts: two decades of experience with 600 cases. Plast Reconstr Surg 1992; 90 (03) 355-374 , discussion 375–376
  • 11 Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg 1993; 92 (02) 187-201
  • 12 Walton RL, Beahm EK. Auricular reconstruction for microtia: part II. Surgical techniques. Plast Reconstr Surg 2002; 110 (01) 234-249 , quiz 250–251, 387
  • 13 Brent B. Microtia repair with rib cartilage grafts: a review of personal experience with 1000 cases. Clin Plast Surg 2002; 29 (02) 257-271 , vii
  • 14 Chen ZC, Goh RCW, Chen PKT, Lo LJ, Wang SY, Nagata S. A new method for the second-stage auricular projection of the Nagata method: ultra-delicate split-thickness skin graft in continuity with full-thickness skin. Plast Reconstr Surg 2009; 124 (05) 1477-1485
  • 15 Baluch N, Nagata S, Park C. et al. Auricular reconstruction for microtia: a review of available methods. Plast Surg (Oakv) 2014; 22 (01) 39-43
  • 16 Kurabayashi T, Asato H, Suzuki Y, Kaji N, Mitoma Y. A temporoparietal fascia pocket method in elevation of reconstructed auricle for microtia. Plast Reconstr Surg 2017; 139 (04) 935-945
  • 17 Park C. Subfascial expansion and expanded two-flap method for microtia reconstruction. Plast Reconstr Surg 2000; 106 (07) 1473-1487
  • 18 Cronin TD. Use of a silastic frame for total and subtotal reconstruction of the external ear: preliminary report. Plast Reconstr Surg 1966; 37 (05) 399-405
  • 19 Olcott CM, Simon PE, Romo III T, Louie W. Anatomy of the superficial temporal artery in patients with unilateral microtia. J Plast Reconstr Aesthet Surg 2019; 72 (01) 114-118
  • 20 Cornejo J, Cornejo-Aguilar JA, Vargas M. et al. Anatomical engineering and 3D printing for surgery and medical devices: international review and future exponential innovations. BioMed Res Int 2022; 2022: 6797745
  • 21 Guzman J. Biotech company says woman received 3D printed ear made from her own cells. The Hill. https://thehill.com/changing-america/well-being/medical-advances/3509610-biotech-company-says-woman-received-3d-printed-ear-made-from-her-own-cells/ . June 2, 2022
  • 22 Joo OY, Kim TH, Kim YS. et al. Fabrication of 3D-printed implant for two-stage ear reconstruction surgery and its clinical application. Yonsei Med J 2023; 64 (04) 291-296
  • 23 Roberson Jr JB, Reinisch J, Colen TY, Lewin S. Atresia repair before microtia reconstruction: comparison of early with standard surgical timing. Otol Neurotol 2009; 30 (06) 771-776
  • 24 Romo III T, Morris LGT, 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 2009; 62 (04) 384-389