1 / 8

Microtia

Microtia. Diagnosis and Management. About Microtia. Congenital anomaly of the external ear, usually evident at birth Occurs in 1 every 6,000 to 12,000 births Higher risk with higher maternal age. About Microtia. Possible causes:

helmut
Download Presentation

Microtia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Microtia Diagnosis and Management

  2. About Microtia • Congenital anomaly of the external ear, usually evident at birth • Occurs in 1 every 6,000 to 12,000 births • Higher risk with higher maternal age

  3. About Microtia • Possible causes: • in utero tissue ischemia secondary to obliteration of the stapedial artery • Ischemia due to actual hemorrhage into the local tissues • Genetic influences • Medications such as thalidomide and isotretinoin • May present in syndromes such as Goldenhar Syndrome or Treacher Collins Syndrome

  4. About Microtia • Grading: • Grade I – malformation of the pinna, with most of the characteristics of the pinna, such as the helix, triangular fossa, and scaphae, are present with relatively good definition • Grade II – pinna less developed than in Grade I, the helix may be underdeveloped, with the other structures with less definition

  5. About Microtia • Grading: • Grade III - pinna is essentially absent except for a vertical sausage-shaped skin remnant • Superior aspect of the remnant consists of underlying unorganized cartilage • Inferior aspect of this remnant consists of a relatively well-formed lobule • Anotia – total absence of the pinna

  6. Considerations • Inner ear in microtia is almost always functional, and thus hearing loss is basically conductive (the affected ear can still hear by some degree) • In unilateral microtia, the unaffected ear is usually normal, so speech development is usually at par with age • The MD should reassure the parents of the patient and outline the plan of management for the child

  7. Management • Auricular Reconstruction is usually performed at 6-8 years in children with unilateral microtia • Pinna is 85-90% of its adult size by this age • At this age the patient is usually large enough that rib size is sufficient to harvest an adequate rib graft • Surgery may be done earlier if the child has adequate rib size, and postponed if not

  8. Management • Auricular Reconstruction is usually performed at 6-7 years in children with bilateral microtia • The usual goal is to fix at least one ear, and achieve adequate hearing without assistive devices • Ear canal and middle ear may be evaluated for reconstruction using CT scans of temporal bones • External ear reconstruction is usually done prior to middle ear reconstruction to preserve the skin and blood vessels • Bone-anchored Hearing Aids (BAHAs) may be used if the child is not a candidate for surgery

More Related