Microtia of the ear — what is it, causes, surgery, treatment, photos before and after
Pathology may be of varying severity:
- Stage 1: the ear canal may be normal in size or narrowed, auricle decreased in size, may be missing some elements, such as the tragus or proteomelab;
- 2 degree: the auditory canal is narrowed or completely absent, the Pinna is underdeveloped, deformed;
- 3 degree: usually the ear canal Sarasin, and the place of the ear is a fold of skin devoid of cartilage.
- 4 degree: the external ear is completely absent.
In itself, nedorazvitie the auricle and the auditory passage says nothing about the state of the middle and inner ear. These two divisions can be developed properly, and can be underdeveloped or partially absent. For example, in full imperforate auditory canal may be missing an eardrum.
In order to establish the status of middle and inner ear MRI, and to establish the degree of hearing loss the child examined by a doctor, who conducts special tests.
When imperforate auditory meatus and intact middle and inner ear hearing may be reduced. This is known as conductive hearing loss.
When underdevelopment of the middle ear or inner ear may be completely absent.
From the healthy ear, the hearing in the vast majority of cases saved entirely. Because normally in children with unilateral microtia, there is no need to wear a hearing aid and there is no risk of violation of speech development.
The reasons for the development
To date, consensus on why developing microtia of the ear. There are several theories that can explain the appearance of anomalies in certain cases. Here are the main ones.
- The genetic defect.
In some cases, microtia occurs as one of the symptoms of a number of genetic syndromes. While immature is not only the ear but also the upper and lower jaw, soft tissues of the face. In some cases, microtia may be associated with cleft lip and palate (cleft lip and cleft palate).
- A viral infection of the mother during pregnancy.
It is believed that the rubella virus can cause birth defects in the fetus, including underdevelopment of the structures of the ear.
- Reception of medicines by mother during pregnancy.
In particular, the development of microtia the child can cause the drug thalidomide. Exactly, it was found that the appearance defect can be affected by Smoking, alcohol consumption, unhealthy lifestyle of the mother during pregnancy.
If passed by inheritance?
If a person has underdevelopment of the structures of the ear and the auricle, and there are no other features of the structure of the facial skull and intellectual development, to be afraid to transfer her child is not worth it.
Treatment has two main objectives:
- the hearing, if there is such a need;
- the elimination of cosmetic defect.
Usually to restore hearing is necessary in the case of bilateral imperforate auditory canal, or when microtia unilateral and progressive hearing loss of the second ear.
To restore hearing in conductive hearing loss may be applied:
- operation to restore patency of the auditory canal;
- a hearing aid that conducts sound through the bone.
The surgery can be done when a part of the auditory canal is preserved, but ends blindly. It is desirable to maintain and eardrum. But in children the operation does not always give satisfactory results: the auditory canal can be displaced by the growth of tissues, and sometimes again completely closed.
Because most of used hearing AIDS that amplify sound transmission through the temporal bone.
The restoration of the ear
To correct a cosmetic defect, which is the absence or underdevelopment of the ear, can be used:
- the ear prosthesis;
- plastic surgery aimed at the reconstruction of the auricle.
Fabrication of the prosthesis
The ear has three-dimensional structure, which complicates the work of a plastic surgeon. As a rule, to create the most natural shape of the ear at once is not possible. Because one of the options to resolve the cosmetic defect is the use of facial prostheses. And if before the prosthesis is attached to the glue and could not provide an acceptable aesthetic effect, is currently developed and implemented a system VistaFixTM. The method is based on the use of titanium pins which are attached directly to the bones of the skull.
Surgery to install a metal implant is technically simple and not time consuming. The implants themselves are small in size, but their design is such that they can securely hold the denture in place.
The post how to bone implants settle in, they are placed external support. The supports are designed to attach the prosthesis and to ensure its reliable fixation.
The prosthesis is made in such a way to to mirror the healthy ear of a patient. Edge of the prosthesis can be done as thin as possible in order to avoid transition between skin and artificial auricle.
Fixed prosthesis on the supports with clamps or magnets. Technology VistaFixTM allows you to obtain the most natural result without serious problems for the patient and with a guaranteed result.
Surgical correction of hypoplasia of the ear
Plastic surgery reconstruction of the auricle has many modifications and is often in several stages. Method that will be used by the surgeon to recreate the ear, depends on the degree of microtia: the higher the grade the more work will have to be done the surgeon.
To create future frame of the auricle can be used:
- the body’s own tissue: the costal cartilage, the cartilage with the healthy ear;
- artificial materials: nylon, silicone, etc.
Artificial scaffolds for auricular enable you to make the most of manipulation before the operation and thus to shorten the time of the operation. But foreign materials and elements sooner or later cause a reaction of rejection. Because the body’s own tissues are more preferred.
The main stages of operation:
- The formation of the ear canal.
An optional step. But in cases when you need to restore the patency of the auditory canal is performed before the reconstruction of the auricle.
- The formation of a scaffold of an ear.
At this stage produces the removal of part of rib cartilage or cartilaginous part with a healthy ear and giving the frame the desired shape.
- The placement of the frame.
The location of the finished frame on the sides of the head are made in a way to maximize the use of existing underdeveloped skin of the auricle of the patient. For the healing of the cartilage usually takes 4-6 months.
- The formation of ear structures.
It usually takes 1-2 operations. At this stage the ear attach to a normal anatomical position, completed the formation of such structures as the tragus, eliminate scar tissue, which could be formed after the previous stages. By the time the operation to remove microtia with all its phases may take up to a year and a half.
Video: Surgery — ear reconstruction
At what age is best to do the operation?
Currently, there are techniques that allow the reconstruction of underdeveloped auricle in the 1.5-2 years. But often surgery is recommended not earlier than 5-6 years, as the growth of the child formed the auricle may lose the symmetry, to lag behind in growth. If a child sees his difference from other children and suffers from it, then the operation can be done in the year before school.
The price of microtia
|The country of operation||The cost|
|Russia||from 100,000 rubles|
|Israel||from 5500 to 6500 dollars|
The people of Russia would be superfluous to ask your surgeon about the possibility of surgery to eliminate microtia auricle free.
The before and after photos