Microtia

What is microtia?

Microtia is a congenital abnormality of your outer ear. The term “microtia” comes from the Latin words “micro,” which means small and “otia,” which means ear.

“Congenital” means you’re born with the condition. This abnormality can range from mild structural issues to a completely missing external ear. When accompanied by a missing ear canal, it also can cause hearing problems and difficulty telling which direction a sound comes from.

Microtia usually affects one ear but can occur in both ears. It usually occurs due to abnormal ear development during the first trimester of pregnancy.

Grading of microtia

Healthcare providers use a classification system for the grading of microtia. The severity of the condition determines the type:

• Type 1: External ear is smaller than average but all parts are present with minor deformities.
• Type 2: Outer ear is partially formed and small.
• Type 3: Some auricular structures but no recognized ear parts.
• Type 4: Anotia (complete absence of external ear).

How common is microtia?

Healthcare providers diagnose microtia in roughly 1 to 5 out of 10,000 births in the U.S. The condition occurs more often in babies assigned male at birth (AMAB). It also affects the right ear more often than the left.

What are the symptoms of microtia?

The symptoms of microtia include:

• Abnormally formed outer ear.
• Missing outer ear (anotia).
• Smaller than normal ear size.

Can you still hear if you have microtia?

People who have microtia may have some degree of hearing loss in their affected ear, particularly if there are issues with middle ear or ear canal development. But the structures in your inner ear may have the ability to conduct sound, even if your ear canal is completely closed. Therefore, surgery to open your ear canal may improve hearing. There are also hearing devices that can help even if your ear canals are closed.

If your baby has microtia, it’s important to get their hearing tested. Even mild hearing loss can affect how speech develops.

What is the cause of microtia?

Healthcare providers don’t know what causes most cases of microtia. It usually develops during the first trimester of pregnancy.

In some cases, microtia is a feature of a larger syndrome such as hemifacial microsomia (a condition that affects the development of a baby’s face before birth). Some cases of microtia are genetic (passed down among biological family members).

Is microtia genetic?

In some cases, microtia is hereditary. This means that biological parents can pass the condition on to their children. In many instances, though, microtia is a randomly occurring event.

How is microtia diagnosed?

Healthcare providers usually diagnose microtia at birth. The abnormality is visible when your baby is born. Sometimes, a provider uses an imaging test called a CT scan to get a detailed picture of your baby’s ear. This test helps them look for abnormalities in your baby’s middle and inner ear.

How is microtia treated?

The external appearance of microtia doesn’t always require treatment, but it’s important to address any hearing loss if present. It’s essential to undergo hearing evaluation early and maintain hearing follow-up through early childhood. If there’s hearing loss associated with microtia, your child could develop speech difficulties if the hearing loss isn’t treated.

If you choose to treat microtia, there are a couple options:

• Ear prosthetics.
• Microtia surgery (surgical reconstruction).

Ear prosthetics

Usually made of silicone, an ear prosthetic attaches with adhesive or magnets. Ear prosthetics require maintenance over time and may not be the best option for some children.

Microtia surgery

Microtia surgery involves reconstructing the affected ear. Healthcare providers usually recommend beginning reconstructive surgery between the ages of 6 and 9. Depending on the technique used, reconstruction may require multiple stages.

During this process, a surgeon creates a new ear from cartilage taken from your child’s rib or from synthetic (human-made) materials. Surgeons can also use an ear implant to rebuild your child’s ear. All of these techniques provide a framework that your surgeon will cover with your child’s own tissue.

When can my child go back to regular activities?

Surgery is the only time when a child living with microtia might have restrictions on their activities.

Recovery after microtia surgery depends on the specific treatment. Your provider will tell you when it’s safe for your child to resume normal activities.

Do people with microtia have health complications?

Hearing loss is the most common complication associated with microtia. Some people with microtia feel embarrassed or have self-esteem issues caused by their ear’s appearance. Support groups can help you or your child feel less isolated.

Is microtia preventable?

There’s really no way to prevent microtia. But factors such as avoiding certain medications during pregnancy may help. Research is ongoing in this area, so ask your healthcare provider if there are ways to reduce your risk of having a baby with microtia.

What can I expect if I have microtia?

Many children with microtia have otherwise normal development and lead active and healthy lives. For most people, if there’s hearing loss associated with microtia, treatment can prevent any long-term issues with speech or language development.

Is there a cure for microtia?

Surgical intervention can improve and restore structural abnormalities of the ear. Surgery can help improve hearing loss if it’s from an ear canal that hasn’t developed.

When should I see my healthcare provider?

If you’re pregnant or want to become pregnant, you should talk with your provider about how to care of your health. Someone who’s already had one baby with microtia has a small risk of having another child with the condition.

What questions should I ask my child’s doctor?

If your child has microtia, you may want to ask your healthcare provider:

• How severe is the condition?
• What signs of complications should I look out for?
• What’s the best treatment for my child?
• Who should I see to test my child’s hearing?

A note from Cleveland Clinic

Microtia is a congenital condition characterized by structural abnormalities of your outer ear. It’s usually diagnosed at birth, and treatment depends on the type or severity of the condition. If your child develops self-esteem issues as the result of microtia, there are resources that can help. Most children with microtia lead full, healthy lives.