Congenital external ear malformation

If you find that some people's ears look different from yours in life, this is mostly caused by congenital external ear deformities. Congenital external ear malformation is a very common condition. Most of the time, this condition is formed when the baby is in the mother's womb. Therefore, congenital external ear malformation is closely related to genetic inheritance, pregnancy and the mother's diet. So how should we detect congenital external ear malformations in babies and what other complications are there?

Symptoms of congenital ear malformations

Congenital ear malformations can be diagnosed at a glance. If they are accompanied by middle or inner ear malformations, an auditory examination is needed to determine the nature of the deafness. CT scans can be used to understand the malformations of the ear canal and middle ear. What are the symptoms of congenital ear malformations?

The clinical features of patients with congenital microtia mainly involve the auricle, external auditory canal and middle ear, while the inner ear is often not affected. According to the degree of deformity, the most commonly used clinical classification is three types:

Grade I: The size and shape of the auricle change, but the important surface landmarks of the auricle remain, the external auditory canal is narrow, and in severe cases, the external auditory canal is closed.

Grade II: The most typical, only the vertical helix exists, sausage-shaped, and the external auditory canal is closed

Grade III: Only a mass of skin and cartilage remains. In severe cases, the ear is missing.

There are more than ten types of middle ear developmental disorders in patients with congenital microtia, mainly developmental malformations of the auditory ossicles, tympanic muscles and facial nerves, and they are closely related to the severity of the external ear deformity. Congenital external ear malformations can manifest as one of the clinical symptoms of a sequence in severe cases, such as the eye-ear-spinal sequence.

In addition to microtia, patients also suffer from hemifacial microsomia (hypoplasia of the temporal bones, maxilla or mandible), soft tissue malformations (preauricular growths or macrostomia), eyelid coloboma (eyelid coloboma, palpebral conjunctival epithelial cyst), spinal malformations, and congenital kidney and heart defects.

Treatment of congenital malformations of the ear

It is normal for people to keep their eyes and ears open while living in this world. But some people are born without this ability, which is very common and natural to the general public. This is undoubtedly a cruel thing. How is congenital ear malformations treated?

The treatment of congenital microtia mainly includes two aspects: one is the reconstruction of the external ear, and the other is the reconstruction of hearing function. Generally, the external ear is reconstructed first, followed by the restoration of hearing function. Hearing reconstruction surgery often damages the skin behind the ear and must be performed after auricular reconstruction.

1. External ear reconstruction

1. Timing of surgery: The timing of ear reconstruction surgery is very important and is one of the main determining factors for achieving ideal surgical results. We believe that considering the development of costal cartilage, auricle and psychological factors, 9, 10 and 11 years old are the best ages for ear reconstruction.

2. Reconstruction method: Ear reconstruction usually requires 2 to 3 operations. There are two specific methods. One is called the Brent method. Brent was an American doctor. Later, Japanese doctor Nagata made major technical improvements. This method is the most widely used and popular method in the world. This method does not require skin expansion.

The other is the skin expansion method, which usually requires three operations. During the first operation, a 50-80 ml water bag (i.e., skin and soft tissue expander) is implanted in the mastoid area behind the residual ear, and the hospital stay is about 4 days. Start injecting saline solution 7 days after the operation, and inject it every other day. It takes about 1 month to fill up with 50-80ml of saline solution. After the injection is completed, rest for 1 month before coming to the hospital for the second operation.

2. Hearing reconstruction

For patients with bilateral microtia and external auditory canal atresia, external auditory canal plasty surgery to improve hearing can be considered. However, for patients with unilateral microtia, my experience is to perform partial external auditory canal reconstruction with a depth of about 1 cm, without entering the middle ear cavity, and try to cover it with a local skin flap turned inward.