How to perform congenital microtia correction surgery

Microtia is a relatively common ear deformity. Most pediatric deformities are related to congenital malformations. When such a condition occurs, parents should promptly perform corrective surgery on their children to avoid adverse effects on their children's future lives. There are many surgical methods, including reshaping surgery using autologous rib cartilage transplantation. As long as the treatment is started early, it generally will not cause a greater impact on the child.

What is ear deformity

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, and the external auditory canal is narrow. In severe cases, the external auditory canal is closed.

Grade II: The most typical, with only the vertical helix present, sausage-shaped, and the external auditory canal 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, tarsal conjunctival epithelial cyst), spinal malformations, and congenital kidney and heart defects.

Surgical method

Autologous rib cartilage is transplanted for sculpting, and the anatomical structures of the external ear contour are reconstructed to form an ear frame. The skin of the residual ear is then properly transposed and covered. This not only solves the problem of small skin donor volume and easy necrosis, but also makes the first-stage earlobe transposition successful, shortening the operation cycle. The reconstructed ear not only has a realistic shape and clear contours, but also has blood supply and sensation, and can withstand normal pressure during sleep as the patient ages.

The cause of microtia is still unclear. It is generally believed to be the result of the combined effects of environmental and genetic factors. Among the environmental factors, viral colds in the mother's early pregnancy, severe pregnancy reactions, and toxic substances in home decoration are all possible factors that may lead to microtia. The genetic incidence rate of patients with a family history of microtia is approximately 2.9%-33.8%.