The surgical treatment of microtia: a long-term review of 17 patients
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Published on: May 23, 2021
Insights
Surgical reconstruction for microtia (ear deformity) yielded disappointing cosmetic results and caused significant emotional and educational distress in children. Hearing improvements were also limited, suggesting careful consideration before proceeding with such surgeries.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Pediatric Health
Background:
- Microtia, a congenital ear deformity, presents significant cosmetic and functional challenges.
- Surgical reconstruction aims to improve both the appearance and hearing for affected children.
- Previous outcomes for microtia reconstruction highlight the need for objective evaluation.
Purpose of the Study:
- To evaluate the long-term cosmetic and functional outcomes of surgical pinna reconstruction in children with microtia.
- To assess the emotional and educational impact of microtia reconstructive surgery.
- To discuss the challenges and indications for surgical intervention in microtia cases.
Main Methods:
- Review of 14 children 3.5 years post-surgical reconstruction for unilateral or bilateral microtia.
- Objective assessment of cosmetic results.
- Evaluation of hearing outcomes and associated emotional/educational sequelae.
- Inclusion of three untreated children for comparison.
Main Results:
- Cosmetic outcomes were objectively disappointing across the cohort.
- Treatment involved prolonged hospitalization and multiple surgeries, leading to adverse emotional and educational effects.
- Hearing improvement attempts in bilateral microtia cases were largely unsuccessful.
- Most children concealed their ears post-surgery.
Conclusions:
- Surgical reconstruction for microtia has significant drawbacks, including poor cosmetic results and negative psychosocial impacts.
- Hearing rehabilitation efforts in bilateral microtia were disappointing.
- Reconstruction may be contraindicated for severe cases (bilateral anotia, deformities) or in unstable family environments.
Abstract:
Fourteen children were reviewed approximately 3 1/2 years after surgical reconstruction of the pinna had been completed. Seven had unilateral microtia and seven bilateral microtia, including four caused by thalidomide. Using objective criteria the cosmetic results were disappointing. Treatment entailed protracted hospitalisation, numerous operations and produced adverse emotional and educational sequelae. Nearly all the children covered their ears by growing their hair long. Attempts by the ENT department to improve hearing in the children with bilateral microtia had been disappointing. Three other children who were not treated although they had been referred for surgery were also reviewed. The problems of reconstructive surgery for microtia and the indications for treatment are discussed. It is suggested that reconstruction may be inadvisable for children who have bilateral anotia or associated deformities and who have an unstable family background.
