Review of Microtia : A Focus on Current Surgical Approaches

Abstract

A wide spectrum of anomalies may involve the auditory system. As a visible structure, auricular malformations constitute a great burden. A wide set of anomalies may affect the ear including the microtia spectrum, protruding ears (bat ear), constricted ear (Lop and Cup ears), Stahl ear, and cryptotia.In plastic surgery practice protruding ears and microtia are common presentations. Microtia literally means small ears. Microtia is a spectrum of anomalies of the auricle that range from disorganized remnant of cartilage attached to soft tissue lobule to complete absence of the ear (anotia). Ear reconstructive procedures has made in impact in the lives of these patients. The early attempts to surgically restore the ear in microtia was in 1920 using a rib cartilage. Up to 49% of microtia cases are associated with other anomalies or a known syndrome. The most common syndromic associations are hemifacial microsomia, Towens Brocks syndrome, Treacher Collins, Goldenhar and Nager syndrome. Oculo-auriculo-vertebral spectrum (OAVS). Generally, the ear can be retrieved by two possible methods: Surgical reconstruction using autologous or alloplastic cartilage and the use of prosthesis which could be adhesive or implant retained. Surgical reconstruction proved to be superior to other methods due to its longevity and less complications. The only limitation is the skill of the surgeon. Ear prosthesis are reserved for special cases including traumatic anotia in adults.