Introduction
Microtia is when an ear has grown differently and can include differences like:
- being smaller than the usual size
- being folded over
- a very narrow ear canal
- the ear or ear canal is missing entirely.
Differences in microtia will affect the following:
outer ear – the part of the ear you can see
ear canal – the inner passage that connects the outer ear to the eardrum
middle ear – the eardrum and three small bones that carry sound waves.
Microtia can happen in one or both ears.
The cause of microtia is not known. In some cases, it can be passed down from a parent who has a genetic syndrome, which is a condition caused by differences in their DNA.
Signs and symptoms
The main signs of microtia are a difference in the shape or structure of the outer ear.
It might look slightly different to the other ear or smaller. It might have the skin and cartilage of the ear but no canal. It may also be missing altogether.
The ear canal may also be narrow or missing altogether, and the middle ear bones may have differences ranging from mild to severe.
Some children will also be born with other visible differences in the shape of their ears, nose, and throat. In many children, the ear will be the only body part not developed properly.
Diagnosis
Microtia is usually diagnosed at birth, after a physical examination and the Statewide Infant Screening - Hearing (SWISH) test.
Some children have microtia caused by a genetic condition, including:
- Goldenhaar syndrome – a condition that causes abnormal development of the eyes, ears, and spine
- Treacher Collins syndrome - a condition that causes abnormal development of the head and face.
Your child’s doctor and medical team confirm the diagnosis of microtia and check the ear canal and middle ear with further tests and scans.
Treatment
Microtia may not need any treatment if the differences are mild, like an ear that is smaller or shaped slightly differently.
For more severe cases, your child may have plastic surgery to improve the appearance of the ear. Surgery can happen when your child gets older, and they can decide whether they want to change their appearance. Some children are not bothered by the difference in their ears.
Surgery is rarely done on the ear canal or the middle ear as they can be difficult to access.
Children with microtia may get frequent ear infections or fluid build-up, known as glue ear. This happens when changes to the inner shape trap germs and stop fluid from being able to drain properly. Surgery to insert tubes called grommets can be done to help the ears drain.
Management
Microtia and hearing loss
Most children with microtia will have hearing loss in one or both ears.
Children with hearing loss will need regular hearing checks to make sure their language and communication development is not affected. Parents and carers must also check their child regularly for ear infections and glue ear to ensure their child’s hearing does not get worse.
Make sure your child’s hearing Is tested if you notice any differences in the ear shape when they are born.
Appearance of the ear
Because microtia affects the appearance of the ear, it can be good for parents and carers to talk to their doctor about the condition and how they can respond to people who may be curious. It is important for parents and carers to speak with their child about the differences in their ears, to answer any questions and to promote good self-esteem.
Building your child’s confidence and self-esteem is an important part of their development. Focus on all the fantastic things about your child that are not related to their body or their appearance.
When your child is older, they may want to have surgery to change the appearance of their ear. This is something you can discuss with your child’s doctor when they are 8-10 years old.
Resources and more information
