1. A Prosthetic Ear
A false ready-made ear usually made from silicone
is attached to fixtures that are embedded into the bone at the
side of the head. It may also be attached using a special adhesive.
It usually involves 2 surgeries, 3 months apart when the child
is 7/8 years old. The prosthetic ear must be renewed approximately
every 2 years. It should be removed every night and cleaned daily.
Patients in Ireland who wish to pursue this method are usually
sent to the UK for this procedure, although the fixtures for the
prosthetic ear can be implanted by ENT's in Ireland.
2. Ear Reconstruction using
An ear is reconstructed by removing some of the patient's
own rib cartilage and shaping an ear framework from this. The
number of surgeries involved varies between 3 to 5 operations
over 18-24 months before the ear is finished. Most surgeons using
this method of reconstruction prefer to wait until a child is
about 10 years of age before starting surgery to ensure the ear
has stopped growing and that the rib cage is large enough to provide
the donor material necessary. If atresia repair is done with rib
graft, then the atresia repair should be done AFTER the rib graft.
Results using this technique are variable
and heavily dependent on the experience and skill of the surgeon.
The surgeons best known for reconstructing ears using ribgraft
include Dr Burt Brent in California, USA, Dr Nagata in Japan and
Dr Francoise Firmin in Paris, France.
3. The Medpor Implant
An ear framework is made using a synthetic material called porous
polyethylene. This material has been successfully used in plastic
surgery for over 30 years. For 15 years, it has been used for
ear reconstruction. This readymade ear is placed under the patient's
scalp and covered in the patient's own skin taken from the
tummy and back of the other ear, if present. The procedure can
be done on children from the age of 3. It involves two outpatient
surgeries, 3 months apart. The implant is porous and so blood
vessels grow through the implant. The surgeon best known for this
method of ear reconstruction is Dr John Reinisch at The Children's
Hospital in Los Angeles, USA, who developed this technique and
has reconstructed 500+ ears using the medpor implant. Dr Reinisch
has also successfully reconstructed ears on patients who lost
ears due to burns or who had failed surgery using other methods
of reconstruction. If atresia repair is done with the medpor implant
then the atresia repair should be done BEFORE the medpor implant.
This method of reconstruction is currently not available
in Ireland or The European Union but patients from Ireland have
travelled to the USA for this procedure.
4.Soft Tissue Reconstruction
This may be possible when there is sufficient existing tissue
in milder forms of microtia. The surgeon best known for this is
Dr Roland Eavey in Massachusetts, USA.
5.Opt Not To Reconstruct The Outer Ear
Some patients may opt to not pursue surgery. It's an individual
decision and often depends on the degree of the microtia and many