Ear, Nose and Throat (Otolaryngology) – Head and Neck Surgery

About Microtia and Atresia

Microtia is a congenital deformity affecting the outer ear and atresia (also known as aural atresia) is the absence or closure of the external auditory ear canal. Microtia affects the outer ear and is often accompanied by associated middle ear deformities and hearing loss. It affects one in every 7,000-10,000 children born today and requires a very specialized team approach.

Different severities and extents of microtia exist and the most common classification system is by grade. Below is an explanation of each grade of microtia:

  • Grade I is a slightly small ear with identifiable structures and a small but present external ear canal.
  • Grade II is a partially formed ear, usually with a closed off or stenotic external ear canal producing a conductive hearing loss.
  • Grade III is the absence of the external ear with a small "peanut" skin and cartilage  structure and the absence of the external ear canal and ear drum.
  • Grade IV is absence of the total ear (anotia). 

Microtia and Atresia Repair at NYEE

The microtia/atresia comprehensive care team at New York Eye and Ear Infirmary of Mount Sinai is one of very few expert teams that exist in the world. The NYEE microtia team provides help to children and adults who need expert and experienced care with this very rare condition.

The team consists of facial plastic surgeons, pediatric otolaryngologists, neuro-otologists, anaplastologists, pediatricians, geneticists and pediatric and adult audiologists who create a comprehensive treatment plan after a thorough and complete evaluation of each individual patient. Our team is well known for world-class cutting edge and innovative care, and proudly serves the community with charitable care for children and adults in need, both in New York City and Internationally.

Microtia and Atresia Treatment

Each patient is unique and requires individual attention that allows for the best care possible. Our team offers the full gamut of surgical and non-surgical treatments (including MEDPOR implants, and prosthetics).

External Ear Reconstruction:

Our team most commonly performs a two-stage reconstructive procedure, which uses the patient’s own rib cartilage to sculpt an ear that is inserted under the patient’s skin. Using careful measurements and cutting edge technology and surgical technique, the new ear is sculpted to mirror the appearance of the existing ear. (If both ears are missing, then the new ear is created to look similar to one of the parent’s ears).

The technique of creating an ear from the patient’s own rib cartilage lets the patient heal without any rejection of foreign implant material. This technique only requires two surgical stages, one to build the new ear and the second to elevate it away from the head (usually performed six months after the first procedure). The two-stage technique is much more comfortable for the patient and their family then the four-six stage techniques that have been typically performed at many institutions. At the end of the first stage of surgery, the patient has the appearance of a sculpted ear.

Hearing Restoration:

Depending on several factors, including degree of hearing difficulty, patient age, anatomy, and the development of internal hearing structures, a hearing treatment plan is developed to obtain the best possible outcomes for each patient. The options include external hearing aids, bone anchored hearing aid procedures, and opening the ear canal with a drill out procedure. These procedures are performed at the same time as the ear reconstruction to decrease the number of procedures whenever possible and safe to do.

To learn more about microtia and atresia treatment at NYEE, please contact us at (212) 979-4200.