Reconstruction of the ear is one of the most challenging problems facing a reconstructive surgeon as it demands precise technique combined with artistic creativity. Microtia is a congenital deformity of the external ear where the auricle (the external ear) is severely deformed. There may be a spectrum of external ear deformities with various degrees of involvement of the middle and inner ear. This type of ear deformity is commonly seen in patients with hemifacial microsomia and Treacher-Collins syndrome.
Psychological effects of an ear deformity play a significant role in timing of reconstruction. Most surgeons prefer to initiate treatment when the patient is between 5 and 7 years of age since this early intervention will reduce anxiety as a result of peer pressure. This also allows for sufficient rib growth to provide the quantity of cartilage needed by the surgeon for adequate framework fabrication. Surgery at this time can give a more consistent result than earlier intervention due to the fact that the child has had a chance to grow, thus making it easier for the surgeon to balance the size and shape of the reconstructed ear to the child’s normal ear.