For children or adults whose ears failed to properly develop at birth, living with an ear defect can be a source of great insecurity. Microtia is a congenital condition in which an infant is born without external ears or with a severe ear deformity. This usually occurs as a result of improper formation of the internal and/or external ear(s) while the child is still in the womb. Microtia can affect one or both ears and may also impair hearing. Fortunately, the condition can be improved through reconstructive surgery. Surgery for microtia is a very delicate procedure that requires detailed knowledge of both facial plastic surgery and otolaryngology (head and neck surgery). Kansas City plastic surgeons J. David Kriet and Clinton D. Humphrey use their unique training and significant experience to treat microtia and achieve the best possible outcome. If your child was born with this condition, our doctors can help him or her attain a more normal ear appearance for restored confidence and improved self-esteem.
What is Ear Reconstruction Surgery?
Ear reconstruction surgery is a procedure designed to treat aesthetic defects in one or both ears. The surgery can be utilized to correct damage or trauma sustained from an ear injury, restore a normal ear appearance after cancer removal surgery, or recreate the ear(s) in patients affected by microtia— a condition involving ear malformation that can present in varying degrees of severity. Ear reconstruction is tailored to accommodate the unique needs of each patient, therefore each procedure will employ different techniques depending on the nature of your anatomic features and surgical goals. All approaches to ear reconstruction require detailed knowledge and understanding of external as well as internal ear physiology to allow an optimal cosmetic outcome.
What Can Ear Reconstruction Surgery Do For Me?
Unlike an otoplasty procedure, which is used to minimize the look of prominent ears, ear reconstruction can benefit individuals who wish to correct a partial or total ear defect. Candidates for surgery generally include patients who:
- Are missing one or both external ears as a result of microtia
- Are affected by malformation in one or both ears
- Require ear reconstruction after cancer or tumor removal
- Seek to repair the ear following an injury or trauma
Our facial plastic surgeons perform ear reconstruction surgery with the goal of achieving a natural ear appearance that exists in harmony with your surrounding facial features. A consultation for this procedure typically involves a physical examination of the affected ear, a review of your (or your child’s) medical history, and a thorough discussion of your surgical goals.
How is Ear Reconstruction Surgery Performed?
There are different approaches that can successfully recreate or restore a normal ear appearance. The best technique for your unique situation will depend on the details of your treatment plan. Generally speaking, the surgery is performed using either autologous, prosthetic, or synthetic reconstruction.
Autologous reconstruction involves using a patient’s own tissue to rebuild the ear structure. Cartilage from the ribcage is used to create a new framework for the ear shape, and subsequent techniques are used once the ear has healed to form the earlobe, adjust the shape and symmetry of the ear, and elevate the ear to a natural projection away from the scalp. Once completed, autologous ear reconstruction can typically yield a natural-looking and long-lasting result. Because this approach uses a patient’s natural tissue rather than a synthetic appliance, the outcome provided by autologous reconstruction can generally withstand the rigor of sports and physical activity to a greater degree than other techniques.
Prosthetic reconstruction uses an artificial ear to mimic a natural ear appearance. A less invasive approach than autologous reconstruction, patients who wish to avoid a multi-stage reconstructive operation often find that use of a prosthesis can achieve their aesthetic goals. The prosthesis can be extremely realistic-looking and restore a symmetrical appearance in patients with an ear defect. Additionally, children under the age of seven whose rib cartilage is not yet fully developed to undergo an autologous procedure can benefit from this technique.
Depending on your treatment goals, the prosthesis is usually attached with an adhesive or through magnetic fixation. Magnetic fixation involves a procedure in which implants are surgically inserted into the side of the skull (similar to a dental implant). These implants provide the fastening point for the prosthesis.
One of the more recently introduced reconstruction techniques, synthetic ear reconstruction has proven to be a highly effective method of recreating the ear(s). This approach uses a patient’s own tissue— a temporal parietal fascia graft and a skin graft—to cover a high-density polyethylene framework, known as a MEDPOR® implant. The reconstructed ear is sutured to the side of the head and meticulously adjusted to match the size and projection of a natural ear. Synthetic reconstruction can provide patients with an opportunity to achieve a more normal ear appearance using part of their own tissue in fewer stages than is typically required by autologous reconstruction.
What is Recovery Like for Ear Reconstruction Surgery?
Each patient’s recovery period will vary according to the techniques used for their ear reconstruction. Depending on which approach is utilized, some individuals may require multiple procedures to achieve the most optimal result. If a patient has undergone surgery, soft dressings will be applied to the treated ear(s) to facilitate the healing process. Any discomfort can usually be managed well with oral pain medications. To avoid unnecessary pressure on the reconstructed ear, patients should temporarily avoid sleeping on their side. Incisions are typically placed in a natural crease behind the ear, so visible scarring is generally minimal. Your surgeon will go over every detail of surgery, as well as post-operative aftercare instructions for you or your child, in person.
Please contact KU Facial Plastic Surgery for any questions you may have, or to schedule a consultation.