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Microtia is a condition in which some type of deformity is present with the outer ear. Sometimes referred to as small ear, this condition may occur with one ear, or affect both ears. However, when only one ear is involved, this ear deformity seems to occur more frequently with the right ear.
There are several grades or classes of microtia. With a Grade I condition, the ear is slightly smaller than normal and is distinguished by a structure that resembles a normal ear, as well as sporting a tiny but functional ear canal. A Grade II microtia has a different appearance, with a partial ear visible, but involving a close external ear canal that inhibits the hearing function.
When a Grade III microtia is present, there is no recognizable outer ear present. Instead, there is a small structure that roughly resembles a peanut. There is no external ear canal, and no eardrum present at all. Grade III appears to be the most common of all reported cases of microtia. With Grade IV, the entire ear, both internal and external, is missing.
Of the four classes or grades, Grade III microtia is the most commonly reported. Fortunately, it is often possible to make use of corrective surgery to fashion a proper outer ear. Before any surgery takes place, tests are conducted to make sure the inner ear is present and functional. When that is the case, tissue can be harvested and combined with other materials to fashion a credible outer ear and create an outer ear canal and eardrum.
Surgery can also be used to correct situations involving Grades I and II microtia. This involves reconstruction of the outer ear, as well as dealing with the presence of aural astresia, a condition in which the there is no external opening to the ear canal. When it is not possible to surgically correct the astresia, a small hearing aid can be adhered to the bone. The reconstruction may be accomplished by harvesting rib cartilage, using plastic implants, installing an ear prosthesis, or a combination of the three.
While some people feel there is no real need to intervene when only one ear is affected by microtia, there is some evidence that children who do not receive treatment are likely to have a much harder time in school. In addition, the fact of not having two normal ears may also create a great deal of self-esteem issues for children, with these issues continuing into adulthood. Even if the decision is to not attempt a physical reconstruction of the affected ear, providing the child with professional counseling can make a significant difference in how he or she perceives the impact of the deformity.
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