Microtia and Microtia Reconstruction Dnb ent 2013

What is MICROTIA RECONSTRUCTION and its surgical steps? This is a short question for 5 marks.

Microtia:

1. Major auricular malformation.
   1. Often associated with EAC atresia.
   2. Degree of auricular malformation correlates with degree of middle ear deformity.
   3. Associated inner ear abnormalities are rare.
      1. Vestibular dysplasia is the most common.
   4. Usually unilateral with right side is the most common.
   5. 25% of cases are bilateral.
   6. M:F ratio of 2.5:1.
   7. May have syndromic association (eg, hemifacial microsomia).
   8. Causes:
      1. Genetic
      2. Teratogens (vitamin A/isotretinoin, thalidomide)
      3. Vascular insult

MICROTIA AND MICROTIA RECONSTRUCTION

Classification

• Grade I:
  • Small auricle with all subunits are present.
• Grade II:
  • Small auricle with some subunits are severely underdeveloped or absent.
• Grade III:
  • Small remnant of skin and cartilage (Peanut ear) associated with aural atresia.
• Grade IV (Anotia):
  • Complete absence of auricle and lobule associated with aural atresia.
  • Usually forms part of 1st Arch Syndrome.

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