More complex treatment is required for small, deformed ears (microtia) and missing ears (anotia).
Autologous Ear Reconstruction
Autologous refers to the use of your child’s own cartilage to reconstruct the missing or severely deformed ear. This process usually requires two to three procedures. In the first operation, the plastic surgeon will remove deformed ear tissue. Cartilage is taken from your child's ribs, then carved and shaped into the framework for a new ear. The framework is then placed in its new position under the scalp. After surgery, your child may wear a head wrap and have drainage tubes to prevent blood from accumulating under the scalp. The second- and third-stage operations continue the work to create a normal appearing ear. Whether two or three stages are required depends on the type and severity of your child’s original ear deformity.
Prosthetic Ear Replacement
A deformed or missing ear may also be replaced by a prosthetic ear made of medical-grade silicone and plastic materials. During this procedure, a plastic surgeon and otolaryngologist work together to remove deformed ear tissue. Metal implants are placed in the bone, similar to dental implants. These serve as the anchors upon which to attach the prosthetic ear. There are several reasons that parents may prefer prosthetic ears to autologous reconstruction: First, whereas autologous reconstruction requires a series of operations, prosthetic reconstruction only requires one operation. Second, the prosthetic ears are created by expert anaplastologists. These prostheses look lifelike and appear identical to the other side. Third, many children with an ear deformity may also receive a BAHA hearing aid. Its placement and this procedure can be done at the same time.
BAHA Hearing Aids
Children with ear deformities who experience hearing loss may be candidates for a bone-anchored hearing aid (BAHA). The surgery is performed by otolaryngologists. Audiologists and speech pathologists work closely with your child to help him or her adjust to this implanted hearing aid. If autologous ear reconstruction is planned, BAHA placement is typically deferred until after ear reconstruction. If prosthetic ear replacement is planned, the BAHA procedure may be performed under the same anesthetic.