Ear Reconstruction

Reconstruction of a deformed or damaged ear is one of the most challenging jobs faced by a plastic surgeon. It involves precise technique with artistic creativity. Ear reconstruction becomes necessary when a child is born with a deformed ear, which is very obvious, or an ear is torn or traumatized due to injury or accident.

Congenital malformations of the external ears are quite uncommon. About one child in seven thousand may be affected. The disability called microtia has the highest incidence in people of Asian, Mexican and Latin American descent and is relatively less among Europeans while Africans have the least number of such births. Also in most cases the right ear is affected more than the left. More boys than girls are afflicted with this deformity. The biggest problem is if the hearing is also impaired which may result in learning difficulties. Also, cosmetic and psychological problems may surface. The ear reconstruction in such cases is done when the child is between six and eight years of age, when the ear has grown fully and the rib from where the cartilage is removed for the surgery, is also fully formed.

Possibly the first ear reconstruction was done in 600 BC and it became more common in the sixteenth century. From the twentieth century, cartilage grafts have been common usage for ear reconstruction. Today microtia repair is done in three or four stages and involves the use of the patient’s rib cartilage to make a framework, which is then implanted in the skin to form an ear. Surgeons have to see that the reconstructed ear is similar to the other ear. The skin and the cartilage used in the surgery are different from the natural one; hence this is a very skilled job. The surgery is done under general anesthesia.

Often microtia also involves loss of hearing, the curing of which is a more difficult procedure. If one ear has normal hearing then the reconstructed ear may be left with only the external ear reconstruction and not the internal ear. If there is residual hearing in the ear, attempts may be made to make hearing also normal in addition to the external appearance of the ear.

Ear reconstruction in cases where the eardrum has been perforated or some infection has taken place, resulting in the eardrum injury, is also done. Middle ear problems are also overcome by middle ear reconstruction procedures. These are microsurgeries involving precision and care. Sometimes the ear lobes may be torn or cut off which can also be repaired by ear reconstruction procedures. Some children are born with massive ears, which need to be shortened and reconstructed.