Patient's Complete Guide to Atresia and Microtia

Overview of Atresia and Microtia

Microtia (کانوں کا غیر قدرتی طور پر چھوٹا رہ جانا/Kanon k Ghair Qudarti Tor pe Chota Reh Jana) is a congenital deformity in which the development of the external ear is incomplete. Atresia is a condition in which the external ear canal is completely absent. Both of these conditions occur simultaneously. Microtia and atresia affect the hearing ability. Microtia ears are usually small in size and pear-shaped. Atresia affects the bones of the middle ear including (incus, stapes, and malleus). 

Atresia and Microtia occur during the first trimester of pregnancy. These conditions require medical treatment from an ENT specialist and audiologist. Microtia is divided into four grades:

  • Grade 1: Small ear with the small ear canal 
  • Grade 2: Underdeveloped ear with the narrow ear canal
  • Grade 3: External ear is completely absent but a peanut-shaped structure consisting of cartilage and earlobe is present. The ear canal and eardrum are also absent
  • Grade 4: Anotia- In this condition entire ear is absent

Occurrence of Microtia and Atresia

Microtia is a rare ear deformity in which the external ear is underdeveloped. It occurred in approximately 1.1% of births. Microtia has been reported in approximately 3 in 10,000 births. It's more common in males as compared to females.

Causes of Atresia and Microtia

The cause of microtia and atresia is not known. However, evidence shows that it occurs during the first 2-3 weeks of pregnancy when soft tissues of the outer and middle ear are being formed. Some of its causes are:

  • Use of skin products such as retinol or vitamin A during pregnancy
  • Abnormal gene
  • Use of medicine called isotretinoin (Accutane®) during pregnancy

Risk Factors of Atresia and Microtia

  • Diabetes: Women with diabetes are at high risk of having babies with microtia and atresia.
  • Maternal Diet: If mothers’ diet is deficient in carbohydrates and folic, the chances of microtia and atresia in babies are increased.

Complications of Microtia and Atresia

Given below are some of the common health complications of Microtia and Atresia:

  • Loss of Hearing Ability- Due to the closure of the absence of the external ear canal, the child may suffer from hearing loss. This can also affect the child’s motor speech abilities.
  • Ear Infections- Because of the closure of the ear canal, the child is highly susceptible to bacterial infections. 
  • Inferiority Complex-These psychological issues may also arise due to the aforementioned problems. The other child may pick on the affected one due to the difference in appearance.

Prevention

There are no concrete preventive measures for these diseases. But women should be highly careful both in terms of diet and other precautionary measures. Women should also avoid consuming certain medications during the pregnancy period.

Diagnosis

  • Physical Examination: The pediatrician physically examines the newborn to look for any defect. Microtia and Atresia are congenital disorders present at the time of birth
  • Hearing Screenings: These screenings are performed to detect hearing loss in newborns.
  • Imaging Tests: CT or CAT scan is performed to get a detailed image of the baby's ear.

Treatment of Atresia and Microtia | When to Consult a Doctor

Children with these conditions are more susceptible to ear infections. They also become self-conscious due to their condition. In this condition, moderate-to-severe hearing loss can occur because the outer ear is affected. However, microtia and atresia can be repaired as well as hearing loss can be treated. 

Microtia can be treated by various approaches of reconstructive surgery such as: 

  • Rib Graft Construction: It is a procedure, in which an ear sculpture is prepared by using the patient’s rib cartilage. 
  • Medpor Ear Reconstruction: In this procedure, a plastic ear frame covered with tissues of the patient is used. 
  • Prosthetic Ear: If you don’t want to undergo reconstructive surgery, a prosthetic ear consisting of magnets and adhesives can be used. 

Atresia can be treated by approaches such as: 

  • Corrective Surgery: A procedure in which the ear canal is either increased in size or created.   
  • Bone-Conduction Hearing System: Another option for those who do not want to undergo corrective surgery.

Surgical Risks

Some of the risks of surgery include:

  • Damage to the facial nerve
  • Stenosis (stiffening)
  • Drainage from the ear and infection

Therefore, pediatricians recommend parents wait until children are 5-7 years to prevent surgical complications.

Doctors to treat Atresia and Microtia in Pakistan

Speciality for Atresia and Microtia

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