INTRODUCTION

Microtia is defined as small and abnormal auricle and occurs in approximately 1 in

7,000 – 8,000 of live births.1 – 3 Microtia deformity has right-ear predominance (right-to-
left ratio of 3:2) and affects boys more than girls at a 2.5:1 ratio.3 Unilateral cases
outnumber bilateral cases by a 4:1 ratio (Yazdi A. K., Hosseini M. S., Sadeghi M.,
Sazgar A.A., Safikhani R.; Original Article; Comparison of Microtia Reconstructive
Surgery with Autograft Versus Homograft; Arch Iranian Med 2007; 10 (1): 43 – 47)
Genetic transmission occurs in many of the syndromes that include aural atresia
(Lambert PR, 2006).

Meatoplasty is an operative technique to widen the lateral cartilaginous part of the

external auditory canal. Cartilage displaced anteriorly from the cavum conchae of the
pinna, as well as bulky underlying soft tissue can cause narrowing of the lateral part of
the ear canal. The aim of a meatoplasty is to enlarge the lumen of the entrance of the
ear canal by removing the obstructing cartilage of cavum conchae as well as the
underlying soft tissue ( Tashneem Harris & Thomas Linder, OPEN ACCESS ATLAS
OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY, MEATOPLASTY

DISCUSSTION

 Congenital malformations of the external ear can occur in a spectrum of severity.

Total aplasia of the external ear is termed anotia. Microtia refers to a spectrum of
deformities of the external ear that can range from a slightly smaller ear with the
majority of structures present (grade I) (Fig. 1), to a greater deficiency of ear
structure (i.e. absent lobule or helix, grade II) (Fig. 2) to the classic ‘peanut’
deformity (grade III, Fig. 3) [1]. Throughout this report, anotia will be labeled as
the most severe form of microtia. The term cryptotia refers to a superior pole of
the ear that is buried in the temporal skin (Fig. 4)
 Cho and Lee [18_] also described a two-staged atresia repair and microtia
reconstruction (n=27). Audiometric improvement was reported without reference
 to air–bone gaps, but showed pure tone average improvement in all but five
patients. Complications included chronic drainage (n=3) and meatal stenosis
(n=6).

(Tollefson T. T, Advances in the treatment of microtia, Curr Opin Otolaryngol Head

Neck Surg 14:412–422. 2006 Lippincott Williams & Wilkins).

DISCUSSTION

Microtia is a major congenital anomaly of the external ear. It composes a spectrum of

deformities from a grossly normal but small ear to absence of the auricle. There are
several classification systems to describe microtia. Tanzer classified microtia according
to the description and location of the defect. Melnick and Myranthopoulus noticed that
the occurrence of major ear anomaly is 3 in 10,000. The incidence among Japanese is
1 in 4,000. Microtia is seen more commonly in males and on the right side. Microtia may
present as an independent anomaly or associate with other syndromes (Goldenhar
syndrome and Treacher Collins syndrome). Thalidomide and isotretinoin can cause
congenital deformities such as microtia. Microtia is commonly associated with external
ear canal atresia and middle ear anomaly. These result in conductive hearing loss. Its
appearance also causes a lot of psychological impact on the affected children and their
families. In Hong Kong, most children's vision has refractory problems. These affected
children have difficulties in wearing spectacles. (WONG W. Microtia - How I do it?,
Medical Bulletin , Vol 14 4 April 2009. P.5-7)

DISCUSSTION
several environmental and genetic factors have been claimed to be responsible for this
deformity.4 – 7 Known teratogens such as isotretinoin, thalidomide, and maternal
rubella can produce microtia with other abnormalities. A positive family history of
microtia is reported in less than 15% of cases. (Yazdi A. K., Hosseini M. S., Sadeghi M.,
Sazgar A.A., Safikhani R.; Original Article; Comparison of Microtia Reconstructive
Surgery with Autograft Versus Homograft; Arch Iranian Med 2007; 10 (1): 43 – 47).