Microtia, What It Is and How to Deal with It

Level 3 Microtia
Level 3 Microtia

What is Microtia?

Microtia is a medical term used to describe a type of ear deformity in which the outer ear, and sometimes middle ear, fail to develop. There may be a partial ear, or skin flap where the ear should be.

Normally the microtia is unilateral, meaning that it affects only one ear, however there are cases where the microtia is bilateral, and both ears are malformed to one extent or another.

Generally, a child with microtia has a complete, and normal inner ear, and sometimes even an ear canal. This means that the child can hear some sounds, as well as there being a good chance for a successful reconstruction of the ear, should a parent decide to do that. Microtia occurs in approximately one out of 10,000 births.

Microtia Artresia is the term used when there is no ear canal. This is the most common type of Microtia, since the outer and middle ear develop together.

Levels of Microtia

There are four levels of Microtia, that can be easily identified:

  • Grade 1- The ear is slightly smaller, has identifiable outer ear structure and an external ear canal, although it may be small.
  • Grade 2- A partial ear that has a closed off external ear canal and produces a conductive hearing loss
  • Grade 3-(most common) Absence of the external ear with a small lump of skin that looks like a peanut. There is no external ear canal or eardrum.
  • Grade 4-Total absence of the ear

Any of these issues can be bilateral, occurring in both ears, or just affecting one ear. The grade of microtia will not change. In other words, without medical intervention it will not get worse, or better, over time.

Important Parenting Resources

Raising a Child with Microtia

My son was born with unilateral, stage 3 microtia. I understand all of the feelings involved with it.

It is easy to wonder why, to wonder if you ate or drank something during pregnancy, if you smoked too much or forgot your vitamins one day. The truth is, it is. It happened, and there will probably not ever be a reason that you are aware of. Microtia is not a worst-case scenario, although it can feel devastating at the time.

For some reason microtia seems to affect more boys than girls. You are not more likely to have another child with it than anyone else, although it can happen. And because of the soft tissue, it is almost impossible to pick up on an ultrasound.

Your child will accept his microtia as much as you do. Keeping his hair long will serve to make him feel different and weird. Teaching him to accept it as part of the individual that he is will go a long way in helping him to face the world with confidence.

Your child, if his microtia is unilateral, will have trouble knowing where sound is coming from. We have a large family and my son can get confused when I call him if there is a lot of noise. It is important to realize that he is probably not ignoring you, that it isn't a discipline issue, but an inability to sift through the various sounds to hear individual ones.

A child with Microtia has up to 40% of hearing in the affected ear. He will most likely need help with speech development, and patient work with some sounds. And you will need to be careful about ear infections in the "good ear" because if it is clogged his hearing is basically gone.

Other than that, raising a child with microtia is no different than raising a child with blue eyes. Our son is healthy, self confident, and athletic. He is nine years old and reading on a tenth grade level. He taught himself algebra by listening to me explain algebra to his older brother. Obviously his lack of an ear has not had an effect on his mind. Do teach your child to let teachers, boy scout leaders, etc. know when he is unable to hear a lesson. Often the adults will not realize that the classroom has become to chaotic for easy listening.

Our son has friends, and is outgoing. If someone asks him what happened he tells him that he was born this way. He does not dwell on it or become uncomfortable about it. We are proud of him for that.

Medical Intervention

We have chosen to not pursue surgery for our son at this time. However, surgery is available and may parents have opted to have it done. The benefit is that the child has a normal looking ear, and can wear hats, glasses, etc. easily. A hearing aide can be fitted to the ear and often hearing can be enhanced or even restored.

The outer ear is built from a piece of cartilage taken from the child's rib. After several surgeries it looks like an ear. At that point the physician may go ahead and open up an ear canal to allow the child to hear if he has a normal middle ear. Definitely talk to your doctor about your options. Talk to other parents who have had the surgery done, and try to talk to some who have chosen not to have the surgery done to understand why. Get your child's input about what he would like. This way you will better be able to make wise choices for your child.

While many websites, especially doctors, may push for medical intervention, it is really not something you need to rush into. Consider all options and possibilities carefully, and talk to other parents.

Your child will be just fine with it, if you are. Yes, children tease children that are different. However, we have noticed that our son with microtia gets teased less than our other "normal" children. Why? He shrugs it off.

Children will tease about anything to get a response. It might be an ear today, and the color of one's tennis shoes tomorrow. Instill in your child a confidence in his own worth and then move ahead from there. Surgery will not make him suddenly confident if he isn't all ready. By allowing him to be normal, and working within the boundaries of his needs you can help him to be a strong, confident, and well adjusted individual. Make a big deal out of it and he will always be a victim of his own circumstances.

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Comments 26 comments

Anony Miss 4 years ago

Hello, I am an adult woman with grade 3 microtia. I'm writing to share my experience. I have always enjoyed life, and am quite happy. My parents framed it for me this way - they told me I had a "special ear." That's what they called it, and I still call it that as an adult. Words matter. And, if you think about it, if only one in 10,000 people have one, it is pretty special. :) I've never hidden my ear. It's true, kids can be mean, as a third grader, someone called me an alien, but I think I thought they were bizarre for saying that. In sixth grade, a boy once told me "you would be pretty if you didn't have that gross ear" at the time, it did hurt, but at the same time, I was glad to know that he was such a shallow guy. I've seen other kids get teased for many reasons, and I think the ear is on par with being teased for wearing glasses, being "overweight," being "too tall," or having red hair or anything special. I learned quickly that people who would be so rude as to tease me were jerks, so it kind of acts like a filter. Most children will ask, "what happened" and it's a quick answer "well, I was just born this way." I have trouble hearing, but since I've been this way my whole life, I just compensate. In meetings, I sit so my good ear is facing the other attendees, In classes, I sit at the front so I can read the professor's lips if I need to and when hanging out with friends, I walk with my "good ear" facing them so I don't miss a word. I am a happy person and I have a special ear. So keep in mind surgery isn't the only option.


Marye Audet profile image

Marye Audet 4 years ago from Lancaster, Texas Author

a google search should find you plenty of images


MommyGiselle 4 years ago

my beautiful daughter had microtia level 3 on her right ear, my husband promise me to 'fix' her ear... i'm worry about the result, since many people that already had surgery not satisfied with the result.. can anyone send me pictures after surgery?? pls kindly send to my email at intan_blackaholic@yahoo.com

thanks for sharing..


msshandriaball profile image

msshandriaball 4 years ago

my son is 13 with HFM with microtia he is very confident and only had the first stage of his surgery .I convinced him to go on after encouragement from voc. rehab and in dec 2011 he had additional work done .His ear looks better and better everyday and he has since decided to go back and continue.i don't think it is a good idea to pretend it doesn't exist because other children wont.My son has gotten into altercations because of ignorance and cruelty of other kids.I am glad i live in the U.S. were medicaid pays 100% of the costs associated with this condition up to age 19.


John 5 years ago

I am a 36 year old man that was born with mild microtia. I tried some experimental surgeries when I was younger that did not pan out. I have not attempted to have surgery since. The only roadblcck this caused in my life is I could not join any of the military services, but I still found a way to serve. I think of it as a humbling beauty mark. I do not allow my head to get be when I accomplish things. I have become a better person, because I know that people can overcome anything that life can throw at them. This just proves that anyone at any given time can be in a minority, so I look on people with nothing be love and well wishes. I wish blessings and prosperity for you all.


My boo's "lucky ear" 5 years ago

When I saw this blog, I became very happy to read someone has written about their child having the same ear condition as my daughter and has gone through the same emotions I did.

I have an 8 year old daughter with grade 3 microtia. At first, I kept beating myself up with the thoughts I did this to my precious little baby girl. What did I eat, drink or smoke? Doctors weren't giving me any information on this condition nor did they tell me about it. I found out 6 months later that this slight imperfection had a name. A good friend called and said they saw it in a Parenting magazine. I was very upset with her ear doctor for not telling me her condition actually had a name.

It took about 2 years for me to stop blaming myself for the microtia. I would hear from family & friends saying "she's a girl, she can hide it with her hair." Hide it?? Really?? And teach her to be ashamed of her ear? That's not how I roll.

After watching "Finding Nemo", instead of saying her "little ear", I started calling it her "lucky ear" after Nemo's lucky fin.

I have been talking to her for years that not all kids will be nice about her ear and to ignore the teasing but to answer the nice questions about her ear.

Now that she is 8, her "lucky ear" has not effected her ability to play sports, make friends or grades in school. Matter of fact, she receives straight A's and a few of her teachers didn't know about her ear condition. She is proud of her "lucky ear" She has plenty of friends and not one cares about her ear. She wears her hair in pony tails and when I ask about having the surgery she says "but mom, I love my lucky ear and I don't want to change it." When I hear that, I know I am doing my job, making her emotional strong to handle whatever is tossed her way.

I am so proud of my daughter and I wouldn't want her any other way.


You are blessed 5 years ago

Hi all I am a 28 year old male and I was born with unilateral microtia and had it reconstructed when I was 12 years old. Up until that point I had grown my hair long to hide my microtic ear, however as soon as I got the operation, I got a buzz cut and kept it that way. I used my experiences to fuel an insatiable motivation to achieve my wildest dreams, so that I could help others. I am now in my first year of residency as a M.D. at a major university hospital in Los Angeles. You've been blessed with beautiful children. Encourage them and build up within them the necessary strength and courage to conquer not only their fears but their dreams.


Ratna Fitri 5 years ago

I thank God for giving me my girl, she has microtia grade3 for her right ear. She's 1y old now and a very cheerful baby. I try not no hide anything to anybody and try to make her as confident as possible.

For melanie... I love your comment, and your husband is an inspiration for me... Thank you.


Liz Jones 5 years ago

Hi all, I have set a support group in the UK called Microtia Mingle UK for children, families and adults affected by microtia. Come and visit our website.


lou31 5 years ago

hi my daughter is 8 was born with right ear microtia i have never had a diagnoses of this nobody seems to know what it is and told me about microtia had to find out about it of a tv program my little girl did have hearing test on left and has 98% hearing but didn't say about the right as she has no eardrum or canal sort of lost now as where to go or what to do as at the moment i am in a cleft lip clinic and havnt seen anyone about her ear since she was one yr just a surgeon who asks how she doing every two year when i see him.


Dee 5 years ago

My son is 11 months and he has microtia . I've been sadden because I am also worry how it's going to be when he goes to school. I don't want him to get made fun of.. It hurts me more and more as time is flying, I just wish I can deal with it for him.


Kaylyn 5 years ago

Hannah and Sofia:

I am 18 years old and I have unilateral microtia in my left ear. I've been going through a lot of the same things as you mentioned, Hannah, but in my case I always chose to keep this a secret. My parents put me through four reconstructive surgeries when I was younger...truth be told, it doesn't help everything. My ear is still noticeably different, and I continue to wear my hair down every day and keep everything a secret. I hope that you and Sofia can find the confidence to let people know, but I also am aware that doing so is a lot harder than people think it is. Just know that there are people out there who are going through the same thing :)

@Devastated Father,

Your daughter's microtia is not your fault or your wife's. While it may seem unbelievably hard to deal with this now, just know that the most you can do is support your daughter and instill confidence in her as she grows up. I would NOT recommend hiding her ear from people...when she is old enough to make a decision about showing people or not, then let her...but don't hide it from everyone at first. It will just teach her that she is different and that she should hide that. Your daughter will grow up to be a lovely young woman; microtia is an annoyance, yes, but she'll learn to adapt just fine.


jackie.t profile image

jackie.t 6 years ago

My son was born with microtia as part of a craniofacial syndrome. He is 12 now and had ear reconstruction surgery using rib cartilage in two stages at age eight and nine and a BAHA inserted at seven. We were blown away by the results, his ear is incredible and looks just like the other one! I guess there are pros and cons for every decision but we are extremely happy with the ones that we made.


Melanie 6 years ago

Devastated father,

my husband has grade 3 bilateral microtia. He is 33 years old and leads a very wonderful life. It is not the end of the world, even though you may be sad and confused right now. He never had the reconstructive surgery, and gets along fine with and oticon bone conduction hearing system. He speaks like the average person would and hears even better when he is wearing his bone conductor. He owns his own tree trimming company, runs marathons, and is a very responsible, intelligent, handsome man. If anything, his microtia has helped make him the amazing person he is today. He is an inspiration, and there is no explanation for why microtia develops. Its not something the mother did during pregnancy, it just happened. I will be praying for you and your family!!!


Devastated Father 6 years ago

My daughter was born 2 days ago with Grade 3 microtia and both my wife and I are devastated by this. We are still looking for answers as to why since we do not fit the profile of high risk parents. I don't know what to do.


Sofia 6 years ago

Hannah I feel you, I'm almost 18 and exactly in the same case as you! I agree with everything you've said, it's the story of my life. That would be amazing to meet someone like me.. it's been a long time since I'm feeling alone. I look forward to hearing from you.


Jow 6 years ago

Hello,

I'm a mother have a grade 3 baby with microtia. He is just 6 months and I am very worry what should I do when he go to school before reaching age six to do the surgery because you know not all people know this situation and especially his friends at school if they ask him why your ear is like that and if they laugh or sth what can i do I will be too angry to any person harm my baby on a word! I love him sooo much and can't image my life now without him. I believe that it is a test from my good but still not know how to deal with this. Also not yet know where to go to which DRs especially that our country doesn't have those kinds of surgeries. I really always skare that I could be the reason of that but don't know when and why.


Hannah 6 years ago

Hey, I'm 16 years old and have microtia in place of a "normal" right ear. From what I have read, doctors say that you're not supposed to single out your child who has this birth defect because it will make them feel different. My parents apparently took that advice and instead for the past 16 years they've just pretended it's not there. Everyone ignores it and that taught me to just ignore it growing up. I'm in high school now and to tell you the truth it gets harder to pretend every day. When I was younger my mom would never braid my hair or put it in a high pony tale when I had sports or school, so I have always worn my hair down in public and haven't told a soul about my secret. While not going through with surgery seems like a good idea now, and can be for some, I still spend hours alone thinking about the unspoken in my house. I guess what I'm trying to say is just make sure you're kid(s) have a say in it. Remember, what they think at the innocent age of 6 can be very different at 16. Not everyone is so accepting, not every child is always so confident and not pretending anymore scares the hell out of me almost as much as it hurts me.


Cheryl 6 years ago

I am 44 and didn't know that I have unilateral Grade 1 microtia till now. In my country, 44 years ago, medical is not so advance and thus I grew up and was treated like any normal child.

I am thankful that my speech is not affected but after reading and researching tonight, I think I might have to get my kidney a good check up.

Thanks for providing such valuable information.


ralph 6 years ago

Hi,

My daughter is three and a half with microtia of the right ear. I wanted to know if any of you take your kids with microtia for swimming since we have to make sure kids don't get ear infection in the good ear. If yes they can swim what precautions do you take. Also did you all get BAHA hearing aids for kids with microtia or can they do ok without it.

Thanks


katie m 7 years ago

i hav a son 8 months. he has grade3 microtia n will only b able to hav surgery for the external ear but only wen e is 6 n im very worried about his life.not about his friends n family, older people stare n talk about him.it makes me feel hurt because i feel like its my fault.


David M 7 years ago

hi my name is David i am 25 years old i have unilateral microtia i tried to live a normal life as possible and i can very well say i couldn't be any happier. when it comes down to it, its really about about how much confidence you have in yourself. don't feel helpless, stand proud show the world what you can do.


Daniel 7 years ago

Hi, My son is one month old and i am very worred about his future, anyway still have time to think about the surgery. Thank you all for your good comments.


daniel 7 years ago

hello, I am 16 years old and i had the surgery when i was 10, i would sujest to get the surgery because it really does look better than not getting it, it really doesn't affect the way you hear at all yhou...


alin 8 years ago

my son has bilateral microtia and now he's doing well with the other children, healthy, and happy. i don't prioritize surgery for now because i hope in several years the medical technology in indonesia is better than today. hope our kids has a bright future :)


donnaleemason profile image

donnaleemason 8 years ago from North Dakota, USA

Excellent Marye, glad to hear your child is doing well and adapting. Thanks.

Donna

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