Microtia, What It Is and How to Deal with It
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.
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.
Parents Groups and More Information
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.