Microtia is a congenital absence or deformity where the pinna (external ear) is underdeveloped. Microtia is a very rare disease.

Microtia occurs usually on the right side (unilateral) but it may also occur on both sides (bilateral).

The most common difficulty for microtia patients is the reduced hearing ability resulting from a narrowed or missing ear canal.

Four Stages of Microtia:

  • Stage I: A less than complete development of the external ear with small and narrow ear canal.
  • Stage II: A partly developed ear (usually the top part is underdeveloped) with a closed [stenotic] external ear canal causing a conductive hearing loss.
  • Stage III: Absence of the external ear with a small structure and an absence of the external ear canal and ear drum. This grade is the most common form of microtia.
  • Stage IV: Absence of the total ear or anotia (a completely undeveloped pinna).

Microtia Treatment

Treatment of microtia/anotia will be determined by some significant factors;

  • The stage of the microtia
  • If the microtia is unilateral (on one ear) or bilateral (on both ears)

Microtia repair surgery usually begins when the child is about 5 to 7 years old. There are some microtia surgery options.

A rib graft is the most common procedure for ear reconstruction. Rib graft has several steps. First, cartilage will be detached from the child's rib. Next, the cartilage will be placed underneath the skin and formed into the shape of a "standard" ear. A skin graft will cover the cartilage.

Following stages position the earlobe and lift the ear from the scalp.

In microtia treatment, surgeons sometimes may use artificial materials and usually patient’s body accepts these materials, but the texture of the human is the most natural and healthy. That is why artificial materials are not recommended unless they are really necessary.

Microtia treatment may require more than one operation. It may require 2 or 3 surgeries and between these surgeries there should be about three months.

The anesthesia to be applied varies according to the procedure. It may be general or local anesthesia.


As a mother, did I do something during my pregnancy to cause my child’s ear(s) to be underdeveloped or missing?

No, there is nothing a mother did to cause microtia if you had a healthy pregnancy.  Sometimes, things just happen in utero that are unexpected, even with the healthiest of pregnancies.

Is microtia genetically inherited?

There is solid – yet preliminary – evidence that genetics plays a role in some patients. However, most of families who have a child born with microtia cannot find anyone in their family who has previously had underdeveloped or missing ears.

Is one surgery enough to repair microtia?

It depends on the stage on microtia. In complicated cases microtia treatment may require more than one operation. It may require 2 or 3 surgeries and between these surgeries there should be about three months.

What is microtia?

Microtia is the congenital deformity where the external and middle ear are underdeveloped.

Does microtia prevent hearing?

There is a possibility of partially or completely hearing loss due to the underdevelopment of the ear.

What is the best time for microtia surgery?

Rib cartilage is used when reshaping the ear, so the right time for surgery is when cartilage development is complete which occur approximately at 5 years.

What is the treatment process of microtia?

If the ear is apparently present but has a different appearance than normal and has not completed its development, it can be corrected with a single operation. But, in severe cases where there is no ear at all, multiple operations may be required because the ear will be recreated completely. With taking the recovery period into consideration, there should be a period of 3 months between each operation.

What should I do to avoid making fun of my child because of his ear?

Microtia is a congenital disease. If the child is treated before he/she enters into social life, he / she will not have any psychological problems. Therefore, it’s recommended to treat microtia at preschool period.

What determine the cost of microtia surgery?

Microtia surgery costs differ according to many factors:

  • Type of anesthesia
  • Level of microtia
  • The used technique
  • Hospital features

And many other factors.

Is microtia surgery performed by a pediatrician?

Microtia surgery is performed by plastic surgeons, not pediatricians.

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Prof. Dr. Bekir Atik graduated from Uludağ University Faculty of Medicine in 1993. In 2002, he completed his specialty training in Plastic, Reconstructive and Aesthetic Surgery. He received the title of Associate Professor in 2007. In 2011, he started to work as a founding lecturer in the Department of Plastic, Reconstructive and Aesthetic Surgery at Istanbul Medeniyet University. He received the title of professor in 2013. In the same year, he established the Medeniyet University Micro Surgery education and research laboratory. He gave microsurgery training to over 100 local and foreign surgeons.


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