Genetic ear loss

Everyone hopes that the baby will have all the facial features after birth, but some people are born with missing ears or ears that are too small, making it look like they have no ears. This type of condition can be treated through acquired external auditory canal reconstruction. It is important to pay attention to the examination and diagnosis to see if there are certain genetic factors.

Treatment

The treatment of congenital microtia mainly includes two aspects: one is the reconstruction of the external ear, and the other is the reconstruction of hearing function. Generally, the external ear is reconstructed first, followed by the restoration of hearing function. Hearing reconstruction surgery often damages the skin behind the ear and must be performed after auricular reconstruction.

External ear reconstruction

The normal auricle is composed of a thin skin soft tissue wrapped around an elastic cartilage scaffold. It has an elastic thin shell structure and is composed of the helix, antihelix, tragus, antitragus, earlobe, concha, triangular fossa, and navicular fossa. It is convex, concave, and convoluted with a complex shape. Therefore, auricle reconstruction is a difficult and complicated operation. Although it is currently possible to create a reconstructed ear that is very similar to the normal auricle, there are many factors that affect the shape of the reconstructed ear. The tightness, thickness, and size of the residual ear and the skin behind the residual ear, and the length, shape, and thickness of the rib cartilage used all vary greatly. These conditions will affect the results of the operation. The scar constitution of some individual patients will also affect the appearance of the reconstructed ear. Therefore, patients who request auricle reconstruction, understand the difficulties of the operation, and are realistic about the results can undergo auricle reconstruction surgery; otherwise, they should be cautious. The elderly and infirm should wear prosthetic ears instead of undergoing ear reconstruction surgery.

1. Timing of surgery

The timing of ear reconstruction surgery is very important and is one of the main determining factors in achieving ideal surgical results. We believe that considering the development of costal cartilage, auricle and psychological factors, 9, 10 and 11 years old are the best ages for ear reconstruction. If the patient is too young, his or her own costal cartilage will be small, thin and soft, which will affect the preparation of the auricular cartilage scaffold and thus the final surgical result. In addition, premature surgery will require the removal of more costal cartilage. The chance and degree of chest deformation will be higher and more severe if one more weight-bearing costal cartilage is removed than if one less cartilage is removed at an older age. However, it is best to complete the external ear reconstruction surgery before puberty, because the psychological changes of adolescent children are great, and completing it before puberty will have much less impact on the child's psychological development. Although we have solved the ear reconstruction technology for elderly patients, it is best not to wait until you are too old to have surgery. With age, the texture of the rib cartilage will change and may even turn yellow and brittle, increasing the difficulty of making the ear cartilage scaffold.

2. Reengineering method

Ear reconstruction usually requires 2 to 3 surgeries. There are two specific methods.

One is called the Brent method. Brent was an American doctor. Later, Japanese doctor Nagata made major technical improvements. This method is the most widely used and popular method worldwide. This method does not require skin expansion. This method is usually done twice.

Comparison of the external ear reconstruction surgery before and after (2 photos). In the first surgery, the rib cartilage was harvested and the ear frame carved from the rib cartilage was directly implanted under the skin behind the ear. This ear reconstruction surgery was the most critical. The second surgery was to erect the ears. If you do it a third time, it will be more beautiful. Each operation takes about 10 days, with 4-6 months between each operation. This method can produce thin ears with clear contours and small surgical scars. It is also simple, safe, short in each treatment, and causes little pain to the patient. This method is suitable for patients with abundant skin on the deformed ears, loose skin behind the deformed ears, and a large area, and we prefer this method for patients with such conditions.