What is Ear Reconstruction?

When a person is missing an ear, surgical restoration is best achieved using the patient's own tissues. This includes adults following traumatic ear loss or children who are born without a significant ear.

A child may be born with a tiny malformed ear (microtia), as a manifestation of embryologic underdevelopment. In such cases the primordial structures failed to materialize into a normal ear. Such patients can begin to undergo restorative ear surgery as early as age six or seven to create a new external ear. Older patients can be benefited by similar surgery following traumatic loss of an ear. In all such cases, the most effective method for success is the use of the patient's own rib cartilage from which a new ear framework is carved.

The Procedure

While there are a number of synthetic ear frameworks available on the commercial market, these are not living material, and the chance that they will erode through the skin is high. When this happens the artificial framework has to be removed and the patient will have lost their chance for a successful ear reconstruction. Ear reconstruction is an operation where there is ONE chance to create a new ear and only one chance; therefore it needs to be done right the first time. A living ear created from the patient's own tissue, when done well, is preferable to a prosthetic (stick-on) ear.

The result depends on your surgeon's artistic ability to carve (sculpt) the new ear in cartilage. The process begins with careful planning of the missing ear using a mirror image template of the normal ear. Measurements, patterns, molds and plaster casts are made from the ear on the opposite side. A determination is made where the new ear will be created under the existing skin. At surgery a carefully carved cartilaginous framework of the patient's own cartilage is implanted beneath the skin. If an earlobe is present, this is rotated into the proper position. Once this has been allowed to heal, the ear is elevated and a skin graft is placed behind the cartilage to create the space behind the ear to help bring the reconstructed ear out. Finally the central cup of the ear (concha) is deepened and the protective door over the ear canal (tragus) is created.

If the patient has sufficient internal hearing structures it may be desirable to create an external auditory canal. Creation of the external ear must be completed, however, before an ear canal is made. When you come in for consultation a thorough review will be made of the anatomy of the ear, as well as the stages required to reconstruct a new ear from the patient's own tissues. Your questions about Ear Reconstruction will be answered.

Parents with children who have an underdeveloped ear (microtia) can anticipate an excellent reconstructed ear when properly performed surgically using sculptured living cartilage.