Variations of Microtia

Microtia varies from the complete absence of auricular tissues (anotia) to a somewhat normal but small ear with a narrowed canal. Between these extremes, one finds an endless variety of vestiges, the most common being a vertically-oriented sausage-shaped nubbin (see Fig 5). As noted from the statistical summary of my 1,000 microtia patients (see Table 1), microtia is nearly twice as frequent in males as in females, and the right-left-bilateral ratio is roughly 6:3:1.

Figure 5 - Variance of the microtia deformity.

Figure 5 - Variance of the microtia deformity. Figure 5 - Variance of the microtia deformity. Grade I, II, III microtia, and anotia (complete absence of any ear remnant).

Grade l
Grade ll
Figure 5 - Variance of the microtia deformity. Figure 5 - Variance of the microtia deformity.
Grade lll
Anotia

In most instances, the microtic lobule is displaced superiorly to the level of the opposite, normal side; although incomplete ear migration during development occasionally leaves it in an inferior location. Approximately one-third of the patients exhibit gross characteristics of hemifacial microsomia, although Converse and associates [33, 34] have demonstrated with X-ray studies that bony deficiencies exist in all cases. Whatever the deformity, I have been impressed with its potential for psychological havoc amongst the entire family, varying from the patient's emotional insecurity to the parents' deep-seated guilt feelings (even though it's not their fault).