Reconstruction of the ear is one of the most challenging problems facing a reconstructive surgeon as it demands precise technique combined with artistic creativity. Microtia is a congenital deformity of the external ear where the auricle (the external ear) is severely deformed. There may be a spectrum of external ear deformities with various degrees of involvement of the middle and inner ear. This type of ear deformity is commonly seen in patients with hemifacial microsomia and Treacher-Collins syndrome.
Psychological effects of an ear deformity play a significant role in timing of reconstruction. Most surgeons prefer to initiate treatment when the patient is between 10 and 12 years of age since this early intervention will reduce anxiety as a result of peer pressure. This also allows for sufficient rib growth to provide the quantity of cartilage needed by the surgeon for adequate framework fabrication. Surgery at this time can give a more consistent result than earlier intervention due to the fact that the child has had a chance to grow, thus making it easier for the surgeon to balance the size and shape of the reconstructed ear to the child's normal ear.
Ear Reconstruction.
May be required in.
1.Microtia [congenital absence]
2. Ear loss due to trauma.
3. Ear loss due to burns
What is ear reconstruction?
Ear reconstruction is a specialised kind of plastic surgery which is used to form an ear which looks as normal as possible. The plastic surgeon will use a piece of cartilage (material that holds body structures together) from child’s ribcage to form the framework for the ear. Where possible, the surgeon will use child’s existing ear as a model for the new one. The reconstruction process is in two or three stages about six to twelve months apart.
The first stage
What happens before the operation?
The surgeon will explain about the operation in more detail, discuss any worries you may have and gain your consent for the operation. If your child has any medical problems, particularly allergies, please tell the doctors about these. Please also bring in any medications your child is currently taking and show these to the doctor. Your child may be given some medication to drink (called a sedative) about one hour before the operation is due to start to make him or her sleepy.
The operation lasts about four hours and is carried out under a general anaesthetic. The surgeon will make a small incision (cut) in child’s chest and remove a piece of cartilage from their ribcage. The surgeon will also save another small piece of cartilage to use in the second operation. This will be secured just under the skin of the chest next to the incision or under scalp.
The surgeon will then shape one piece of cartilage using a drawing of your child’s existing ear (where possible) to form the framework for the new ear. The surgeon will then make a pocket of skin on the side of your child’s head, insert the cartilage and stitch up the incision.
He or she will need to wear a head bandage for the first five or six days after their operation to protect the area while it heals. child will have a drains coming from the head bandage.
It collects any blood or fluid that collect around the operation site. These will be changed regularly for six days.Your child will also be given antibiotics to reduce the risk of any infection. These will also be given through the cannula for the first two days and then in tablet or liquid form by mouth when your child is drinking.
Child will need to return to the hospital two weeks after the operation to have the ear stitches removed . They will also check your child’s chest operation site and remove those stitches too, if they are not dissolvable.
The second operation
The operation lasts about two hours and is carried out under general anaesthetic. The surgeon will lift the shaped cartilage and skin away from child’s head so that it looks like a normal ear. After the new ear has been released in this way, the surgeon make a small incision in your child’s chest and takes out the piece of cartilage saved from the previous operation. This is then used as a wedge to lift the ear, which will be covered in a skin graft, usually taken from your child’s groin (the area between the bottom of their tummy and top of their thigh).
Your child should be able to return to school once the stitches have been removed after the operation, but should only take part in gentle exercise for a month. He or she should also avoid swimming and contact sports, such as football and rugby, for three months. This will let the ear settle down and heal well.
Your child will need to return to the hospital two weeks after the operation to have the ear stitches removed by the nurses. They will also check your child’s chest operation site and remove those stitches too, if they are not dissolvable.

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