Information about Microtia Atresia

Posted by Tabitha:

I saw this on another blog. I like how it explained Kacee's special need and adapted it for this post.

We do not want Kacee to define herself by her ears — they are a part of who she is but not all that she is. Her ears are different from most of our ears, but when you think about it don’t we all have different ears, different noses, etc.

There is much debate in the Special Needs adoption community about whether or not to share information about an adopted child having a special need, especially if it isn’t visible. Some parents view it as a matter of protecting their child’s privacy. We understand and respect this reasoning but we believe differently. We believe that taking this approach will also run the risk of a child feeling shame for their medical condition — that it is a secret to be kept and not shared because something is wrong.

We realize that there is likely some curiousity among family and friends about Microtia Atresia. It certainly sounds different. We had ever heard of it either until we fell in love with Kacee's picture. We started researching this medical condition. During this research we learned from other parents that this is very easy to handle and is likely why folks don’t hear too much about it. It is too much of a non-issue that it isn’t really talked about. We are and will most likely continue to be happy to answer questions from folks, but don’t expect us to dwell upon it. As all parents know, there is much more about kids to focus on.

This post contains information about Microtia Atresia for those who want to know more, causes, what it is, and treatment.

Kacee has bilateral Microtia Atresia, meaning the condition affects both of her ears. We are unsure of the extent of the condition yet or whether she has formed ear canals. We do have readable results from a hearing test and there were some comments in her growth report indicating that she has some hearing, but we prefer to wait until she meet her to determine this. It is not uncommon for the medical reports to have false information. Obviously there are some unknowns — as with the addition of any child to a family, whether by birth or adoption.

What causes Microtia Atresia?
The occurrence of microtia is usually a random, sporadic event, and it is not caused by anything the mother did before or during the pregnancy. Researchers theorize that Microtia is not hereditary but is caused by tissue ischemia (decreased blood flow) resulting from an obliterated artery during fetus development

What is Aural Atresia / Canal Stenosis?
Aural atresia refers to the absence an external ear canal. When someone has aural atresia, there is a high incidence of malformation of the external ear (Microtia) and middle ear also, but the inner ear and auditory nerve are frequently normal. A narrowed ear canal (i.e. one where the eardrum can be viewed, but the canal is narrower than normal) is sometimes referred to as a stenotic canal, or canal stenosis. Aural atresia most commonly effects just one ear (unilateral), but can occur both ears (bilateral).

What is Microtia?
Microtia literally translates from the Latin to mean “small ear.” Microtia varies from the complete absence of the ear to a somewhat normal but small ear.

Classifications of Microtia:
Microtia is divided into separate classifications (classic microtia is considered Grade III).

Anotia
Anotia technically means no ear. This is the most severe form of microtia.

Grade 1 Microtia
The ear is smaller than normal although most of the features of a normal ear such as a well-defined lobule, helix and anti-helix are present. This can occur with or without an external auditory canal.

Grade 2 Microtia
The normal features of the ear are missing. There is still a lobule and a remnant of helix and antihelix.

Grade 3 Microtia
"The Classic Microtia": The ear consists of a vertical skin appendage with a malformed lobule (earlobe) on the lower end. There is usually firm tissue at the upper end which is made up of a disorganized cartilaginous vestige. The lower end is usually a piece of lobular tissue which will be the future earlobe when reconstructed. Usually there is no external auditory canal (atresia).

To help Kacee hear better, she will probably wear a small bone-anchored hearing aid (BAHA) to restore hearing. Age for BAHA implantation is around age 5. If the child is under this age, the BAHA can be worn on a headband.

For auricular reconstruction (to restore the visual appearance and form an outer ear), we are leaning toward the Rib Cartilage Graft Reconstruction. The earliest age this surgery can be attempted is age 6. It involves sculpting the patient's own rib cartilage into the form of an ear. Since the cartilage is the patient's own living tissue, the reconstructed ear will continue to grow as the child does. This is a two-stage surgery for each ear. The major advantage of this surgery is that the patient's own tissue is used for the reconstruction.