The clinic has a database of all patients with Microtia to ensure nobody is lost to follow up and all of the appropriate available services are provided.

While the clinic only sees patients with Hearing loss, for those patients with Microtia or other ear anomalies and no hearing loss we are happy to see in rooms.

Psychology & Microtia

The psychological effects of Microtia on the child and the family can be profound.

It is the intention of this website and the Microtia clinic to specifically address the psychological affects of Microtia by providing information and addressing the psychology of the child. We work closely with Social work and child psychologists and psychiatrists if required, to offer support and management of children with Microtia. Your child will have a different psychological affect from Microtia depending upon many different factors. These include your cultural attitudes toward children with a different appearance, your knowledge of Microtia, your child’s age, personality, gender and the severity of the Microtia. The response from other children in particular teasing is also an issue.

Research and experience demonstrates that a parents approach to Microtia is the strongest factor in the ability to create and maintain confidence and a strong self-image for your child. We are here to help with this aspect through education and empowerment in knowledge. At the recent congress in Paris there are ongoing studies investigating the psychology of Microtia and the best possible management. We will ensure we are abreast of any new developments.

When will my child notice his or her Microtia?

Children will become self aware of their appearance compared to others around 2-3 years of age. It is at this age also that other children will notice the difference and begin to ask questions, stare and even begin to tease.

When will my child notice his or her Microtia?

How can I help my child deal with Microtia?

A positive network of support from immediate family, extended family, teachers and friends will help your child successfully deal with Microtia. It is important for your child to ask questions about Microtia and involve them with the management. The Microtia clinic is here to help. It is also just as important to remember that Microtia is just one aspect of your child and you should raise them as you would another. This will ensure they can overcome any psychological and social difficulties from peers.

How can I help my child deal with Microtia?

Is earlier surgery better or should we wait until our child can be involved in the decision?

Our aims are to give you the best information and knowledge and empower you to understand the timing of the surgery. A costal cartilage reconstruction cannot occur prior to the age of 8 and at this stage the child can be involved with the decision making process which empowers them. If your child has no apparent concern or self-consciousness about Microtia, and is progressing well academically and socially, there may be no need for early ear reconstruction until there teens.

Is earlier surgery better or should we wait until our child can be involved in the decision?

Places of Consultation

North Shore Medical Centre

Suite 5, Level 2, 66 Pacific Highway
St Leonards NSW 2065
Tel: (02) 9439 8534

Children's Hospital at Westmead

Cnr Hawkesbury Rd & Hainsworth St,
Westmead, 2145
Tel: (02) 9845 2139

Royal North Shore Hospital

Reserve Rd,
St Leonards, NSW 2065
Tel: (02) 9926 7111

Frequently Asked Questions

The cause of Microtia is not completely understood and is multifactorial. Both genetics and the environment are implicated. Genetics are thought to be a cause in only 5% of all patients. Multiple theories have been proposed to explain the cause of Microtia during fetal development, such as neural crest cells disturbance, vascular disruption, and altitude, but these have not been proven.

It is important to understand that nothing a mother does during pregnancy, such as drinking coffee, alcohol use, or even drug abuse, has been shown to cause Microtia.
The chances are between 4-5% as the cause is multifactorial and the Genetics do not display a Mendelian hereditary pattern.
Microtia usually occurs on only one side (more commonly on the right), but about 10% of patients have Microtia on both sides (Bilateral Microtia). Microtia is often seen as an isolated condition, but it may also occur with other syndromes including Hemifacial Microsomia, Goldenhar Syndrome, or Treacher Collins Syndrome.  Other syndromes with Microtia can also affect the kidneys, the heart, the eyes, the craniofacial bones, and the skeletal system. These children are often cared for in the craniofacial unit.
As long as the patient has an inner ear then hearing may be possible in the affected ear. Watch our explanation video here: https://youtu.be/K1J4a__bKJQ
Rib cartilage is harvested from the same side as the ear to be reconstructed. After preparing the ear pocket the rib cartilage is sculpted to form a new ear. This sculpting is modelled after a template of the normal ear. The entire 3-D contour of the ear is reconstructed during this stage. The new ear is placed into the pocket with suction tubing. Due to a lack of skin the new ear is flat against the head. Watch our explainer video here: https://youtu.be/K1J4a__bKJQ
You will remain in hospital for 4 days with a head bandage and suction drains that will be changed regularly. After discharge the drains will be removed and a lighter dressing applied. Most of the pain initially comes from the chest wall that is managed with intravenous and oral medications.
The second stage involves elevating the flat 3D construct of the ear from the ear pocket to create elevation and a post-auricular sulcus. A skin graft and/or temporoparietal fascia flap is sometimes needed to project the ear. This stage can be combined with surgery on the other ear to create symmetry.
The second stage is overnight surgery and pain is minimal compared to the first stage. Again a head bandage is worn for a few days.
The second stage is after 6 months to allow the new ear to heal into the pocket and be stable.
If that is what you prefer then we can offer this reconstruction. Our role is to inform you of all the available options and outline the reasons why we prefer using costal cartilage from the rib. If you insist on Medpor reconstruction then yes we can do this.
Medpor is a synthetic material that is foreign to the body. It can therefore not be placed under the skin directly as the body will reject it in over 50% of cases. A fascia flap from the temple is required to cover the Medpor. If you change your mind after Medpor or if there is a complication with Medpor then it is not possible for a costal cartilage reconstruction. The reasons are that the skin cannot be re-used and the fascia is no longer available so there will be no skin available to cover the costal cartilage. This is one of the main reasons why Medpor is not our preference.
At this stage stem cells are experimental and not in clinical trial for any human body part. In the next 10 years clinical trials will commence most likely for breast in breast cancer patients and heart muscle in heart failure. From this the research can then be applied to build an ear scaffold from stem cells. Realistically this is 20 years away at least. The best form of ear reconstruction at present is with costal cartilage.
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