Microtia surgery serves two purposes. It cosmetically improves the ear, along with addressing the hearing loss caused by aural atresia. Dr. Tahiri works alongside board-certified pediatric anesthesiologists and an experienced otologist who have special training in the treatment of aural atresia. Having these specialists on staff ensure our patients safety and positive outcomes from surgery. Dr. Tahiri is known around the world as a leading expert in microtia surgery, and patients travel internationally to benefit from his abilities.
In 1991, Dr. John Reinisch invented the MEDPOR ear reconstruction technique, which is used by surgeons around the world. MEDPOR uses porous polyethylene to create an artificial framework that is attached to the patient’s own body tissues to grow a fully-formed ear. MEDPOR can be completed in as little as a single surgery, and results in minimal scarring. MEDPOR is so effective that it can be completed without a hospital stay, and on patients as young as three years old.
An older method of ear reconstruction is achieved through harvesting a patient’s rib cartilage. Rib cartilage reconstruction was invented more than a half-century ago, long before MEDPOR was created. This often painful surgery takes cartilage from the ribcage to fashion an ear framework. Because this method requires removal of the patient’s ribs, it is not performed on young children, as it would result in a chest deformity.
A third option for ear reconstruction is a silicone prosthetic. Silicone prosthetic ears do not address hearing loss, but instead are worn purely for cosmetic purposes. This method involves fashioning a prosthetic ear that is worn around the underdeveloped ear. Dr. Tahiri does not create prosthetic ears, but he can recommend it to patients who prefer this to MEDPOR or rib cartilage reconstruction. The patient will then be referred to an anaplastologist who will assist them. Ear prostheses are not recommended for children, as they often knock the prosthetic off if they aren’t playing carefully.
Inner Ear Reconstruction
In addition to the lobe of the ear being underdeveloped, many microtia patients may also have a narrow or absent ear canal. Dr. Tahiri will check to see if the bones inside the inner ear fused correctly. If not, Dr. Tahiri works with a skilled otologist to create a new ear canal and eardrum. Inner ear reconstruction can be performed in conjunction with MEDPOR surgery.
Atresia occurs when the patient’s ear canal is underdeveloped. Dr. Tahiri can perform aural atresia which rebuilds the inner ear, and can restore hearing. An otologist will perform the surgery required to restore the ear canal, which is called a canalplasty. Dr. Tahiri will then complete the cosmetic improvements to the outer ear. Aural atresia repair is performed under an anesthetic. If aural atresia repair is not possible, Dr. Tahiri will recommend alternatives, like bone-anchored hearing aids, or a vibrant sound bridge. All of these options will be explained to the patient.
