Microtia is a congenital condition in which an infant is born with a malformed or underdeveloped external ear, which can range from barely discernible to entirely absent. This article intends to clarify and elaborate on the ‘grading of microtia‘, which is a system used to categorise and quantify the severity of this condition.
What is Microtia?
Before we delve into the grading, let’s touch briefly on ‘microtia’. Statistically, Microtia affects approximately one in 12,000-15,000 births. The exact causes are not definitively known, but it is acknowledged that both genetic and environmental factors can contribute. It may occur in one ear (unilateral) or both ears (bilateral). The internal workings of the ear, such as the cochlea and the auditory nerves, are usually normal.
The Grading System
The grading system for Microtia has been widely accepted by professionals in the medical field since it was first established by medical researcher Dr. Francoise Firmin. This system classifies Microtia into four distinct categories or ‘grades’, which ranging from Grade I to Grade IV.
Grade I
This is the least severe form of Microtia. Here, the external structures of the ear are present but underdeveloped and smaller than normal. These abnormalities are often limited to the upper part of the ear. The ear canal is narrow or slightly underdeveloped, but usually present.
Grade II
Grade II Microtia involves more significant underdevelopment, with more components of the external ear being affected. The ear appears ‘constricted’ or ‘peanut’ shaped, and the external ear components may be positioned irregularly. The ear canal is typically restricted, which could lead to conductive hearing loss.
Grade III
This is the most common and severe form of Microtia. The external structure of the ear is underdeveloped to the extent that it might just appear as a sausage-shaped structure of skin and cartilage, often referred to as a ‘peanut ear’. The ear canal is completely absent, resulting in conductive hearing loss.
Grade IV
Grade IV, also known as Anotia, represents the complete absence of the external ear and ear canal. This is the highest and utmost severe grade of Microtia.
Treatment Options
When it comes to treating Microtia, many options are available. The decision on the form of treatment is typically based on the severity of the condition, also known as the ‘grade’ of microtia. However, options include observation, hearing amplification devices, or microtia surgery.
Microtia surgery aims to achieve a natural-looking external ear. This procedure usually involves constructing the ear framework using rib cartilage or a synthetic material. The microtia surgery often initiates at the age of 6-7, when the child’s rib cage has grown enough to provide ample cartilage for the graft. However, this disagrees with the approach of adopting an observational approach until the child is old enough to participate in the decision.
To conclude, understanding the ‘grading of microtia‘ is essential for families and medical professionals alike. While the journey may be challenging, with a clear understanding of the condition, its grading, and treatment options – most notably microtia surgery – it becomes manageable.