Microtia plastic surgery using a  plastic frame  is also called  MedPor ear reconstruction . First introduced by Dr. John Reinisch, Medpor is a surgery that uses a foam  polyethylene  ear frame with autologous tissue to shape the ear. The polyethylene frame is sculpted to resemble a healthy ear frame is implanted in the appropriate position  and then covered by a thin layer of tissue that turns down from the subcutaneous layer (called the temporal flap) and cover with a skin graft taken from patient’s own thigh or abdomen. All of these steps are performed in one operation. Advantages Disadvantages Can be done with three-year-olds, before they go to school; For children with hearing loss, surgery to restore the ear canal   can be done before or at the same time with reconstructing the defective ear; Minimizes pain relief while allowing children to go home (outpatient) one hour after surgery; Reconstructive surgery is performed once and in 80% of cases are outpatient; The reconstructed ear is formatted to correspond to the normal ear in size and appearance; The reconstructed ear can withstand most sports. The ear frame is the plastic that replaces the body’s tissue; Only a few surgeons are trained in this surgery, an inexperienced ear surgeon with a defective ear will lead to unexpected results.

Microtia plastic surgery using autologous rib cartilage is also simply called “reconstructive ear using rib cartilage”. This method has been in use for more than 50 years. According to this method, the surgical process consists of . The first is to remove a few pieces of cartilage from the ribs on the thorax, sculptural grafting them into the ear frame (Figure 1) and then transplanted under the scalp behind the defective ear (Figure 2). Then, it takes many operations to lift the ear frame off the scalp, create grooves behind the ears, cover the cartilage frame, skin graft on the scale and adjust other details of the ears.     Advantages Disadvantages Using tissues of the patient’s own body; With a good surgeon, the patient can get excellent, long-term results; The reconstructed ear can withstand most sports. Only children over 7 years old will have enough rib cartilage to make ear frame, need many operations (many stages) in a long time to make children go to school always with remarkable different ears; The rib cartilage dissection causes pain, permanent scarring of the chest and potentially deforming the chest wall; Ear canal surgery must wait after ear reconstruction is complete thereby delaying hearing recovery for many years.

There is no scientific answer to what causes Microtia. Currently, there is no sound scientific evidence that can say or show that Microtia is completely genetic. Although it appears to be more frequent in certain ethnic backgrounds, it also appears to be completely random in many others. There are many families who give birth to a child with Microtia when no one on either side of the family has ever had Microtia as far back as history can show. Microtia does not appear to be present in the bloodline for many families. One child may be born with Microtia where his/her twin sibling may not show any signs of having Microtia. There is no evidence proving that the use of fertility drugs can cause Microtia. There is also no proof that the mother has used some drug, medicine or by eating drinking something wrong during pregnancy period can cause Microtia. Some people infected with Agent Orange can give birth to children with various defects including handicapped ears.

In Vietnam, Dr. Nguyen Hong Ha, after a period of acquiring techniques from his mentor Pr. Reinisch, who is known worldwide for his design and development of the Medpor ear reconstruction technique. Dr Ha with his associates, has successfully performed many ear reconstruction surgeries using Medpor or Omnipore plastic implant at Vietnam-Germany Friendship Hospital. The ear reconstruction using the Medpor, Omnipore plastic implant done in the US or at Vietnam-Germany Friendship Hospital is similar in terms of technique. Before making any decision, you need to know more about the process of shaping ears using plastic implant. The plastic implant ear shaping method is one that only requires one-time operation (one-stage surgery). The rib cartilage classic method need 2-4 stage of surgery. Thus, if including the time of pre-operative examination and pre-operative counseling, the patient and caregiver take only about 1-2 month. The rib cartilage classic technique takes at least 2-3 years to complete this procedures.

Cryptotia is a congenital (present at birth) infant ear deformity characterized by an auricular muscle abnormality that causes the upper portion of the external ear cartilage to be partially buried underneath the skin on the side of the head. Because a portion of the ear is beneath the skin, the condition is sometimes referred to as hidden ear, buried ear, or pocket ear deformity. While the upper part of the ear may appear to be missing, the ear cartilage framework is actually present under the skin. In some cases of cryptotia, the buried portion of the ear may present with other malformations as well. The cause of cryptotia is not known, however it does occur more commonly in people of Asian descent (reports show up to 1 in 400 births). It typically does not affect hearing however, wearing eyeglasses or sunglasses is often difficult or impossible as the temple pieces of the glasses have no resting place. Studies also show that cryptotia can affect self-esteem and result in teasing as the child becomes old enough to attend school. Treatment for cryptotia involves separating the buried portion of the ear from the head which leaves a raw area both at the back of the ear and the side of the head. Covering the raw areas entails maneuvering tissue from the back of the ear or, in some cases the scalp, to close the gap. Can Cryptotia be Corrected Without Surgery? While most congenital ear deformities require seeking medical treatment shortly after birth to enable non-surgical correction, cryptotia can often be treated without surgical intervention well beyond the neonatal time window (even up to age 5). In cryptotia cases where the cartilage framework is normal but simply hidden under the skin, ear molding can be a treatment option that can be utilized for a longer period of time since the cartilage does not need to be soft and pliable at the time of correction as in many infant ear deformities. The Earwell™ Infant Ear Correction System can be used to release the buried portion of ear cartilage and then expand the skin needed for the newly exposed cartilage. When correcting cryptotia, The Earwell™ Infant Ear Correction System can be applied in reverse order from its typical application. First, the Earwell™ retainer tapes are applied in order to: Retract the ear cartilage framework Expand the skin Lengthen the muscle Approximately two weeks later, the molding portion of the four piece Earwell™ System is placed to reshape the released cartilage. Benefits of the EarWell™ Infant Ear Correction System include: Permanent non-surgical method to correct infant ear deformities FDA approved Pain free procedure Over 90% success rate Results within weeks of application Less expensive than otoplasty (surgical ear reconstruction) Typically covered by insurance as a congenital condition Surgical Correction for Cryptotia Surgical ear reconstruction (otoplasty) for cryptotia involves dividing muscle fibers through a small incision. The available skin is moved from the depression behind the ear (auricular sulcus) to the needed portion in the superior area of the ear. Several correctional surgery options are available for cryptotia treatment and are recommended on a case by case basis. Most cryptotia surgeries involve the use of skin flaps however, skin grafts may be necessary when the condition is severe. Goals of cryptotia surgery are: Restore the natural groove between the upper ear and the side of the head, also known as the auriculocephalic sulcus Replace insufficient skin with local skin flaps or grafts to ensure embedded cartilage is covered Release tethered ear muscles Reinforce collapsed cartilage Cryptotia ear deformity repair is typically performed under general anesthesia on an outpatient basis, and the patient is able to return home the same day as surgery. If your child has symptoms of this ear deformity, please see our physician locator for a list of experts who are qualified in treating cryptotia with The Earwell™ Infant Ear Correction System. For patients who require surgical correction, we are pleased to offer referrals to plastic surgery experts who are highly skilled in performing otoplasty.