It is always important for you and family and friends to be there and offer positive support to your child in dealing with the reactions of others, and this also helps your child in dealing with his or her own inner thoughts and feelings about their difference. Rehearsing some responses with your child in a casual matter-of-fact way will help prepare them for the inevitable situations they will encounter at school or at play. For instance your child could say, “My   is called  but it doesn’t change how I play or anything. I’ll decide later if I want to let doctors try to change the shape, but for now its fine”. Microtia is just a small aspect of your wonderful child. Raise your child as you would any other without overdoing attention or focus on this one aspect. This will help them cope with microtia and avoid self-esteem and confidence issues so they can grow up and engage.

Answer: The most common condition in which  is seen is Hemifacial Microsomia, in which half the face does not grow in proportion to the other. The degree of hemifacial microsomia varies from barely perceptible to very noticeable. Treacher Collins Syndrome involves both ears and also affects the eyes which appear to have a downward slant or “pulled down appearance.” The cheek bones are small and the eyelids and jaw are affected. Goldenhar Syndrome may involves one or both ears and is characterized by incomplete development of ear, nose, soft palate, lip, and jaw. That is also the reason why at the Center for Plastic Aesthetic Surgery where Associate Professor, Doctor Nguyen Hong Ha works, there are always a full range of specialists in plastic aesthetic surgery, facial surgery, dentists. , ear, nose, throat, eye, psychology worked together in   multidisciplinary clinics. At these consultation sessions, leading experts will discuss and choose the best surgical option for the pediatric patients. Usually, a pediatric patient with birth defects without ears and combined cranial defects will be centrally monitored from baby to adulthood to be able to repair and complete as much as possible lesions at the right time for the baby.

The most common complications associated with ear reconstructive surgery are: To understand why complications can occur it should be seen that ear reconstruction is a very complex process as shown below. According to the traditional method of using autologous rib cartilage, the surgical process consists of many stages. The first stage is to remove a few pieces of cartilage from the ribs on the chest, sculpture them to become the frame of the ear and then implant it under the scalp in site of the defective ear. Then, it takes many operations to lift the ear frame off the scalp, create the grooves behind the ears, cover the cartilage frame, skin graft on the scale and adjust other details of the ears. With many such operations, the risk of complications is possible. According to the Medpor method, using porous polyethylene ear frame with artificial synthetic tissue to shape ears, although the advantage is that it only undergoes one surgery but requires delicate dissecting techniques to remove the temporal flatform the layer under the scalp to cover the plastic frame and skin grafting should be taken from the patient own thigh or abdomen. Associate Professor Dr. Nguyen Hong Ha, who has successfully performed many ear-defected or microtia reconstructions at the Vietnam-Germany Friendship Hospital, said: When performing difficult techniques, if the surgeon is not experienced, not only this will result in poorly reconstructive ears, which may also increase the risk of complications.

On Monday (Nov. 4), good news from the hospital revealed that after two years of research and technical improvement, the doctors at the hospital’s Plastic Surgery Department have successfully performed MER using self-costal cartilages with only one operation under the support of an endoscopy. This is one of the most demanding challenges in plastic surgery and the well-known medical facility is the first hospital in Vietnam and one of the very few centres in the world to successfully carry out the most advanced MER, making it a routine operation. Assoc. Prof., Dr. Nguyen Hong Ha, Head of the Department of Plastic Surgery at the Vietnam - Germany Hospital, said that microtia maybe congenital or acquired due to an accidental loss of ear or burn. Although it is not dangerous to the life of the patient, it can leave a huge negative impact on aesthetics and psychology, especially for children at a pre-school age. Currently, there are two popular methods of ear reconstruction in the world, in which the use of autologous rib cartilage has been implemented in the past 50 years, but requires at least 2-3 major surgeries with full risks during anesthesia and surgery to build the ear canal, by removing rib cartilage No. 6,7,8 or 9 from rib cage and sculpting into an ear cartilage frame. The newer method is to shape the coronary ear with an artificial cartilage frame that patients only need one surgery at a very early age as 4-5 years old, in which could bring better aesthetic results than other methods. “So far, the latter using artificial cartilage has the most advantages. However, the disadvantage is that the artificial cartilage frame is very expensive and has not been covered by health insurance like other high-tech medical supplies such as artificial hip and knee joints. In Vietnam's economic conditions, only a few families are capable of purchasing artificial ear cartilage frames to implement this method for their children,” said Dr. Ha. In order to help Vietnamese children with congenital microtia, doctors at the hospital have improved the technique and successfully applied the new method of ear reconstruction, using rib cartilage with the help of laparoscopic surgery, which brings the same results as the artificial cartilage method, but the cost is much lower. “In this technique, we still use the patient's own cartilages to make an ear canal. But instead of having to bury the mold under the skin to wait a year later for the second surgery, the doctors immediately used the superficial temporal flap to cover the cartilage frame, and only with one surgery, the patients are able to get a new ear with almost normal function,” Dr. Ha said. According to him, the most difficult point of this surgery is how to cover the whole cartilage frame with the superficial temporal flap. Even a small 1-2 mm exposure in the frame can lead to infection or necrosis for the cartilage frame. Previously, to get the superficial temporal flap, doctors often had to carry out open surgery that would leave a 15-20 cm T-shaped scar on the temple area, causing hair loss or keloids. Currently, thanks to the application of laparoscopic technique, the hospital’s doctors can get the entire superficial temporal flap without having to make any scars. The application of laparoscopic not only minimises the smallest aesthetic scars, but also plays an important role in helping enlarge tiny blood vessels like hairs on the screen for close observation, helping to preserve all of these small blood vessels to ensure the superficial temporal flap can be 100% viable. After two years of technical research and improvement, the doctors at the hospital have successfully performed a range of MER surgeries using self-costal cartilages with the help of laparoscopy. "So far, only one or two of the most advanced centres in the world are able to perform this technique on a regular basis as at our hospital," Dr. Ha said. Integrating the advantages of both the most popular MER surgical methods in the world has created a new opportunity for patients in Vietnamese conditions, helping them still approach the most modern high-tech techniques in plastic and cosmetic surgery. From November 9 to 17, the Cosmetic Surgery Department at the hospital will collaborate with the world's leading team of UK experts on MER to offer free examinations and sharing experience in the field as well as face and neck plastic surgeries.

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.