The choice of ear reconstruction technique for each patient requires a careful discussion and examination of the ear region. Autogenous reconstruction of an ear involves using the patient’s own rib cartilage to reconstruct an ear. This is different than prosthetic replacement of an ear because the ear will be made of tissue from the patient’s body, rather than from synthetic materials. Some patients' circumstances may make the treatment selection relatively straightforward. For others, it may be more challenging. It is important to know the risks and benefits of each approach before making a decision.
For a child, the chest circumference must measure 60 cm to provide enough cartilage for the reconstruction.Typically this occurs by age 8; however, in some children, surgery may be delayed until age 9 or 10.
The most common autogenous technique used is the Nagata Technique. This requires taking cartilage from three ribs on the same side of the chest as the ear problem. The surgery can take up to seven hours and requires a hospital stay of around four days. Depending on healing, a second stage may be considered after one year to give the ear more projection. The reconstructed ear is firmer than a normal ear because stronger cartilage is needed to make the ear and not have it deform in the healing period. Once healed there is no ongoing maintenance required. With proper head protection, children can consider playing most sports safely.
There is also an option to be considered to help restore hearing on the affected side. Typically the inner ear is normal. The middle ear, ear drum and ear canal are abnormal. If the inner ear can be stimulated directly, hearing can be improved. This involves placing a small titanium implant behind the ear and attaching a bone anchored hearing device. Trying to make a functional middle ear and canal has been fraught with difficulties and is not recommended at this time.This will be discussed with you or you may ask about it at your visit. For more information on bone anchored hearing devices, please refer to the Bone Conduction Amplification Laboratory (BCAL) page on this website.