What Are the Different Grades of Microtia? By Dr. John Reinisch on September 04, 2021

child holding a shell to his earMicrotia is not just a cosmetic concern. It can affect hearing and have a significant impact on confidence. Microtia treatment can improve hearing and help those with microtia feel more confident about their appearance.  

At Reinisch Plastic Surgery, Dr. John Reinisch offers a variety of treatment options to address the unique needs of each microtia grade in patients in Beverly Hills, CA, and surrounding areas. To discuss options for you or your child, we welcome you to schedule a consultation.  

About Microtia

Microtia is a condition affecting the ear that occurs during fetal development. Those with microtia are born with an external ear that may be small, sometimes not properly formed, or completely absent. Although not as common, microtia sometimes affects both ears. In addition to issues with the external ear, individuals with microtia may also have a narrowed or missing ear canal. 

The Four Grades of Microtia

Microtia severity varies and is categorized into one of four grades depending on the degree of ear malformation. Grade 1 is the most mild form of microtia and grade 4 is the most severe. 

Let’s take a closer look at each grade of microtia and how the ears are affected. 

Grade 1

Grade 1 is the most mild form of microtia. With grade 1 microtia, the ear often looks similar in shape to a normally formed ear but smaller in size. Frequently, people with grade 1 microtia also have a narrow ear canal. 

Grade 2

Grade 2 microtia usually has some development of the external ear. In most cases the bottom third portion of the ear has developed and may appear normal. A tragus, the small piece of cartilage at the inner side of the external ear and slightly covers the ear canal, may also be present.  

Additionally, the ear canal may be narrowed or absent.  

Grade 3

Grade 3 microtia is the most common form of microtia. Grade 3 microtia is characterized by an absence of most of the external ear. The portions of the external ear that do develop are small and without the typical ear shape. 

The ear canal and ear drum are also absent with grade 3 microtia.

Grade 4

Grade 4 microtia is the most severe form of the condition and is characterized by a complete absence of the external ear with no present ear canal. 

Grade 4 microtia is also called anotia and is extremely rare. 

Treating Microtia

The goal of microtia treatment for our Beverly Hills patients is to improve hearing and improve the appearance of the ear. There are several techniques that may be used to treat microtia. 

  • MEDPOR® ear reconstruction: In 1991 Dr. Reinisch created the MEDPOR reconstruction technique to overcome the limitations of using rib cartilage to reconstruct the ear. The MEDPOR technique is the most advanced method for treating microtia. It uses a biocompatible polyethylene to create the ear’s framework. The framework is then covered in the patient’s own tissue. This procedure may be performed on children as young as 3. 
  • Rib cartilage ear reconstruction: This technique uses cartilage from the patient’s own ribs to create the framework for the new ear. The framework is then placed within a pocket of skin made where the ear is to sit. Removing cartilage from the chest in very young patients can cause chest deformity so this technique is delayed until at least the age of 8. 
  • Silicone prosthetic ears: Patients who may not be good candidates for surgical ear reconstruction may benefit from silicone prosthetic ears. Prosthetic ears do not improve hearing but they can help people with microtia feel more confident. 

Learn More about Microtia Treatments

If you would like more information about microtia treatments, call Reinisch Plastic Surgery in Beverly Hills at (310) 461-4375 to schedule a consultation

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Dr. John Reinisch, MD

Reinisch Plastic Surgery

  • Exceptionally well-qualified
  • Graduate of Harvard Medical School
  • Board-certification in plastic surgery 
  • Created the MEDPOR® technique in 1991
  • Has successfully treated over 20,000 children 

Patients come from across the country and around the world to benefit from his expert care. To schedule your consultation, contact our office online or call us at (310) 385-6090. Spanish speakers can contact Lilian Chavez Lillian.chavez@cshs.org & for any surgical scheduling questions. For Mandarin speakers please contact Michelle Yang qiang.yang@csmns.org.

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International Institute for Microtia Repair

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