Anotia: Understanding Grade 4 Microtia By Dr. John Reinisch on September 13, 2023

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Dr. John Reinisch has been answering common questions about microtia for decades. As a recognized authority on the treatment of this ear condition, he’s provided expert insight into diagnosis and surgical treatment at his facility in Beverly Hills, CA.

When looking up information on microtia, you may have encountered the word “anotia.” To help reduce ambiguity about the condition, we’d like to go over some of the basics of anotia and how it is related to microtia.

What Is Anotia?

Anotia is another word for Grade 4 microtia. In this type of microtia, the patient lacks both an external ear and the ear canal.

Anotia often occurs unilaterally (affecting only one side of the head). Anotia can occur bilaterally (on both sides of the head) in rare instances.

The Other Grades of Microtia

For perspective, let’s look at the three other grades of microtia:

  • Grade 1 Microtia - There is a small external ear present, though the patient may have a narrow ear canal or lack an ear canal
  • Grade 2 Microtia - Some external ear anatomy is present, and the patient has either a narrow ear canal or lacks an ear canal
  • Grade 3 Microtia - The most common form of microtia, there is no ear canal and only a remnant of the external ear present

The Effects of Anotia

The most notable effect of anotia is hearing impairment. Without an ear canal, sound cannot properly reach the inner ear. This can cause issues with language acquisition as an infant gets older. Similarly, difficulty hearing words can lead to problems with language development and speaking if the condition is not addressed.

In terms of aesthetics, a child may feel self-conscious about the lack of an external ear. This can lead to some problems with social interaction and socialization among peers and other young children.

Anotia vs. Atresia

You may be thinking about atresia now, which is another A-word related to microtia.

Atresia refers to the absence of an ear canal and ear drum, though it is most commonly associated with Grade 3 microtia. Anotia refers to the next grade of microtia.

Treatment Options for Anotia

We have different ways of treating anotia at our facility in Beverly Hills, CA.

When addressing the absence of the ear canal, we can perform surgical revision of aural atresia, which can reconstruct the ear drum and the ear canal.

For the external ear, we offer different types of microtia surgery that can help your child have a natural-looking external ear.

Timing Your Child’s Treatment

With any condition that affects your child, it’s best to get professional attention as soon as possible. MEDPOR® ear reconstruction can be performed as early as age 3. More traditional rib cartilage ear reconstruction is often performed when a child is about 7 years old.

During your consultation, we can review all of your treatment options and develop a solid treatment plan based on age and other factors.

Discuss Your Child’s Anotia with our Team

Help is available at our facility in Beverly Hills, CA. We’re ready to answer your questions about anotia and surgical treatment from microtia. To get information about treating anotia, contact Reinisch Plastic Surgery today.

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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 (833) 896-3277

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