Conditions
Microtia (Underdeveloped Ear)
Quick answer
Microtia is a condition present from birth where the outer ear is small, misshaped or missing, usually on one side. A new ear can be built in stages using the child's own rib cartilage or a synthetic frame, usually from school age. Because the ear canal is often closed too, a hearing specialist checks hearing early and may advise a bone-conduction hearing device.
Medically reviewed by The Curaventa Team · Last updated 2026-10-27
The outer ear forms in the early weeks of pregnancy. In microtia, this process is incomplete. Severity ranges from a slightly small ear to a small peanut-shaped piece of skin, or no ear at all (anotia). It often comes with aural atresia, a missing or closed ear canal.
Care involves two goals: hearing and appearance. Hearing is assessed in infancy. Ear reconstruction is often done from about age six to ten, when the rib cartilage is large enough to carve. Rib cartilage reconstruction usually needs two or more operations, while a porous implant frame can be done in fewer stages.
Symptoms
- A small, folded or peanut-shaped outer ear
- Missing outer ear in severe cases
- Narrow or absent ear canal on the affected side
- Hearing loss on the affected side
- Low-set ear or uneven jaw in some children
- Teasing or self-consciousness as the child grows
Causes and risk factors
- Abnormal ear development early in pregnancy, cause often unknown
- Hemifacial microsomia (underdevelopment of one side of the face)
- Treacher Collins and Goldenhar syndromes
- Certain medicines in pregnancy, such as isotretinoin
- Diabetes in the mother
- More common in boys and on the right side
How it is diagnosed
- Clinical examination and grading of the ear
- Hearing tests, starting in the newborn period
- CT scan of the temporal bone to assess the middle ear and canal
- Assessment for related face, jaw, heart or kidney problems
- Chest measurement to check rib cartilage size before reconstruction
Stages
- Grade 1: ear smaller than normal but with most features present
- Grade 2: ear partly formed, with some normal parts missing
- Grade 3: small peanut-shaped piece of skin and cartilage, the most common type
- Anotia: no outer ear at all
When a procedure is needed
Reconstruction is a choice made by the family and child, not a medical emergency. It is usually planned from around age six to ten, once the ear on the other side is near adult size and enough rib cartilage is available. Canal opening surgery is considered only in selected children with favourable CT findings.
Frequently asked questions
Rib cartilage or implant: which is better?
Rib cartilage uses the child's own tissue, which grows and resists infection, but needs a chest donor site and more stages. A porous implant avoids rib harvest and can be done earlier, but carries a risk of exposure if the skin breaks down. Your surgeon will discuss both.
Can my child hear on the affected side?
Usually hearing is reduced on that side, while the other ear often hears normally. Bone-conduction hearing devices can help, especially in school. An audiologist will advise based on tests.
How long do we need to stay in India?
For the first stage of rib cartilage reconstruction, plan for about two to three weeks. Later stages are often several months apart, each needing around one to two weeks. Your surgeon will give you a staged timeline.
What should we bring?
Bring hearing test reports, any CT scans and photos of both ears. List any other health conditions or syndromes diagnosed. A recent check-up from your paediatrician is helpful.
What care is needed after we go home?
Protect the new ear from pressure and knocks, especially during sleep and sport. Keep the wound clean as advised. Photos and video calls let the surgeon check healing between stages.
Medically reviewed by The Curaventa Team. Last updated 2026-10-27. General information, not medical advice. Medical editorial board · Editorial policy · How we get prices
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