![]() A poorly functioning Eustachian tube keeps it from allowing air into the middle ear, which can cause negative pressure or a buildup of fluid, eventually leading to middle ear effusions and hearing loss. Children commonly have problems with their Eustachian tube as they are often horizontally oriented rather than downward, as in adults. Its job is to protect the middle ear by maintaining an equalized pressure within the middle ear and draining out middle ear fluids. The Eustachian tube is a tube that sits behind your sinuses and connects the space behind the nose to the middle ear space behind the eardrum. This is one of the most common ear related problems in young children. Cosmetic repairs can be made for microtia to replace external ear structures. If the patient qualifies, surgery may be appropriate and is a decision made by the parents and/or child. To assess if the patient meets criteria for surgical intervention, we will order a hearing test to see if the surgery could improve the patients’ hearing, as well as a CT scan of the head to further assess the middle and inner ear structures. In these situations, the patient should be fitted with a bone conduction hearing device as soon as possible to avoid these delays.Īfter 6 years of age, surgical repair of atresia to open the canal may be considered. If this occurs bilaterally, the hearing loss can interfere with normal development and cause developmental delays. This condition causes the patient to have a conductive hearing loss. A completely absent pinna is referred to as anotia. Microtia is a congenital deformity where the pinna (external ear) is underdeveloped or absent. Aural atresia is seen in about 1 in 10,000-20,000 births. This occurs more commonly on one side but may also occur bilaterally. These children have severe hearing loss on both sides and must be aided with a bone conduction hearing device.Aural Atresia or Microtia (malformations of the ear)Īural atresia is a condition that occurs in utero when the ear canal fails to form properly and instead of being open like a tunnel, the canal remains closed. “Doing nothing” is NOT a choice on a child with bilateral (both sides) microtia and atresia. There MUST be excellent communication between the surgeon and the parents. If a parent decides to give a child with unilateral microtia the option of waiting for hearing correction later, it is hard to argue that choice. With this important knowledge, now surgeons can discuss whether a child is a good candidate, medium candidate or poor candidate for ear canal surgery. ![]() With much advancement of CT scan technology and facial nerve monitoring during surgery, now it is much easier to evaluate the anatomy of the facial nerve, middle and inner ear. The first was the worry of risking damage to the facial nerve (the nerve that controls the movements of the face). Many years ago, this was a common option for several reasons. This is an option for a child born with unilateral (one-sided) microtia and atresia. As a result, there will be conductive hearing loss. All this means is that the child’s inner ear is normal (normal sensorineural status), but because there is no ear canal, there is no way for sound to “conduct” to the inner ear via the ear canal. In conclusion, a child with a microtia will usually have normal sensorineural hearing and moderate to severe conductive hearing loss. When hearing loss occurs because of an inner ear problem, this is called sensorineural hearing loss. When hearing loss occurs because of an outer or middle ear problem, this is called conductive hearing loss. So when someone asks whether your child is deaf, the answer almost always is usually no. As a result, the inner ear functions at a normal level, even in a child with a microtia. Luckily, the inner ear (the location of the hearing and balance organs) forms at a different time as the outer and middle ears. Most of the time, the middle ear malformation consists of fused or malformed middle ear bones, a smaller middle ear cavity and an abnormal course of the facial nerve. ![]() When there is a severe congenital malformation of the outer ear, such as a microtia, then there is usually a malformation of the middle ear as well. Why? During in-utero development the outer ear and middle ear form at about the same time. Is a child with microtia deaf? In almost all cases, the answer is no.
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