The surgical treatment of microtia: a long-term review of 17 patients.

Fourteen children were reviewed approximately 3 1/2 years after surgical reconstruction of the pinna had been completed. Seven had unilateral microtia and seven bilateral microtia, including four caused by thalidomide. Using objective criteria the cosmetic results were disappointing. Treatment entailed protracted hospitalisation, numerous operations and produced adverse emotional and educational sequelae. Nearly all the children covered their ears by growing their hair long. Attempts by the ENT department to improve hearing in the children with bilateral microtia had been disappointing. Three other children who were not treated although they had been referred for surgery were also reviewed. The problems of reconstructive surgery for microtia and the indications for treatment are discussed. It is suggested that reconstruction may be inadvisable for children who have bilateral anotia or associated deformities and who have an unstable family background.