Microtia Question and Answer

Thousands of questions have been submitted to our microtia site. We try to answer every single question. We are including some of the questions (excluding any private information) as well as the responses.

Our goal is to educate as many people as possible, but it is equally important to protect the confidentiality of your questions. Different physicians may have different opinions so it is important to ask many questions and do your due diligence during this journey. These are our opinions only. If you would like to speak with Dr. Bonilla in person, please feel free to call our office.

"Dr. Bonilla, I am confused. What is a BAHA designed to do?"

First of all, let's define what the acronym "BAHA" stands for: Bone - Anchored Hearing Aid. Although some associate the BAHA with one specific company, a bone-anchored hearing aid or processor is actually represented by various companies, such as Cochlear, Oticon, Sophono and Med-El. Because most children with microtia also have atresia (lack of an ear canal), sound cannot make it to the inner ear, where the hearing nerve is located. Also, even though there is no ear opening, the hearing nerve usually functions normally. So sound has to figure out how to make it from the outside surroundings to the inner ear. The way sound makes it to the inner ear is by vibration. When sound strikes our skull, it causes mini-vibrations to transmit through the skull toward the inner ear. The hearing nerve in the inner ear recognizes this sound and converts it into electrical signals to the brain.

A Bone-Anchored Hearing Aid or Processor converts sound into vibrations. This vibration is transmitted via the abutment and implant and eventually makes it to the inner ear so the child can hear, even without an ear canal.

"Dr. Bonilla, my son is 1 month old and he has bilateral microtia. I am very confused as to what my next step is. I have been told that there is not much to do for now. Is that accurate?"

Although I do not know what has been recommended so far, there are several things that I would make sure you do:
1) Make sure that you take your son to your primary care doctor, who will direct the care and management of the specialist referrals.
2) Ask to be evaluated by an Ear, Nose & Throat doctor. This kind of doctor usually has an audiologist (hearing specialist) as part of his/her practice. A hearing evaluation is mandatory! Depending on the hearing test result, it is important to get your son a bone-conduction hearing aid. This will allow your son to be able to hear much better.
3) If possible, a referral to a microtia surgeon is the next step. Although it is still early, I strongly feel that parents need to be educated on the management of microtia and atresia as early as possible.

"How do I raise my child with microtia?"

Raise them normally! Of the hundreds of children I have seen in my practice within the past few years, there has been a common pattern. The children who have had their ears covered by long hair have a more difficult time dealing with people looking at them. These children are aware that their parents are trying to hide the microtic ear. They tend to have less self-confidence and have more difficulty adapting to social surroundings. In contrast, the children who have been raised as any other normal child have had the fewest difficulties with social surroundings. They are well aware of the microtic ear and have dealt with it in their own way. In addition, if these children understand that their ear will be fixed down the road, they can adapt better.

"Hi, I am from Kenya and my daughter has microtia and we are currently attending microtia clinics at Kinyata National Hospital. Please advise if there is a way you can help me."

The most important thing to do presently is to have a doctor fully evaluate your daughter for other medical problems. Once it is established that the microtia and possible atresia is the only problem, the hearing evaluation should be performed. If the child is only affected on one side, then it is important to make sure that the normal side has normal hearing. Once that is established, there is now time tosee the visit the specialist who will manage your daughter's condition. Much depends on your daughter's age presently to fully understand the next plan of action.