Clinical Areas
Ear Reconstruction & Congenital Ear Differences
This area covers reconstruction of the external ear: differences present from birth, loss of part of the ear after injury or tumour removal, and correction of unsatisfactory results from previous surgery. It is distinct from otoplasty for prominent ears — an aesthetic procedure for a fully formed ear, which has its own page.
Care is led by Dr. Khalid Almutairi, a consultant plastic surgeon who is board certified in plastic and reconstructive surgery and double-fellowship trained in Canada and the USA.
Microtia
Microtia is congenital underdevelopment of the external ear. Its severity ranges from an ear that is smaller than usual but recognisable, to a severely deficient auricle. Assessment covers the degree of deficiency, the opposite ear, the status of the ear canal, and the child's age and growth; reconstructive options and their timing are then discussed — and reconstruction may be staged in some cases.
An important point: reconstruction of the external ear addresses form and does not, by itself, restore hearing. Hearing evaluation is a parallel pathway involving audiology and ENT specialists where needed. Complete or near-complete absence of the auricle (anotia) is assessed on the same principles with wider considerations.
Other congenital differences in ear shape
Other congenital differences are not microtia, and each has different anatomical considerations:
- Constricted or cup ear: deficiency or folding of the upper cartilage with reduced vertical height.
- Stahl's ear: an additional abnormal cartilage fold that alters the shape of the upper ear.
- Cryptotia: the upper part of the auricle lies buried beneath the scalp skin.
- Varying degrees of asymmetry or differences in the cartilage folds.
Why are these not all treated as standard otoplasty?
Correction of a prominent ear reshapes cartilage that is present and fully formed. Congenital differences may involve a genuine deficiency of cartilage or skin that requires reconstruction, not merely reshaping. Everything therefore begins with the correct diagnosis, followed by the approach appropriate to it.
Reconstruction after injury or previous surgery
This area also covers loss of part of the ear after accidents, burns, or tumour excision, and correction of unsatisfactory results from previous ear surgery — such as recurrent prominence, overcorrection, or distorted cartilage. Planning depends on the missing subunits, the condition of the remaining cartilage and skin, blood supply, scarring, and previous operations, and every case is assessed individually.
Timing in children
Planning in children takes account of ear and cartilage growth and the child's readiness, and the appropriate timing differs with the condition and the type of reconstruction. These considerations are discussed with the family during consultation, without assuming one timing for all cases.
Limitations and risks
Complete symmetry with the other ear, or a specific outcome, cannot be guaranteed. Risks discussed before any decision include scarring, infection, cartilage exposure, contour irregularity, partial tissue loss, and the need for stages or later revision. The risks relevant to each case are explained before consent.
What is offered routinely, and what is assessed individually
Assessment of ear differences and otoplasty for prominent ears are offered routinely at the clinic. Staged congenital reconstruction and complex cases are evaluated individually, and the appropriate pathway and treating facility are determined according to the case and facility requirements.
Medical-information notice
This information is general and does not constitute a diagnosis or individual medical advice. It does not replace consultation, discharge instructions, or patient-specific follow-up advice.