In general, microtia occurs more often in Hispanics and Asians than it does in blacks and whites. The cause of microtia is multifactorial. Fewer than 15% of the cases have a positive family history.
It is fairly common for microtia to be associated with other congenital abnormalities. Among associated malformations, facial cleft and cardiac defects are the most common followed by anophthalmia or microphthalmia, limb reduction defects, severe renal malformation, and holoprosencephaly.
And it has long been felt that microtia represents the mild end of the spectrum of hemifacial microsomia. Goldenhar syndrome is the most severe end of the spectrum.
There are many classification systems for microtia. One widely adopted system assigns a grade from I to III based on the severity of the deformity. Grade I represents a pinna with all anatomic subunits present. Grade II represents a pinna with some recognizable subunits but is rudimentary and malformed. Grade III includes the classic "peanut" ear, which is severely deformed with an inferior fibroadipose lobule and a nubbin of cartilage in the superior remnant.
“If you are considering reconstruction, it is my view that you have been through enough already. You don’t need the added difficulty of a doctor who is less than compassionate about your ordeal. I hope that you will find my entire staff to be fully understanding of your challenge and responsive to your concerns. Remember, I am here for you. I try to model my patient relationships around a mutual relationship of trust and confidence. If you have concerns or anxieties about any part of the process, I want to hear about it!”
--Dr. Mark Chariker, MD, FACS