Microtia: Epidemiology, Clinical Characteristics, and Medical Interventions

Microtia is a congenital malformation of the auricle, ranging from mild structural anomalies (Grade I) to complete absence of the external ear (anotia, Grade IV), and is often accompanied by external auditory canal atresia or stenosis and middle-ear abnormalities. Reported global prevalence varies considerably across regions and ethnic groups, with higher rates documented in Hispanic, Asian, and Indigenous populations, suggesting an interplay of genetic, environmental, and prenatal factors. Microtia may occur in isolation or as part of broader craniofacial syndromes (such as hemifacial microsomia, Treacher Collins, or Goldenhar syndrome), and most affected children present with conductive hearing loss that, if not addressed early, can compromise speech, language, cognitive, and psychosocial development.Despite advances in three-dimensional imaging, autologous costal cartilage reconstruction, polyethylene-based implants, prosthetic rehabilitation, and bone-conduction and active middle-ear implants, important gaps remain. Standardised epidemiological data, harmonised classification systems, evidence-based timing of surgical and audiological interventions, long-term functional and aesthetic outcomes, and equitable access to care across health systems are still actively debated.GoalThis Research Topic aims to bring together current evidence on the epidemiology, clinical presentation, and management of microtia, with the goal of informing clinical decision-making and guiding future research priorities. By assembling contributions from otologists, audiologists, plastic and reconstructive surgeons, geneticists, paediatricians, and allied health professionals, we hope to provide a multidisciplinary reference that supports earlier diagnosis, more consistent classification, individualised treatment planning, and improved hearing and quality-of-life outcomes for affected patients and their families.ScopeWe welcome submissions addressing (but not limited to) the following themes: ○ Global and regional epidemiology of microtia, including incidence, prevalence, risk factors, and disparities across populations. ○ Genetic, syndromic, and environmental contributors to microtia and associated craniofacial anomalies. ○ Clinical phenotyping, classification systems (Marx, Weerda, Nagata, HEAR), and standardisation of diagnostic criteria. ○ Prenatal and neonatal screening, imaging (HRCT, MRI, 3D reconstruction), and audiological assessment of the microtic ear. ○ Conductive and mixed hearing loss in microtia: natural history, audiological monitoring, and impact on speech and language development. ○ Non-surgical interventions: softband and adhesive bone-conduction devices, contralateral routing of signal (CROS) systems, and auricular prostheses. ○ Surgical management: autologous costal cartilage reconstruction, alloplastic implants (porous polyethylene), atresiaplasty, and active or passive bone-conduction implants. ○ Comparative outcomes (functional, audiological, aesthetic, and patient-reported) across reconstructive techniques and implantable devices. ○ Psychosocial, educational, and quality-of-life outcomes in children, adolescents, and adults living with microtia. ○ Multidisciplinary care pathways, timing of intervention, and access to specialised microtia services in different healthcare settings. ○ Emerging approaches: tissue engineering, 3D-printed scaffolds, regenerative medicine, and artificial intelligence applied to surgical planning. Topic editors: Shin-ichi Usami, Kristen Rak, Danielle F. Eytan Source: https://www.frontiersin.org/research-topics/80848/microtia-epidemiology-clinical-characteristics-and-medical-interventions