Summary:

Background:
Patients with severe ear malformations have several options for auricular reconstruction: 1. surgical auricular reconstruction and 2. prosthetic solutions. In addition, there are also a wide range of options available for restoring hearing. All implants are inserted into the mastoid or its immediate vicinity. Whilst there is only limited scope for epithesis implants, the implantation site for hearing aids can vary somewhat more widely. This can lead to a situation of competition at the implantation site.

Materials and Methods Case Report and Review Results:
The options currently available for external ear and hearing rehabilitation are outlined. Various scenarios are identified depending on the patient’s age and treatment preferences. A further complication is that the patient’s preference regarding the auricle may not yet be established in childhood or may change over time. If a hearing implant system has already been placed in the mastoid, a situation may arise where, on the one hand, the implantation site is already occupied and, on the other hand, bone has already been removed, making implantation for an auricular prosthesis difficult in that location.    

Conclusions:
The various clinical disciplines involved in the treatment should be aware of the challenges associated with care. In particular, parents of children with microtia should be given comprehensive information prior to surgery for hearing implantats.