Hearing loss and previous hearing aid placement.

Family history of ear abnormalities, facial clefts, or syndromes.

Asymmetric facial movements.

Visual impairment.

Cardiac or renal dysfunction.

Classify anomaly: Unilateral or bilateral; severity of auricular hypoplasia (lobular type, conchal type, anotia); presence of external canal.

Evaluate quality of periauricular skin, position of hairline.

Complete physical examination: Assess for facial symmetry (hemifacial microsomia), epibulbar dermoids (Goldenhar syndrome), occlusal abnormalities, mandibular hypoplasia, facial nerve function, orofacial clefts, Treacher Collins syndrome (bilateral microtia; hypoplasia of maxilla, zygoma, and mandible; downward-slanting palpebral fissures; colobomas).

Complete audiometric testing

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  Evaluate conductive or sensorineural hearing loss.

  
  
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  The cochlea (inner ear) is usually intact. The patient may therefore benefit from a conductive hearing aid or external canal/middle ear reconstruction to restore hearing to the affected ear.

  
  
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  Assess patient for use of a bone-anchored hearing aid (BAHA) and discuss the possibility of surgical reconstruction to aid hearing.

Temporal bone computed tomography to evaluate middle ear and inner ear anatomy.

Audiologist: For hearing evaluation. Most patients with microtia have middle ear atresia with resultant conductive hearing loss. However, the inner ear is usually intact with a viable sensorineural apparatus.

Otolaryngologist: Evaluation for BAHA. With bilateral microtia and hearing loss, hearing aids should be placed within weeks of birth to allow speech development. Even in cases of unilateral microtia, conductive hearing aids may be a beneficial option.

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  When hearing is present in only one ear, the unaffected ear must be closely monitored and aggressively treated if problems occur to optimize patient′s hearing.