CAM Surgery for Microtia
How does Microtia Treatment work?
Microtia is a congenital condition in which a child is born with an underdeveloped or absent outer ear. In most cases, microtia occurs together with ear canal atresia, a condition in which the ear canal and eardrum never fully form. This can lead to significant conductive hearing loss and challenges in sound transmission to the middle and inner ear.
At The Ear Center, our work focuses on the surgical creation of an ear canal and reconstruction of the eardrum and middle ear – the procedures necessary to restore functional hearing – in patients born with microtia and atresia. The first step in treatment planning is a thorough evaluation, including imaging and audiological testing, to assess the individual anatomy of the ear canal, middle ear structures, and facial nerve. Only with this complete picture can the surgical approach be safely determined.
Unlike many practices where canal reconstruction and outer ear reconstruction are done separately, we specialize in a comprehensive, coordinated surgical solution that addresses both hearing restoration and cosmetic ear reconstruction.
A Specialized Surgical Approach: CAM Surgery
Dr. Nazarian works closely with a dedicated team of world-renowned plastic and reconstructive surgeons, including Dr. Reinisch and Dr. Tahiri, to offer a coordinated procedure known as CAM surgery—short for Canal and Microtia surgery.
CAM surgery is a joint, single-stage procedure that addresses:
- Creation of a functional ear canal and eardrum
- Reconstruction of the middle ear for hearing improvement
- Reconstruction of the outer ear for natural appearance
By combining these procedures into one surgery, patients avoid multiple operations spread over several years.
One Surgery Instead of Many
Traditionally, patients with microtia and ear canal atresia undergo several separate surgeries—first to reconstruct the outer ear, then later to address the ear canal and hearing.
Our approach is unique.
By performing canal reconstruction and microtia repair together, we:
- Reduce the total number of surgeries
- Shorten overall recovery time
- Minimize anesthesia exposure
- Improve coordination between functional and cosmetic outcomes
This unified approach allows both hearing and appearance to be restored in a carefully planned, collaborative procedure.
What happens during CAM surgery?
At The Ear Center, we perform a Combined Atresia & Microtia (CAM) surgery, a collaborative procedure in which ear canal reconstruction and outer ear repair are completed in a single surgical session. This joint surgery is carefully planned and carried out with Dr. Nazarian working alongside an experienced plastic surgery team, including specialists like Dr. Reinisch and Dr. Tahiri.
Preparation and Anesthesia
Under general anesthesia, detailed surgical planning guides the precise surgical approach. Preoperative imaging ensures the location of critical structures such as the facial nerve is well understood. Based on those findings, Dr. Nazarian begins the canal and middle ear portion of the operation.
Ear Canal Creation and Middle Ear Reconstruction
A new ear canal is created by carefully drilling a channel through the temporal bone, which is then lined wth a skin graft to form a functional passage for sound. If necessary, the eardrum is also reconstructed from native tissues, and middle ear bones may be refined or reconstructed to maximize sound transmission.
Outer Ear Reconstruction
Once the canalplasty and internal work are complete, the plastic surgery team reconstructs the outer ear framework. This typically uses an implant covered with soft tissue to create an anatomically natural ear. Because these procedures occur in the same session, the outer ear is formed in precise alignment with the newly created canal.
Closure and Recovery
After the surgical repairs are complete, all incisions are closed and protective dressings or molds are put in place. Patients are typically monitored for a short period and may go home the same day. A custom ear canal mold may be used during healing to help maintain canal patency and support optimal long-term results.
When Can I Hear / See Results?
Hearing and Ear Canal Results
Most patients begin to experience hearing improvement as early as their initial postoperative follow-up visit once swelling has lessened and the new canal has had time to heal. While individual outcomes vary, the goal of CAM surgery is to achieve a functional canal and eardrum that allow sound to travel more naturally, with many patients reporting significantly improved hearing compared to their pre-surgery status. Dr. Nazarian continues to monitor ear canal development and hearing outcomes closely as part of long-term care.
Outer Ear Results
The appearance of the reconstructed ear is immediately noticeable following surgery, with refinement continuing as swelling subsides over several weeks. Because canal and outer ear reconstruction are coordinated, the cosmetic result is harmonized with the functional ear canal position. Permanent aesthetic outcomes typically become evident in the months following surgery, as tissues settle and remodeling completes.
Recovery Timeline
Most CAM surgery patients are discharged on the same day or after a short outpatient stay. Early recovery focuses on comfort, care of the surgical area, and ensuring proper positioning of healing structures. Follow-up visits are scheduled to monitor healing, adjust molds if used, and track both hearing and cosmetic progress.
Long-Term Outcomes
With careful surgical technique and multidisciplinary planning, CAM surgery offers durable results for hearing and appearance. Individual follow-up schedules vary, but Dr. Nazarian and the team will guide each patient through long-term monitoring to maximize function and aesthetics.
With careful surgical technique and multidisciplinary planning, CAM surgery offers durable results for hearing and appearance.
Still Have Questions About Microtia Treatment?
Our team is here to guide you through each step of diagnosis, treatment planning, and long-term care.
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What our patients say about us
Thanks to the expert care and skillful ear surgery I received, my life has been transformed. I can hear clearly again, and I’m forever grateful for the life-changing experience provided by the talented team.
“Dr. Nazarian, who gave me back the wonderful gift of hearing!”
“Dr. Nazarian is the best! I was referred to Osborne Head & Neck Institute. They told me I needed to wait for a specialist. So I did. Dr. Nazarian got here and I saw him his first day. He has since fixed my ear problems. The entire staff has been great and would recommend to anyone.”
“He’s the greatest surgeon and physician I have ever had the pleasure of being cared for.
"I was referred to Dr. Nazarian by my ENT in San Fernando valley after my ear drum failed to heal on its own. I didn’t know what to expect. He explained everything and was extremely compassionate to my situation. He not only reconstructed for me a completely new ear drum but gave me a better ear than I was born with. Thank you Dr. Nazarian for being the best!"
“You’ve changed the way I hear and feel and will forever be so grateful.”
"I am truly amazed by this total process… You and your staff have been great. I can hear things that I have not been able to hear in years. After 15 years of hearing aids and only a little help I was afraid that I was going to have to medically retire due to not being able to hear. With my Cochlear implant, I know that I can work until I am ready to retire. Thank you so much!!!"