(1038) The Psychosocial Impact of Microtia: A Systematic Review

Introduction: The psychosocial impact of microtia is substantial and can include depression, low self-esteem, and decreased social functioning. The objective of this study is to systematically review the literature on psychosocial outcomes in microtia patients, including those who opted to forego reconstruction.

Methods: A systematic review was conducted evaluating studies from January 1, 1990, to November 3, 2025. Included articles focused on the psychosocial impact of congenital microtia. Descriptive analyses were performed.

Results: Thirteen studies met criteria, including 1,092 patients (ages 3 to 86). 370 patients underwent surgical intervention (autologous rib reconstruction = 301, Medpor = 51, prostheses = 14, unknown = 4). Clinical assessment tools varied across studies (eight validated questionnaires, five clinical interviews, four semi-structured questionnaires, one chart review). Measured psychosocial outcomes included depression, anxiety, self-esteem, social functioning, and body image.

Compared to patients with normally developed ears, patients with microtia were found to have higher levels of depression, anxiety, and aggression and decreased popularity/gregariousness. Older microtia patients had higher rates of teasing, anxiety, depression, and social withdrawal compared to younger patients. Increased teasing was associated with reported sadness, social withdrawal, and hostility.

Several studies compared patients’ pre- and post-operative metrics and found decreased levels of depression, self-consciousness, and teasing post-operatively. Patients who opted to undergo reconstruction had lower preoperative self-esteem than those who opted to forego surgery. Strong social support was associated with improved ear integration (e.g., feeling like their new ear is “part of their body”) post-operatively.

Conclusions: Microtia can have a negative psychosocial impact on patients, though surgical reconstruction and social support can improve outcomes. Further research on outcomes of psychosocial interventions could benefit this population.