Honors Program


Document Type


Date of this Version

Spring 3-12-2018


Puatu, A. (2018). The Psychosocial Effects of Microtia on Family's Decision Process. The University of Nebraska-Lincoln.


Copyright Alexandra Puatu 2018


One in every 10,000 live births result in a facial anomaly called microtia, which affects the outer, visible part of the ear. This can have varying levels of severity, ranging from a smaller than average ear size (type one) to the complete absence of any external ear (type four). Families are presented with three options: surgery, hearing aids, or to allow the child to continue developing with no technological help. When families are presented with these options, the process tends to be stressful because of the added, unexpected decisions needed to be made on a family with a new member.

A literature review of the three options was conducted to better understand the options that are presented to families in the hospital. During each option psychological and social reasons were surveyed for, with the intent to understand why families choose to go that route. What were the factors that lead them to picking the option they did? What factors lead them to not pick the other two options? Who were crucial players in the decision making process?

There was not sufficient psychosocial research on this specific facial anomaly, which lead the literature review to broaden its scope to all facial anomalies, namely cleft lip/palate, because the assumption was made that the reasoning would be similar.

Research was conducted as a phenomenological study of one individual that was known to have type three grade of microtia. The individual was a young adult and the parents decide to not pursue surgical or hearing aid options. After interviews with the individual and their parents, a complete phenomenological analysis was conducted to reveal social and psychological patterns between responses. These responses were then filtered by category, one specific to the decision making process, emotions during, and emotions after the decision was made.

Between the literature review and the phenomenological study that was conducted, it is concluded that professional impressions play a major deciding role in swaying a family one route or another, along with personal aesthetic reasoning. Even with aesthetic reasoning, professionals are what pushes a family toward one route. Professionals must be cautious in how the present information and how they counsel the family with their options because it is the deciding factor for a child’s lifetime.