Microtia is a congenital disorder, present at birth, characterized by the inadequate development of the external ear, also termed as the pinna. This condition is usually associated with a blocked or absent canal opening leading to various degrees of hearing loss and can affect one or both ears. The term ‘microtia’ literally translates to ‘small ear’.

Microtia is classified into four grades based on the severity of the deformation. Grade I denotes a slightly smaller but other than that, structurally normal pinna. Grade II presents a partial formation of the pinna with identifiable structures. Grade III, also called ‘classic microtia’, represents a small structure on the side of the head, often described as ‘peanut-like’. Lastly, Grade IV, or anotia, signifies a complete lack of ear development.

The probability of an infant being born with microtia does not have a definite and direct cause, however, it is often associated with genetic conditions or exposure to specific environmental factors during pregnancy. For instance, medications such as Accutane used in acne treatments, maternal diabetes, or consumption of alcohol during pregnancy may increase the risk.

Diagnosis of microtia is typically made at birth through a visual examination of the infant. Once microtia is identified, doctors usually perform further investigations to ascertain the severity and also identify if there are any associated conditions such as kidney and heart issues or facial symmetry abnormalities.

Coming to the management of this condition, reconstructive surgery is often considered a viable option for physical and functional restoration of the ear. Depending upon the grade of microtia, doctors may opt for rib cartilage grafts from the child’s body, synthetic material, or use a combination of the two for building up the auricle. The surgery usually takes place once the child is of an older age so that the ear is large enough for the graft.

In certain scenarios, when patients with microtia also have a skin condition known as a ‘melanocytic nevus’, they might require a separate ‘melanocytic nevus surgery‘ along with ear surgery. A melanocytic nevus is a very common type of skin growth, often presented as a small, brownish spot made up of pigment-producing cells. If the nevus presents any changes in color, size, or shape, or if it’s in a location that hinders cosmetic appearance or functionality, a melanocytic nevus surgery may be required.

The procedure aims to remove the nevus and typically involves either surgical excision followed by stitching or more advanced techniques like laser surgery, depending on the size and position of the nevus. This procedure, combined with the reconstruction of the ear, can help in achieving a better cosmetic and functional outcome.

In conclusion, microtia is a congenital condition that significantly affects an individual’s quality of life due to its influence on hearing and appearance. However, with advancements in medical science, there are various effective treatments available today. Reconstructive surgery can successfully restore both the function and aesthetics of the ear, providing individuals afflicted with microtia with a chance at leading a normal life. It is recommended that anyone dealing with this condition should consult with a specialist for the best possible consultation and treatment.