New care standards for Microtia and Atresia

26th April 2015

 

The prospects for patients with microtia and atresia have improved significantly in recent years. Not only should the restoration of appearance with an aesthetic ear be a reasonable expectation, for those that want it, but we are now in a position to overcome the conductive deafness associated with atresia. This, however, requires close collaboration and multidisciplinary audiological, psychological and surgical care. 

BAPRAS members involved in ear reconstruction have collaborated with colleagues from ENTUK, various audiology societies, charities and patient interest groups to produce new care standards for the multidisciplinary management of microtia and atresia.

Ill co-ordinated care has in the past led to frustration for patients and surgeons. Examples include bone anchored hearing aids placed where a new ear should belong. The development of new buried hearing implants has, in the hand of capable teams, led us to the position where the restoration of form and function is achievable for all. 

We have long appreciated that bilateral hearing impairment is a devastating disability. We now appreciate that unilateral conductive hearing impairment has a negative impact on individuals lives.  We know that kids with unilateral deafness are more likely to struggle at school. We know that adults experience occupational difficulties due to sound localisation dysfunction, and occasionally we see extreme examples such as a polytrauma victim hit by a car approaching from his non-hearing side. 

The challenge for clinicians working in this arena is to help often young patients choose the treatments that will meet their lifelong requirements, and to work together to offer a package of care in which one intervention does not compromise another. 

Just as the BAPRAS/BOA guidelines have facilitated the management of open fractures, we hope these guidelines will offer clinical teams and patients an evidence-based framework for collaboration in the management of microtia and atresia. 

The guidelines are available from the Clinical Guidance section of the BAPRAS website.

 

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