Microtia

Recap of Dr. Bonilla's presentation:

The purpose of this year's 1st Annual Los Angeles Microtia Atresia Conference (LAMAC) was to discuss the options available to parents of children born with microtia and aural atresia. More importantly, it was important to offer realistic expectations of the surgical reconstructions. It was important to stress to parents that surgical outcomes can be wonderful...but are not always a perfect science. It is our responsibility as surgeons to be truthful, realistic and caring. We owe this to parents.

There are four options for reconstruction of the microtic ear:

• Do nothing
• Cartilage technique
• Medpor technique
• Prosthetic

The most important question to ask the surgeon:

• How many of these microtia reconstructions do you perform on children?
• Do you specialize only in children or do you operate on adults as well?
• Do you specialize only in microtia or do you perform other plastic surgery operations in adults and children?
• What are your complication rates?

Responsibilities as surgeons:

• Offer patients all of the alternatives (even if it means another surgeon has more expertise in a certain technique)
• Be truthful by offering the advantages and disadvantages of the surgical technique
• Remind the parent that this is not a perfect science and complications can occur (there is no surgeon on the face of this earth that can or should say that every surgery will be perfect)
• Do not push your technique on a parent
• Let the parents decide on the best option for their child once they have had a chance to evaluate ALL options
• Remember that neither the parent nor the surgeon is undergoing surgery....the child is!

On the topic of timing and number of surgeries:

• There is absolutely no reason to rush a surgery
• One less surgery does not necessarily make it better
• Remember that the most important goal is the end result, so starting a surgery at an earlier age or pushing the envelope to do everything in one surgery may compromise the new ear

On the topic of insurance:

• All offices have different billing practices
• Must ask the surgeon how their office handles their billing
• Surgeons that perform microtia surgery on a routine basis have special relationships with insurance companies
• This relationship helps the patient and can lessen the financial burden

Finally,

• These children are a true blessing
• They can conquer the world just like any other chil
• We need to give them every opportunity to succeed
• Never let a question or a concern go unanswered
• Live life to the fullest