Socioeconomic disparities in reconstructive pediatric microtia surgery
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Published on: February 16, 2022
Kalena Liu1, Alex J Gordon2, Danielle F Eytan3
1City University of New York School of Medicine, New York, NY, USA.
Insights
Non-White pediatric patients with microtia underwent more surgeries and interventions for hearing and ear reconstruction compared to White patients. Further research into socioeconomic factors is needed.
Area of Science:
- Otolaryngology and Audiology
- Pediatric Surgery
- Health Disparities Research
Background:
- Microtia is a congenital ear deformity requiring surgical intervention for hearing and external ear reconstruction.
- Understanding factors influencing treatment pathways is crucial for equitable care in pediatric otologic surgery.
Purpose of the Study:
- To evaluate the impact of race/ethnicity and education on the timing and number of interventions for pediatric microtia.
- To identify disparities in hearing intervention and external ear reconstruction for children with microtia.
Main Methods:
- Retrospective chart review of pediatric patients with microtia from 2013-2021 at a major surgical institution.
- Analysis of demographic data, patient conditions, time to surgery, and number of surgical procedures.
- Statistical methods included ANOVA, chi-squared tests, and multivariate regression analysis.
Main Results:
- Non-White patients with microtia underwent significantly more external ear reconstructive surgeries compared to White patients (p=0.004).
- All non-White racial groups showed increased total surgeries and interventions versus White patients (p=0.007 and p=0.02, respectively).
- Race was a significant predictor of reconstructive and overall surgeries; aural atresia strongly predicted hearing surgery needs.
Conclusions:
- Significant disparities in the number of surgical interventions for microtia exist among racial groups.
- Further investigation into socioeconomic determinants of care is essential to address these observed disparities in pediatric microtia surgery.
Objective:
To assess the association of race/ethnicity and education status on time to intervention and the total number of interventions in pediatric patients with microtia undergoing hearing intervention and external ear reconstruction.
Methods:
A retrospective chart review was performed in pediatric patients diagnosed with congenital ear deformities evaluated by an otolaryngologist or audiologist from January 1, 2013 to December 1, 2021 at a large surgical institution. Variables analyzed included demographics, patient conditions, time to surgery, and number of surgeries. Statistical analysis included analysis of variance, chi-squared tests, and multivariate regression.
Results:
Disparities were identified in reconstructive microtia repair, with non-White patients having an increased number of external ear reconstructive surgeries (p = 0.004), with Black patients average 2 external ear reconstructive surgeries, Hispanic patients 1.74 surgeries, while White patients averaged 0.812 surgeries. All non-White patients also demonstrated increased total number of surgeries (1.94 Asian, 2.57 Black, 2.11 Hispanic, 3.29 Other/Unknown, vs 1.23 White, p = 0.007) and total number of interventions (2.17 Asian, 2.71 Black, 2.37 Hispanic 3.43 Other/Unknown, vs 1.56 White, p = 0.02) as compared to White patients. In multivariate regression analysis, race was a significant factor influencing the number of reconstructive and overall surgeries, while the presence of aural atresia was the strongest predictor for requiring additional hearing surgery.
Conclusion:
An increased number of interventions and surgeries were seen amongst non-White patients with microtia. Further investigation is warranted to understand the socioeconomic factors associated with pediatric microtia surgery.
