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Multidisciplinary care improves hearing intervention rates in children with microtia
Brandon D Abell1, Marta Kulich2, Kaitlin E Olson3
1University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO, USA.
Insights
Children with microtia/atresia (M-A) benefit from multidisciplinary care, receiving bone amplification devices earlier. This study shows improved outcomes for M-A patients in a specialized clinic.
Area of Science:
- Otolaryngology
- Pediatric care
- Audiology
Background:
- Microtia/atresia (M-A) presents complex, long-term challenges for children.
- A Multidisciplinary Clinic (MDC) offers integrated care with multiple specialists and inter-disciplinary discussions.
- Comparing outcomes between MDC and non-MDC patients is crucial for understanding care effectiveness.
Purpose of the Study:
- To compare patient characteristics, treatment choices, and outcomes for children with M-A.
- To evaluate the effectiveness of a Multidisciplinary Clinic (MDC) model for M-A care.
- To identify potential benefits of centralized, inter-disciplinary M-A management.
Main Methods:
- Retrospective cohort study of 507 M-A patients (2001-2022).
- Comparison of demographic, socioeconomic, and clinical factors between MDC and non-MDC cohorts.
- Analysis of treatment choices, including non-surgical and surgical bone amplification.
Main Results:
- MDC patients showed higher rates of non-surgical (82.1%) and transcutaneous bone amplification (40.6%).
- MDC patients received non-surgical bone amplification devices significantly younger (0.8 vs. 2.5 years).
- No significant differences were observed in sex, race, insurance, or surgical rates between groups.
Conclusions:
- The MDC model leads to improved outcomes for M-A patients.
- Children in the MDC are more likely to receive bone amplification devices at younger ages.
- Early referral to MDCs and implementing similar programs are recommended for better M-A care.
Objectives:
Children with microtia/atresia (M-A) have a spectrum of complex and longitudinal needs which we aim to address at our center's innovative Multidisciplinary Clinic (MDC). Children attending the MDC see multiple specialists on the same day and participate in an inter-disciplinary discussion. The aim of this study was to compare patient characteristics, treatment choices, and outcomes between MDC and non-MDC patients.
Methods:
This was a retrospective cohort study of patients with M-A treated at a tertiary children's hospital between 2001 and 2022. Demographic, socioeconomic, and clinical factors were compared between MDC and non-MDC patients.
Results:
507 children with microtia and/or atresia were included, 319 (63 %) of which attended the MDC. The two cohorts did not significantly differ in sex, race, ethnicity, insurance status, language, distance from the MDC, or the Distressed Communities Index. MDC patients had higher rates of both non-surgical (82.1 % vs. 53.7 %; p < 0.001) and transcutaneous surgical bone-amplification (40.6 % vs. 18.3 %; p < 0.001). Additionally, median age at first non-surgical bone amplification fitting was significantly lower in MDC patients (0.8 years vs. 2.5 years, p = 0.011). Device compliance and functional or reconstructive surgery rates were similar between groups.
Conclusion:
To date, this is the largest study of interdisciplinary M-A care. In this model, children have improved outcomes: they are more likely to receive a bone amplification hearing device and were fitted with non-surgical bone amplification devices at younger ages. It is worthwhile to promote early referral to the MDC, as well as implement similar multidisciplinary programs at other institutions.
