Multidisciplinary care improves hearing intervention rates in children with microtia.

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.