AFTER THE BIRTH OF A CHILD WITH MICROTIA
EXAMINATIONS AND TESTS TO BE CARRIED OUT
AFTER THE BIRTH OF A BABY WITH MICROTIA, PARENTS WHO HAVE RECOVERED FROM THE INITIAL SHOCK WILL FACE AN EXHAUSTING PERIOD DURING WHICH EXAMINATIONS AND TESTS WILL BE CARRIED OUT FOR THIS UNEXPECTED CONDITION THAT HAS ARISEN IN THEIR CHILD.
Since it is not a very common condition, there is a lack of information that applies not only to you, but also to many doctors who do not specifically deal with this issue. Here, you will find the information you need to avoid wasting time with unnecessary examinations and to plan your child's treatment correctly.
EXAMINATIONS DURING INFANCY
THIS PROCESS WILL BE SHAPED ACCORDING TO THE GUIDANCE OF THE PEDIATRICIAN WHO CONDUCTS YOUR FIRST EXAMINATION AFTER BIRTH, AND THE FIRST THING TO BE EXAMINED WILL BE THE HEARING STATUS, WHICH IS THE ISSUE THAT WORRIES PARENTS THE MOST.
A hearing screening test in children with microtia should preferably be performed before the children leaves the hospital where they were born. There are two test methods: otoacoustic emission (OAE) and stimulated auditory brain stem response (BERA). The baby should be fed and peaceful before both tests are performed. Preferably, the baby should be asleep. Both of these tests are painless and harmless. The audiologist or the doctor decides which test to perform. Sometimes one, sometimes both can be performed. Both tests should be performed by audiologists who are experienced in their field.
After performed these two tests, no other examinations and treatments are required other than the routine doctor's check-up recommended every SIX MONTHS until auricular reconstruction.
ARE GENETIC TESTS NECESSARY?
This is one of the most frequently asked questions by parents of children with microtia. The main thing when deciding on this issue is whether the parent has a request or not. Because only in cases that manifest themselves with Microtia, this constitutes more than 90%. Since there is no determined genetic transmission in this group of patients, genetic tests are not essential. Although it is not necessary in children with microtia only, if there are Goldenhar syndrome, Treacher Collins Syndrome or similar conditions that affect the facial structure, bones and nerves in addition to microtia, and which are seen together with other anomalies in the body, the parent should be asked. Genetic testing can be done upon request.
INVESTIGATIONS ON ANOMALIES THAT MAY BE ACCOMPANYING
In addition to MICROTIA, imaging tests for the detection and treatment of head-neck and spine anomalies, abdominal ultrasonography for kidney and heart anomalies, eye examination, etc. investigations may be required. It is important that these examinations are performed as early as possible in the postpartum period, so that multi-faceted treatments can be performed without wasting time.
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TESTS TO BE DONE AFTER 5 YEARS OLD
High Definition Computerized Tomography
This examination is performed to evaluate the ear canal and middle ear structures. Tomography findings are evaluated with the "JAHRSDOERFER CLASSIFICATION" and a score between 0-10 is determined. This score is decisive in deciding whether to open the ear canal in a child with microtia. According to this scoring, at least 7 points are required to make a decision about attempting to open a canal. In other words, canal opening should not be attempted in cases with a score of less than 7.
Oval Window Open
Middle Ear Cavity
3D Chest Tomography
DETERMINING WHEN THE
OPERATION CAN BE PERFORMED
This examination is used to evaluate the development of the thoracic cartilages, which is important for deciding the time of auricle construction. In chest tomography, it is checked whether the cartilages of the 6th, 7th and 8th ribs are sufficient in size to make a new auricle for the child. In cases with adequate cartilage development, ear construction is possible from the age of 5 years. In cases with insufficient cartilage development in 3D chest tomography, we wait 1-2 more years for surgery.
It is better not to do tomography examinations before the age of 5, so that the child does not receive radiation at an early age.
Here you will find a chart as a summary of the information that can help you in during this period.
Please carefully examine the image that we can define as
“EXAMINATION ANDTREATMENT SCHEDULE OF THE CHILD WITH MICROTIIA”.
This chart, where you can find out at what age which test or examination you should have, will guide you during the period from the birth of your child with microtia to ear reconstruction.