Multidisciplinary care improves hearing intervention rates in children with microtia

IF 1.6 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI:10.1016/j.ijporl.2025.112672

Brandon D. Abell , Marta Kulich , Kaitlin E. Olson , Megan E. Hedman , Kirsten H. Adkisson , Peggy E. Kelley , Sarah A. Gitomer

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引用次数: 0

Abstract

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.

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多学科治疗可提高听力障碍儿童的听力干预率

患有小症/闭锁（M-A）的儿童有一系列复杂和纵向的需求，我们的目标是在我们中心创新的多学科诊所（MDC）解决这些需求。参加争取民主变革运动的儿童在同一天看多名专家，并参加跨学科讨论。本研究的目的是比较MDC和非MDC患者的患者特征、治疗选择和结果。方法：本研究是一项回顾性队列研究，研究对象为2001年至2022年在某三级儿童医院接受治疗的M-A患者。比较MDC和非MDC患者的人口学、社会经济和临床因素。结果共纳入507例小个子和/或闭锁儿童，其中319例（63%）参加了MDC。这两个队列在性别、种族、民族、保险状况、语言、与争取民主变革运动的距离或贫困社区指数方面没有显著差异。MDC患者的非手术率（82.1%比53.7%;p < 0.001）和经皮手术骨扩增率（40.6%比18.3%;p < 0.001）均较高。此外，MDC患者首次非手术骨扩增安装时的中位年龄显著降低（0.8岁比2.5岁，p = 0.011）。两组之间的器械依从性和功能或重建手术率相似。结论：这是迄今为止规模最大的跨学科综合护理研究。在这个模型中，儿童的结果有所改善：他们更有可能接受骨放大助听器，并在更年轻的时候安装了非手术骨放大设备。促进早日转介到争取民主变革运动，以及在其他机构实施类似的多学科方案是值得的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.