I’m in awe of Simone Cheadle. Eleven years on, she continues to run this wonderful Microtia & Atresia annual conference at Brisbane Hear and Say. She creates a warm and welcoming atmosphere, puts families at ease, and brings together as many sources of information as possible. She has created the service she wished was available when her own daughter Chelsea was born with microtia and atresia. Chelsea is now 15 years old and a leader in her own right. Like her mother, she cares deeply about helping other families navigate the often confusing and complex path that lies ahead of them, to help them find the right options for their children, and to give them peace of mind that everything is going to be ok.
These two gems are just part of the dedicated team who pulled together the 2019 Conference on 14 & 15 September at Hear and Say in Brisbane, and I feel proud to be playing a part in this endeavour. While we’ve held mini conferences in Sydney and Melbourne this year, it’s this annual gathering in Brisbane that offers families access to the widest cross section of information and experiences. In 2018, at the 10th annual conference, I delivered information about emerging innovations in ear reconstruction such as custom 3D printed implants. This year I was able to share the stories of 3 children who have received these implants; Maxim, Sebastian and Joanna. Click on their names to read more about their journeys, including updated photos of Sebastian’s progress 3 months after surgery.
Most importantly to me, the conference was a great opportunity to meet new families, and offer the information that I hope can help them on their journey. Without exception I was impressed by the resilience and empowerment of parents who are taking control of their family’s healthcare and becoming educated in some of the most rapidly advancing areas of medicine imaginable. No mean feat!
Families were able to hear about a comprehensive range of concepts such as:
Implanted electronic devices and bone interfacing hearing implants.
Reconstruction of the hearing parts of the outer ear, tympanic membrane and ear canal.
Reconstruction of the outer ear with rib cartilage.
Reconstruction of the outer ear with synthetic materials like Medpor, Su-Por and StarPore (all types of porous polyethylene).
Customised implants using 3D printing technology.
The future of tissue engineering and 3D printing of cartilage.
My favourite presentation of the whole conference was undoubtedly when the older kids and teenagers talked about the new resilience program they participated in during the conference.
I’ve summarised a few of the common questions families asked me regarding having ear reconstruction in Australia if they choose to go down that path.
What is the ideal age for surgery?
This was the most common question of the conference and probably the question which gets the most varied responses from doctors. My personal belief is that parents know their children the best and I work closely with parents to determine when their child might be ready for a procedure, if ever. For 3D printed ear implants, the earliest age that I would consider offering surgery is 3 and a half. I personally feel 5 yrs old is a good time that coincides with starting school, but this is not necessarily right for everyone. There is no upper age limit, though I have witnessed that older children may have fear and anxiety related to surgery and their body image that can make their journey more psychologically distressing than it is for younger children.
Rib cartilage ear reconstruction in my practice is offered from 9-10yrs in a big child or 10-12yrs in a small child, as we need the chest to be sufficiently developed before proceeding. There is no upper age limit for this technique.
Do I need private health insurance to have an ear reconstruction procedure in Australia?
At present I am only able to offer ear reconstruction for children in private hospitals, though in the future I hope I can offer it in public hospitals as well. If you don’t have private health insurance we do recommend taking out a policy as soon as possible, as there will be a 12 month waiting period prior to any surgery. My office can send you details on insurers who routinely cover this procedure.
How early do we need to get the ball rolling
In planning for surgery we commence the 3D planning process with a 3D scan 6 months prior to surgery, and we have a meeting or skype call to kick off the planning process. One or two more meetings will be required to finalise the design of your child’s implant before we have it custom-made.
What should we do about hearing?
You should consult with an ENT surgeon regarding hearing, as this is their area of expertise. The BAHA Attract system can be implanted at the same time as a microtia repair for no significant additional cost. We have performed this combined procedure twice so far and will continue to offer it to families. Canalplasty is not available in Australia as a combined procedure. If you choose to have a canalplasty before microtia repair we can work with your ENT to make that plan possible.
Please reach out if you have questions about microtia treatments. I also encourage you to reach out to Hear and Say and join the growing community of parents and supporters who are changing the experience of microtia and atresia in Australia.