Notes from Quito 2014
I’m excited to report on another successful mission trip to Ecuador. Since my first mission a decade ago, my passion for the work that we do in South America has slowly and steadily developed. The founders of the mission, Drs. Vito Quatela, Mack Cheney, Tessa Hadlock, and Paul Sabini have pushed us to new heights with our reconstructive efforts. This is no small feat given the complexity of this particular work.
Microtia is simply the congenital absence of a normal ear. The ear can be nearly completely missing or in milder cases, significantly deformed. This condition occurs in both males and females and can affect either or both ears. Both environmental and genetic factors are thought to be involved, but no single cause of the condition has been discovered. Inner ear hearing mechanisms are often intact, resulting in limited hearing with the assistance of a special hearing aid. In addition to the difficulty of diminished hearing, growing up without one or both ears can be quite challenging socially. As we’re all aware, children are curious and often don’t hesitate to point out physical differences of those around them. For the children in Ecuador, the stigma of a missing ear can at most be a harsh social disadvantage and at least an obvious distraction and cause for embarrassment and decreased self-confidence.
Over the years, reconstructive surgeons have slowly developed techniques to construct a framework in the size and shape of an ear by using cartilage from the chest of affected patients. This is no small feat as the external ear is a highly complex and three-dimensional structure that sits in space apart from the blood supply and skin of the head. Attempting to create an ear structure of the correct shape, size, and position of a normal ear is fraught with potential complications including infection, poor blood supply, scar tissue, and a host of other challenges. Further complicating the process is that this surgery requires multiple stages, only one of which can be performed with each trip to Ecuador. This means that the whole process from start to finish can be a several year commitment.
Happily, the past several years have seen huge forward strides in the predictability and quality of our reconstructive efforts. These improvements aren’t attributable to any one factor, but among other things are due to improved surgical techniques resulting in superior results with fewer surgeries, fewer complications, improved documentation with detailed photography and meticulous record keeping, better methods of patient care, and better follow up with our colleagues in Ecuador. Perhaps most importantly, our success has been fueled by thousands of hours of unselfish service donated by administrative staff working behind the scenes to organize this monumental effort, nurses, surgical assistants, volunteers of all ages, friends and colleagues in Ecuador, anesthesiologists, surgeons, and dermatologists.
I am personally grateful to be a part of this effort and for the opportunity of working with dedicated selfless people who continue to make this effort a reality. As we share hugs and smiles with our patients and their families on the final day of our trip each year, I’m very personally aware of the joy and satisfaction that accompany service to another human being, and my desire to continue this work is renewed.
Scott K. Thompson, MD
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