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Challenges in International Volunteer Microtia Surgery among Palestinians
Tazheh A. Kavoosi, Steven M. Monahan, Rami A. Abu Khalil, Meredith G. Moore, Omar B. Saeed, John A. van Aalst
University of Cincinnati College of Medicine
2019-02-15
Presenter: Tazheh A. Kavoosi
Affidavit:
This work has been discussed with me. It has not been presented before, and the author submitting the abstract, Tazheh A. Kavoosi, has worked significantly in putting this together.
Director Name: John A. van Aalst
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Patients with microtia (1/6500 live births) have difficultly accessing surgery by international volunteer teams due to the requirement of complex, staged reconstruction. This abstract delineates the demographics of Palestinians with microtia evaluated at 6-month intervals during volunteer surgical trips.
Methods: Patient demographics are derived from the Palestinian Congenital Anomalies Database, a secure web-based application created in 2011. Mothers of children with microtia responded to a 700-question survey in colloquial Arabic. Of 128 patients encountered with microtia, 57 families completed surveys; 26 patients underwent surgery performed with Palestinian surgeons utilizing the Brent 4-stage technique: costal cartilage harvest, lobule transfer, skin grafting, and conchal reconstruction.
Results: Among patients with completed surveys (n=57), 51% were male with a mean age of 11.6 years. Half of parents were consanguineous. Fewer than half (46%) of these patients underwent surgery: 17 patients underwent 1st stage reconstruction (mean age 9.4 years), 3 underwent 2nd stage surgery; 7 completed the 3rd stage, and 12 completed all stages (mean age 12.9 years). Completion time was 2.3 years. Average time between surgeries was 12.5 months.
Conclusions: Parents of children with microtia have high consanguinity rates, though no previous link between consanguinity and microtia has been established. Most patients never underwent surgery. Those who initiated Stage I were unlikely to finish further stages; for those who completed reconstruction, time to completion was over two years, and finalized when patients were teenagers. Understanding this data may expose barriers to care and improve surgical care for Palestinians with microtia.
