The Great Debate

There are three ways to address microtia, which is the wacky little ear that Charlie has. Option A is to have a doctor make a new ear out of rib cartilage--or some other kind of cartilage, but rib is really the established method. Option B is to implant a plastic ear and cover it with skin. This is called Medpor. Option C is to do nothing and enjoy life with a wacky little ear.

On my Yahoo! discussion group, little conflagrations erupt over which is the way to go. The rib graft people say the durability of Medpor is unproven. The Medpor people say the rib graft ears are ugly and you have to wait too long. The Medpor docs are doing it on kids as young as three; rib graft patients are at least six years old so their chests are big enough to spare the cartilage. The Medpor ears look more perfect, but the rib graft ears feel more natural and actually grow a little along with the patient. 

There's a woman named Julie who recently opted for Medpor on her three-year-old son. She blogged it, and I am grateful--she has deterred me from doing Medpor on a three-year-old Charlie. When your baby is born with a "facial difference," your first instinct is to want to fix it right away. But babies and small children don't know and don't care that they look different. A three-year-old is just too little to understand why the nice doctor wants to slice open his scalp. (There is an exception here, which is that if the child needs surgery to hear, you're going to want Medpor. With rib graft, you have to do the rib graft first and then the hearing repair, which means your child can't hear until he's at least six. With Medpor you do the outside first, and then you can get surgery for hearing when it heals, so your child can be hearing at age three instead. Charlie doesn't really need to worry about that--though I will be posting soon on the whole unilateral hearing loss controversy, so stay tuned, I'm sure you're so excited.)

It turns out that Julie has another blog, one that she did not share with our Yahoo! group. She vented her views on the rib-graft-vs.-Medpor debate here. She doesn't know I found her--unless Langer Loksh readers click through to her post and she checks her stats and sees where the clicks are coming from, and she looks up Langer Loksh and--hi Julie!

I haven't decided anything yet about Charlie's ear, though our doctors are pushing rib graft with Dr. Brent. I am glad I got to see Julie's real feelings about rib graft because people in our Yahoo! group don't want to hurt each other's feelings or judge each other's decisions for our families, so we don't always let it all hang out. I certainly don't doubt that Medpor was right for Julie's family, and I'm so happy they are happy.

And you never know who's reading. I had one woman send me an email privately after I mentioned a certain doctor's name in the discussion group. She told me she has a neighbor with microtia who got a rib graft ear from this doctor, and now he says he would rather cut off his ear than live with what this doctor did to him. But this doctor is apparently part of our Yahoo! group, so she felt she couldn't post her message to the board.

I'm sharing all of this just to let people in on an interesting debate that none of you with two plain ears know anything about.

Comments

[Julie]

LOL, I did find your blog via my blogstats and am honored that you mentioned me and my blogs.

I thought long and hard about making the post about my true thoughts on medpor and ribgraft, and did realize that some would "stumble" across it, but felt a huge urge at the time to vent online.

So what do you think? Do you think the post is too hurtful? Should I delete it? Honest feedback is greatly appreciated.

I love your blog.

Julie

[Kim]

Hey,
Like your blog, now tell me, who is the dr. that worked on the neighbor who is less than happy with his ear? I like to hear all positive as well as negative things before I even begin to think about outer ear reconstruction. Love the blog,
Kim

[Melissa]

Hi,

Wow this blog is exactly what I need. I have had rib graft reconstruction twice! And what I have as a result is from 10 surgeries and 2 plastic surgeons is something that I will never publicly show. I am now 23 and want an ear, I would love any and all info regarding the medpor framework. Please please respond to me with info. mlmixon@umail.ucsb.edu