Mom wins a quicker fix for boy’s microtia, a congenital ear deformity
THE PROBLEM for Monique Herrera’s son was not life or death. She saw the need as one of enhancing her son’s ability to learn and grow as a social being, without jeers and taunts. Mavric, her son, needed a new ear. But conventional medicine dictated that he wait until he was about 10.
He was born with what the 6-year-old calls “a little ear,” and doctors call microtia, a congenital ear deformity. But getting to 10 with a deformed ear hardly bigger than a lobe could scar the young boy’s personality, his mother worried.
One early incident confirmed her fears. The family was at a school recital. Mavric, then 1, was toddling around the auditorium when a third-grader pointed at him. “She said, ‘Ewww, gross. Look at that baby,’ ” Herrera says. She wanted to protect her son from nine more years of that.
In Texas now, the family was living in Orange County when Mavric was born. Herrera had never heard of microtia, but what disturbed her was that when she went to a pediatric ear, nose and throat doctor, the technician administering a hearing test had never heard of it either.
“She didn’t know where to tape the testing equipment,” she said. Mavric’s doctors had heard of it, but none had seen it. “You never want your child to be the first case a doctor has ever seen.”
The physicians close to home offered a surgical technique decades old. It involved creating a new ear from material fashioned from the child’s rib. The unacceptable catch for Herrera was that the procedure could be done when the child reached the age of about 10 to allow the ribs to grow and develop enough material to borrow.
“One doctor just told us not to worry, and come back in nine years,” she says. Meanwhile, the boy’s hearing was compromised in the deformed ear, and he’d also have to wait to have ear canal surgery and any chance of improved hearing. Herrera worried that his language development and learning would be slowed.
A second specialist told her to return every six months for checkups, but insisted nothing could be done for a decade.
Years went by, and as Mavric got closer to school age, his mother worried more that crucial years of educational and social development would pass before he could be helped.
Then her brother, who worked for the children’s healthcare advocacy group Children’s Miracle Network in Los Angeles, heard that Dr. John Reinisch, director of craniofacial and pediatric plastic surgery at Cedars-Sinai Medical Center in Los Angeles, had developed a technique for children with microtia. Herrera got on the Internet, read about the technique and made an appointment.
Because of his disability, Mavric’s medical care was covered under California Children’s Services.
“They try to put you in a box, and don’t want you to deviate,” she says. That meant Mavric would have to wait years to have the procedure done the old way. “The other process was 50 years old,” she says. “They’ve been doing it one way forever.”
But with Reinisch’s help, she persisted, showing evidence of the surgeon’s success with the technique since 1991, when he first developed it.
Children’s Services agreed to pay for the surgery, and last year, at age 5, Mavric had the procedure done by Reinisch.
Using a porous polyethylene substance called Medpor, Reinisch creates an ear with the material and covers it with flaps of the child’s own skin. It eliminates the need for the child to grow into an adequate rib size, and it means that children with the deformity don’t have to endure a decade of compromised hearing, or the possibility of 10 years of being ostracized.
“The tissue actually grows into the pores [of the artificial material],” he says.
“I did the first one in 1991. It wasn’t perfect by any means, but even right away seemed to have a better shape to it. We’ve gotten better every year,” Reinisch says. “We probably do 100 or so a year.” That’s more than any surgeon in the country, and he wants to pass the torch before he retires. “I have one [training fellow] who has the patience and delicacy for this procedure. I feel good about that, that there will be someone who can take care of these children.”
Some of the pediatric specialists Herrera had been seeing cautioned her that her son was too young for the long surgical procedure. And during the more than seven-hour surgery, she had her own doubts. When he emerged from the operating suite with bandages, swelling and draining tubes, the doubts mounted. But every day, the healing improves and the ear looks more normal.
Seven months after surgery, he still has scars. The new ear is slightly larger than his normal ear, but he’ll grow into it. Mavric is proud of his new ear. “It’s getting better every day,” he says.
-- Susan Brink
