Background: The initial step in setting up standardized microtia-
atresia service is investigating the current status of the service and
comparing this to internationally recognized guidelines or care
standards. Inmany countries, documented information aboutmicro-
tia care is lacking. This study is an initiative to guide reform efforts
of national microtia service in any country. The UK care standards
for microtia-atresia can be a useful model to help set up a compre-
hensive microtia-atresia service.
Methods: The authors conducted a survey to investigate different
aspects ofmicrotia service inEgypt.Themajor plastic surgery centers
(n¼22) were surveyed by a structured questionnaire. The results
were compared with the UK care standards for microtia-atresia to
identify the aspects that need improvement. Thorough analysis of the
main problems in microtia-atresia service is presented.
Results: The authors found that microtia service is fragmented
between the surveyed centers with 65% of the centers treating less
than 10 microtia cases annually. Multiple surgeons are responsible
for ear reconstruction in 90% of centers and only 25% of them
practise a multidisciplinary team approach. None of the centers uses
validated tools of aesthetic or psychological patient-reported
Recommendations: These 5 recommendations are the keys to
reforming microtia service in any country:
(1) Establishing nationally designated centers to concentrate the
(2) Assigning fewer high-volume surgeons to optimize the
(3) Providing treatment by experienced multidisciplinary teams.
(4) Using validated tools of patient-reported outcome measures.
(5) Collecting and keeping standardized records for regular audit
and intercenter studies.