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Microtia: A Data Linkage Study of Epidemiology and Implications for Service Delivery
Frontiers in Pediatrics, Volume: 9
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Copyright © 2021 Jovic, Gibson, Griffiths, Dobbs, Akbari, Wilson-Jones, Costello, Evans, Cooper, Key, Lyons and Whitaker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)Download (929.71KB)
Introduction: Previous studies of microtia epidemiology globally have demonstrated significant geographical and ethnic variation, cited broadly as affecting 3–5 in 10,000 live births. The aim of this study was to determine the incidence of microtia in a largely homogeneous ethnic population in the U...
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Introduction: Previous studies of microtia epidemiology globally have demonstrated significant geographical and ethnic variation, cited broadly as affecting 3–5 in 10,000 live births. The aim of this study was to determine the incidence of microtia in a largely homogeneous ethnic population in the United Kingdom (Wales) and to identify factors, such as distance and socioeconomic status, which may influence the access to surgical intervention.Materials and Methods: A retrospective cohort study was conducted using data linkage to identify patients born between 2000 and 2018 with a diagnosis of microtia. Microtia incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Sociodemographic attributes were compared using descriptive statistics to determine differences in access to each type of surgical intervention.Results: A total of 101 patients were identified, 64.4% were male and the median age was 12 (8–16). The mean annual incidence was 2.13 microtia cases per 10,000 births over the 19-year study period. Both temporal and geographic variation was noted. The majority of patients undergoing surgery opted for autologous reconstruction (72.9%) at a median age of 9 (7–10) compared to 7 (5–8) for prosthetic reconstruction. Autologous reconstruction had a higher median number of surgeries (2, 1–3) than prosthetic (1.5, 1–2) and a higher median socioeconomic status of 3 (2–4) compared to 2 (1–4) for the prosthetic cohort. There were no statistically significant differences in the distance traveled for surgery.Discussion: This study highlights a role for data linkage in epidemiological analyses and provides a revised incidence of microtia in Wales. Although the majority of patients opted for autologous reconstruction, demographic disparities in socioeconomic status warrant further investigation, emphasizing the importance of striving for equity in accessibility to surgical intervention.
microtia, epidemiology, reconstructive surgery, congenital, otology
Faculty of Medicine, Health and Life Sciences
This work was supported by Health Data Research UK [NIWA1] which receives its funding from HDR UK Ltd., funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England),
Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF), and the Wellcome Trust. This work has also been supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All.
ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyze anonymized data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). TJ is supported by the Action Medical Research/VTCT Foundation Research Training Fellowship, Microtia UK, and the BAPRAS Paton Masser Memorial Award. IW would like to acknowledge funding from EURAPS/AAPS Academic Scholarship and the Royal College of Surgeons England Cutlers’ Surgical Fellowship in Ear Reconstruction. This work is part of the AFFECT & 3D BIOFACE projects, supported by the
Scar Free Foundation Programme of Regenerative Research at the Reconstructive Surgery & Regenerative Medicine Research Centre (ReconRegen) in partnership with Health & Care Research Wales.