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Patient Safety and Quality Improvement

(333) Newborn Misshapen Ears: Improving Early Identification for Non-surgical Interventions

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • JT

    Jeffrey Teixeira, MD

    Facial Plastic Surgeon
    Walter Reed National Military Medical Center
    Washington, District of Columbia, United States

    • Senior Author(s)

  • JT

    Jeffrey Teixeira, MD

    Facial Plastic Surgeon
    Walter Reed National Military Medical Center
    Washington, District of Columbia, United States

    • Presenting Author(s)

  • ZN

    Zachary Nygren, MD

    Resident
    Madigan Army Medical Center
    Joint Base Lewis-McChord, Washington, United States

    • Co-Author(s)

  • BL

    Brian Liming, MD

    Madigan Army Medical Center, USA

  • Rachel Boone, MD

    Resident Physician
    Madigan Army Medical Center
    Tacome, Washington, United States

Disclosure(s):
Jeffrey Teixeira, MD: No relevant relationships to disclose.
Zachary Nygren, MD: No relevant relationships to disclose.


Introduction: Successful nonsurgical correction of newborn misshapen ears depends on timely referral for early initiation of interventions. Early correction has the potential of cost savings of preventing future otoplasty surgeries and preventing future bullying. The objective of our project was to see if an educational series with pediatrics providers increased early referrals for childhood ear deformities amenable to molding.

Methods: An educational presentation was given to our pediatrics department on misshapen ears that are amendable to non-surgical intervention. Charts were individually reviewed by the primary author for ICD codes in the Q series 17.2-17.9 for newborns within the first months of life referred for ear molding, physical exam findings and whether intervention was completed. Analysis was then carried out looking at referral patterns prior to the educational presentation and afterwards.

Results: Our search yielded a total of 81 encounters over the period of interest. After screening for duplicate patients, a total of 53 patients were identified. 29 patients were seen prior to the intervention. Review demonstrates 6 patients meeting criteria for ear molding over the 17 month period evaluated prior to our intervention. After the lecture 24 patients were identified with referrals for auricular abnormalities. 19 met indications for ear molding over this 9 month period.

Conclusions: Our findings demonstrate a 6-fold increase in referrals from primary care providers for newborn misshapen ears following the in-service lecture when accounting for the periods of time surveyed. Furthermore, of the patients referred, higher number of patients were deemed to be candidates for non-surgical ear molding. This demonstrates that education of primary care providers is a reasonable approach to more quantitatively and qualitatively increase referrals of newborns with misshapen ears that are amenable to intervention. This has the potential to reduce lost economic potential associated with bullying and surgical cost of otoplasty.