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Thursday, April 3, 2014

Microtia Rib Cartliage Ear Surgery done in only ONE surgery!

This blog is to inform other mothers of my son's experience with surgery and what they might expect when they go through the process. Every case is different but this gives you a general idea. Dr. Russell Griffiths can do the same surgery (that takes most surgeons several surgeries) in just ONE surgery.


                                             BEFORE                                              AFTER

                                              BEFORE                                         AFTER


                                              BEFORE                                         AFTER

 

                                                    HOW WE GOT THERE!

We started this process 3 weeks ago in Boise, Idaho with Dr. Russell Griffiths. (we did see Dr. Griffiths when my son was very young but he said come back when he is 5 or 6)
Last year we had a rib ultrasound and his rib was not big enough.

Step 1: Made an appointment with his office 208-433-1736 (I had a referral from my sons Dr.)

Step 2: Got a CT scan of his head to see if he had the inner workings of the ear. He did so we went to see Dr. Van De Graaff also in Boise. If your child had the inner ear Dr. Van De Graaff can create a canal and ear drum during the same surgery as Dr. Griffiths. If your child does not Dr. Griffiths can just create the outer ear.


Step 3: Had a rib ultrasound in the St. Luke's Children Hospital. This is done to insure your child's rib is large enough to make an ear graft.

Step 4: Made an appointment for surgery for May 22, 2014 (told them I would take any cancellations that were earlier.)

Step 5: Made an appointment with Dr. Van De Graaff as soon as possible so that if someone canceled there surgery I could take the earlier date. My appointment was April 1, 2014.  I got a call from Star at Griffiths office and she said there was a cancellation on April 3rd did we want it. So I saw Dr. Van De Graaff for the first time and had a pre op all in the same appt. No ibuprofen for at least 10 days before surgery.

Step 6: Starr, at Dr. Griffiths office called the Ronald McDonald house to put us on the waiting list so that we didn't have to pay for 10 days of hotel room!

Step 7: Had a Pre-op appointment on April 2nd with Dr. Griffiths. It took 2 hours they made a ear mold of the good ear and mapped the veins and arteries on his head. They also went over what to expect. He told us to go get a #3 hair cut no shorter no longer.


Step 8: Checked into Ronald McDonald house for $10 a night!



Step 9: Surgery Day! nothing to eat or drink after midnight we came at 5:30 am for the 12 hour surgery. 


Surgery!



This is a picture of the rib that has been carved into the frame work of the ear. He took several smaller cartilage pieces and sewed them together then carved this out.


He left a little bit of extra skin on the top so that is has enough to curl under the top ledge of the ear.


The new ear is put on with some skin grafts taken from the back of his good ear and the back of the head. There is an ear canal in this picture but you can't see if from this angle.


You can tell in this picture that when the swelling goes down that the ear is almost an exact replica of the other side. WOW!

Post Surgery

He was in recovery for a couple of hours.  He had a little nausea but did pretty good. He whimpered some but was feeling a lot better after some medicine.




After medication he perked up a bit.  He sleeps 3/4 of the time now which is nice.  Most of the pain he has is from the rib area.  Dr. Griffiths made that as little as possible by pulling the muscles to the side and cutting a minimal amount of muscle by the rib to help recovery go faster. 

Day After Surgery

Today was a little rough but we kinda anticipated that.  He doesn't complain about his head much only his side, which I'm sure it will get a little better every day.




2 Days After Surgery

The day started out with mostly tears but got better towards the end.  He got to see a service dog and go for a little wagon ride around the hall.



This evening he relaxed quite a bit and was enjoying a movie with his pretend Dr. Sullie that the staff from St. Lukes made. 


3 Days Post Surgery

What a difference 24 hours makes.  He has been discharged to the Ronald McDonald House across the street from the Hospital and we are starting to see the blessing of Dr. Griffith only cutting a few muscles by the ribs and pulling the others to the side. He is walking and ate part of an egg today.

  

He has had a lot of nausea, but that is probably caused from the pain medication.  Most of his discomfort comes from a skin graft on the back of his head. It has become very itchy.  I was so interested to learn that the skin graft is taken off the very top layer and therefore doesn't disturb the hair follicles since they are much deeper down then the top layer.  That is why they can use skin from a place on the body that has hair.  The new skin graft doesn't have the follicles and there for doesn't grow hair back. 



He has an ear mold that looks like half of a rubber ball to keep the shape of the ear while the swelling goes down.  The pictures from surgery are a mere glimpse of what his ear will look like after a lot of swelling, bruising, and healing. It will take several months to heal completely.   

4 Day Post Surgery  


I switched to a different pain killer and took him off of the pain killer that was making him so sick.  It made a huge difference.  He has wanted to play and eat today.  We had an appt. today and they put a small hole in the rubber mold to let it breathe a little bit.  

9 Days Post Surgery



We had a little bit of green drainage and a slight odor, so Dr. Griffiths told us to come up and take the bandage off one day early. This picture was taken right after the bandages were taken off.  The Dr. told us to expect that is could swell more maybe even double in size by tomorrow.  Now we just wait for the swelling to go down.  

10 Days Post Surgery

Well it quite swollen today but looks good.  You can tell it is the right size and shape.




2 Weeks Post Surgery

The swelling has gone down a little.  I am still not supposed to get his hair wet at all.  We put a plug in his ear to keep the hole open.  There is a 30% chance the hole will close and have to be redone, but the plug is to hopefully prevent that. 



A lot of the red has gone away.  If you look at the photo from 4 days ago it has gone down quite a bit.




The hair is starting to grow through the bandage.  The bandage is supposed to come off with the scab.  You wont be able to tell at all there was a skin graft!  

2 weeks 1 day Post Surgery

These pictures were taken 1 hour apart.  I took the dead skin off like the Dr. showed me and it made a huge difference.



You can see that a small piece of skin graft just above the lobe didn't quite take. Dr. Griffiths said it would probably by fine with some Telfa pad and ointment.

2 weeks 4 days


The Telfa pad and ointment made a big different in 3 days. He is getting tired of not being able to comb his hair. 

The skin graft patch has come all the way off now, and the hair is growing in well. The swelling and color look good.

2 and 1/2 week Post Operation


Dr. Griffths let him help in the patient room. We were cleared to take his first shower since the operation at this appt. 



Only small sore left by the top of the ear lobe.


3 and 1/2 weeks Post Surgery



Although it is hard to tell in the pictures you can see a little more definition in ear.  He still wears the protective cup around his ear all the time (just to be careful). 



We had a check up with both Dr. Van De Graaff and Dr. Griffiths.  He had his ear vacuumed out because it was full of sluffed skin and making it hard to hear out of his new ear. 

May 1st photo (1 month Post Surgery)


The extra skin bubble at the top is expected to be there another month or so. It is put there on purpose to ensure there is enough skin when it starts to go into all the crevices.  The swelling keeps coming down slowly but surely.
May 7th photo (5 weeks post surgery)


There are slight differences between the last week. You can see the middle ridge is more defined.  

 May 15th (six weeks Post surgery)


We had a checkup a few days ago and he told us we had to keep the plug in the ear for 6 months to help keep the hole created open.


You can tell the ear is swollen from the pictures taken from the back more then the ones taken from the front.


Some days the ear appears more red then others. I took all the dead skin off a couple of days ago.  You can also see the fine hair of the ear which makes it look so natural.

May 29th photos (8 weeks post op)







The ear looks better and better every day.  The coloring changes a little.  We always have a little adhesive on the neck left from the tape holding the ear guard on at night. Goo Gone works wonderfully. Dr. Griffiths uses it and we love it, I just need to go buy some.

June 28th (12 week update)

These next two pictures were taken just a day apart.  Just to show you lighting in the room with pictures can make a big difference.


If you look closely you can tell the ridge on the outer part of the ear is much more defined then last months picture. also the little bubble of extra skin at the top of the ear just below the ridge is also gone.





4 months 1 week (August 12th)




October 1 (SIX MONTHS POST OP)





Today was his first day without a ear plug to keep the hole open.  He has worn that since surgery 24 hours a day.  Most people just think its looks like a hearing aid. We will just wear it at night now.





Dr. Griffiths sent us a new cover for his ear.  His other cover has been worn out.  He only wears his cover to bed, but needs to wear it for a year after surgery. 

December 7th  (8 MONTH POST OP)





His ear looks so natural to me now.  I forget from time to time about it.  He no longer wears a cover to bed.  I do leave the plug in during night but probably don't need to.  Very happy with the results so far. Over the last few months he has hit and bruised it a few times and it always heals just fine!   

        1 YEAR POST OPP. (WE MADE IT)