Utilization of Diagnostic Testing for Renal Anomalies and Congenital Heart Disease in Patients with Microtia

• Published in: Otolaryngology-head and neck surgery 2020-04, Vol.162 (4), p.554-558
• Main Authors: Ramprasad, Vaibhav H., Shaffer, Amber D., Jabbour, Noel
• Format: Article
• Language: English
• Subjects: cardiac defect; congenital heart disease; congenital renal anomaly; microtia; renal anomalies; renal ultrasound
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599820901351

Objective Congenital ear anomalies are associated with congenital cardiac and renal defects. Renal ultrasounds, electrocardiogram, and echocardiogram can be utilized for diagnosis of these concurrent defects. No standard of care exists for the workup of patients with microtia. The goals of this study were to describe the utilization of diagnostic testing for cardiac and renal anomalies and to identify their prevalence in patients with microtia. Study Design Case series with chart review. Setting Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center. Subjects and Methods This study is an Institutional Review Board–approved retrospective review of consecutive patients born between 2002 and 2016 who were diagnosed with microtia and seen in the otolaryngology clinic at a tertiary care children’s hospital. Demographics, sidedness and grade of microtia, comorbid diagnoses, and details of renal and cardiovascular evaluations were recorded. Factors associated with retroperitoneal ultrasound and cardiac testing were assessed with logistic regression. Results Microtia was present in 102 patients, and 98 patients were included as they received follow-up. Microtia was associated with craniofacial syndrome in 34.7% of patients. Renal ultrasound was performed in 64.3% of patients, and 12.9% of patients with ultrasounds had renal aplasia. Cardiac workup (electrocardiogram or echocardiogram) was completed in 60.2% of patients, and of this subset, 54.2% had a congenital heart defect. Conclusion Diagnostic testing revealed renal anomalies and cardiac defects in patients with isolated microtia at a higher rate than in the general population. This suggests the need for further evaluation of the role of routine screening in patients with microtia.