One of a kind service transforms the life of Aghalee man born without an ear

Stephen has Microtia, a condition in which the external ear does not fully develop, and he had no hearing on his left side.

Over the years he learned to adapt, but as he grew older and hairstyles changed, he became increasingly conscious of the difference.

When Stephen’s hearing deteriorated in his right ear, South Eastern Trust Maxillofacial Prosthetist, Brian Bigmore had to think outside the box to redesign Stephen’s prosthetic ear so that it could securely accommodate a hearing aid, allowing Stephen to benefit from a crossover hearing system and hear sound from both sides.

The innovative solution is just one example of the specialist, highly personalised care provided by the South Eastern Trust’s Maxillofacial Prosthetic Service. Stephen initially underwent reconstructive surgery in his teenage years. While the procedure created the general shape of an ear, from skin on his upper left arm, it could not replicate the natural profile and distinctive appearance of his other ear.

Years later, his wife read about advances in prosthetics and Stephen decided to explore what was possible.

A referral from his GP brought him to the Ulster Hospital where he underwent surgery to remove the reconstructed ear and have small implants inserted to which his new prosthetic ear could be attached. The process of creating Stephen’s prosthetic ear involved great attention to detail, including taking a mould from his natural right ear to recreate its shape, matching the colour to his skin and ensuring the prosthetic fitted securely and naturally against his face. “Brian was very good at explaining and showing me what was happening,” Stephen continued. “You could see the new ear basically being formed in terms of a moulding taken from my right ear to give the correct shape.

"Then, of course, there was getting the right colour to match my cheek and existing ear. We both wanted something that looked as natural as possible.

"The third thing was getting the closeness of fit. It is obviously quite intricate to get the new ear fitted securely, but also so there is not a gap between the cheek and the top of your jaw where the new ear would be.

“It takes time and I just want to pay tribute to Brian for his patience and the fact that he spent so much time at it. It was never rushed in any way.”

Years after receiving his first prosthetic ear, Stephen faced another challenge when the hearing in his right ear began to deteriorate. He needed a hearing aid, but a conventional hearing aid could not simply be attached to his existing prosthetic.

Working with the hearing requirements of Stephen in mind, Brian redesigned the prosthetic so it could securely accommodate a hearing aid. The result was a specialist prosthetic ear which allows Stephen to use a crossover hearing system, transmitting sound from his left side to his hearing ear. Brian commented: “It was a unique one for me, but again it is something that patients perhaps have not thought about. “As his hearing started to deteriorate on his right side, he needed a hearing aid for meetings and social occasions because he was not able to hear anybody at all on his left-hand side. That was starting to affect him.

“So, I redesigned his prosthetic literally to accommodate the hearing aid. Now he has two ears. He uses one for everyday use and if he is going to a meeting or feels he needs the hearing aid, he puts on his hearing-aid prosthetic and nobody would ever know any different. “It is just thinking outside the box.”

The impact of the service on Stephen has been profound. He is still getting used to his new hearing aid prosthetic he says having a prosthetic ear in the first place has made a very positive difference to daily living.

Stephen added: “It is amazing. It is never as good as the real thing, but to have something like that and have the service here in the Ulster Hospital is just super. I could not express enough gratitude for it.”

Highlighting the emotional moment when a patient sees their new prosthesis for the first time, Brian said: “There is a range of emotions. It is the very first time a patient receives a prosthetic and it is going to be the first time of many times because it is for life.

"Those first moments, especially showing them the mirror for the first time, are very emotional for everybody in the room.

“They may have been afraid to look in the mirror for months or afraid that when they put their nose, eye or ear on it would not be what they expected.

"To see the expression on their face and even their family members who are going through a serious amount of mental trauma as well, they are all in it together.

“It is really heartening to see them smile for the first time in many months and for them to go out proud, not afraid to walk down the street and not afraid even to walk through a hospital corridor.

“To hold their head up high again, that is a big moment.”

The service has meant much more to Stephen than a prosthetic ear, it has helped him feel much more comfortable with his appearance’

Stephen commented: “We are very fortunate to have the service here. I would just say to anybody who is similar to me, or to people who through injury or cancer may need a prosthetic part of their face or neck, that it is wonderful to have the expertise of the specialist Maxillofacial Prosthetic Service.”