‘I want to thank everybody for helping Elijah to live a normal life’

In mid-June, Dr Van Niekerk performed the procedure at the Medicross Kalahari Cataract, Eye and Day Hospital. Elijah’s malformed external ears were surgically removed and the implants were carefully positioned using the patient-specific surgical stent.

“After the initial surgery, we must wait three to four months for the bone to grow around and attach to the titanium implants. Once we are satisfied that the implants are securely integrated with the bone, we will undertake the second phase of the surgery, where we will place small metal structures that will form the pillars to which the prosthetic ears will attach with magnets,” Dr Van Niekerk stated.

The CRPM CUT team will then use 3D printing to create the moulds that Professor Van den Heever and a Master’s engineering student will use to make the medical grade silicone prosthetic ears for Elijah as part of the Changing Faces, Changing Lives programme sponsored by the Carl & Emily Fuchs Foundation, which aims to enhance quality of life and reaffirm the sense of dignity of those with facial disfigurement.

“Ears are fairly noticeable structures, and even though Elijah’s braids have helped to disguise the malformation of his external ears, the prosthetic ears will assist to enhance the aesthetics of his face,” Professor Van den Heever noted.

“The presence of ‘normal’-looking’ prosthetic ears is more than merely aesthetic, however, as it positively contributes to social aspects of a child’s development. We are able to match the skin tone and texture almost exactly, and do everything possible to make the prosthetic ears look as realistic as possible.

“As Elijah is only six years old, his features are still growing and in the future we will need to replace the prostheses to remain in proportion with the rest of his face,” Professor Van Den Heever added.

While the surgeries and prosthetic ears will ad- dress the cosmetic aspects of Elijah’s microtia and aid in some developmental aspects, he also required assistance for his impaired sense of hearing.

The head of the speech therapy and audiology department at Pelonomi Hospital, Julia Jensen, came to learn of Elijah’s situation through the CUT team and arranged for him to have a hearing test with private audiologist, Andra Bester who practices in Upington, which is nearer to the Cloete family’s home.

“The hearing tests indicated that Elijah had partial hearing in one ear. Due to his condition, his ear canals are sealed and we believe that this contributes significantly to his hearing impairment. We performed a bone conduction hearing test and found that Elijah’s cochleas, the part of the inner ear integral to hearing, are functional on both sides,” Bester said.

Elijah was fitted with a special hearing aid. “The bone-anchored hearing aid converts sound into vibrations through the skull and temporal bone, which stimulates the hair cells in the cochlea. Sound is then transferred normally through the acoustic nerve to the brain,” Jensen explained.

Bester added that Elijah would need to have a follow-up consultation with her in a few months, after he has had time to get used to the hearing aid and has learned how to process the new stimuli. She will then be able to determine the extent to which his hearing has been improved.

Dr Billy van der Merwe, managing director of Netcare’s Primary Care Division, says he was most pleased that the Medicross Kalahari Cataract, Eye and Day Hospital and its staff were able to play a role in the interventions to assist Elijah.

“This young boy has shown great courage at such a tender age, and we are pleased and privileged to be doing our part in improving his quality of life. In the coming months we look forward to the successful culmination of the efforts of all the expert health care professionals involved and seeing the meaningful difference these interventions make for Elijah,” he concluded.