Abstract
Advances in anesthesia care make microtia surgery medically and economically feasible in an ambulatory setting. The planned surgical procedure may be an external ear reconstruction, an otologic external auditory canal plus middle ear reconstruction, or a combination of both. Anesthesia care can be safely carried out in a freestanding surgery center or office-based operating room, avoiding the increased costs of hospital operating rooms or an overnight stay. Combined atresia and microtia (CAM) procedures of 8–9 hours of anesthesia duration can be safely done in an ambulatory setting, followed by discharge to home or a hotel setting. Anesthetic challenges for pediatric patients include (1) preoperative evaluation and medical clearance of the patient, many of whom are traveling from remote geographic locations, (2) anesthetic induction at a freestanding outpatient facility, (3) intraoperative care designed for safety and quick recovery, and (4) postoperative management of an ambulatory pediatric patient following an anesthetic of up to 9 hours in duration. Anesthesia care for adult ear reconstruction is discussed as well.
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