Ground-breaking replacement operation at the Royal Free Hospital has Ethan Bowman, 9, all ears!

Published: 10 March, 2011
by TOM FOOT

HE was born with an ear missing and suffered a childhood of psychological torment.

Ethan Giles Bowman’s deformity left him too embarrassed to go swimming or cut his hair how he wanted and he struggled to make friends.

But now the nine-year-old has been given a new lease of life following a ground-breaking replacement operation at the Royal Free hospital in Hampstead – using the same surgical procedures given to victims of pub assaults. Ethan went through a six-hour operation during which cartilage from his ribs was used to form the new ear.

And surgeon Greg O’Toole told the New Journal he believes that most cosmetic operations, including those for “fight bites”, when parts of ears and noses are bitten off in drunken attacks, should be funded by the taxpayer if the injury has also caused  psychological wounds.

Mr O’Toole, 41, who lives in Hampstead Village, said: “You wouldn’t believe how many fight bites we get in here. 

“People bite each ­other’s ears off during fights after the pub, or someone’s ear is ripped off in a road accident. 

“The truth is that there is a difference between a facelift and ear reconstruction. Most people would agree that this little boy was introverted and socially disabled. He grew his hair long, he wasn’t going swimming. He couldn’t wear glasses. You do the operation time after time and there are lives that are no longer permanently blighted. He is happy now. His hair is cut short. He is completely different.

“If you are attacked and you had your nose or lip bitten off, that’s going to cause you trauma. It should be covered by the NHS. What we find is that there is a bit of a postcode lottery, al­though the majority are funded around here by the primary care trusts. My personal view is they should be, but we shouldn’t be doing facelifts.”

Ethan’s family, who are from Sheffield, made the 250-mile journey to the Royal Free because it is the country’s leading centre for ear reconstruction. 

Ethan’s mother Kath­ryn said: “He has had his hair cut shorter, whereas before he was hiding it away underneath it, and although it’s not the right weather for it, I’m sure he will be wearing a pair of sunglasses. It’s great for me and his dad to look at him and see him so happy and feeling so confident.”

Ethan is one of 100 children born each year with microtia. The congenital deformity occurs when the pinna (outer ear) is very small and underdeveloped at birth. 

Mr O’Toole, said: “When children reach the age of eight, we are able to do the reconstruction. We make a small cut on the lower part of the rib-cage, remove the cartilage and sculpt pieces to a framework in the shape of an ear. We hold it together with a steel wire and make a pocket in the skin. It sits there until it becomes incorporated and then we release it from the ear. That is the process simplified, it is highly complex surgery.”

An NHS spokesman said: “To qualify for surgery on the NHS you must meet specific cri­teria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone. Reconstructive and cosmetic surgery to correct, or improve, congenital abnormalities and injuries will usually be carried out free of charge.”

In 2005, the New Journal reported on how Sasha Watson, 40, from Burton Street in Bloomsbury, was refused a “tummy tuck” operation at the Royal Free. She argued excess skin left on her stomach following her caesarian section birth should be removed, but her case was turned down. Similar cases around the country often reach the High Court.