Counsel a family on a small, malformed ear and the hearing pathway — OSCE

Communication tasks

Open by acknowledging the parents' worry and confirming what they have noticed, then explain the diagnosis in plain language: the outer part of the ear did not finish forming on the right while the baby was developing, and the ear canal that should carry sound inward is also closed over — together these are called microtia with aural atresia. Reassure them that the inner ear, the part that actually hears, is almost always formed normally in this condition, so the problem is one of conducting sound inward, not of the hearing nerve itself. ^[1]

Address the fear of deafness directly. Because the left ear hears normally, their daughter will develop spoken language on time; she will need audiology to confirm this, and she may find it a little harder to locate sound or to hear in noisy classrooms, but she is not deaf. Explain the newborn hearing screen result as the expected consequence of the closed canal, not as a separate hearing-nerve problem. ^[11]

Outline the pathway honestly. The ear can be rebuilt, and there are options — rebuilding it from her own rib cartilage, or using a synthetic framework — but this is planned for around six to ten years of age, when she is big enough and the other ear is near its adult size, so there is no rush now. For the hearing on the right side, when she is older the team will do a scan that scores the anatomy out of ten; a good score means an operation to open a canal may be possible, and a lower score means a small bone-conduction hearing device is the safer and equally effective choice. All of this is decided with the family over years, not weeks. ^{[8] [3]}