Medical Services

Bone Anchored Hearing Aid (BAHA)

Children born with middle or outer ear problems, or single sided deafness (SSD), can still benefit from bilateral hearing. Hearing is a vital part of a child’s learning process and it’s of great importance to start the stimulation of speech and linguistic development as early as possible. For mixed, conductve hearing loss or SSD, bone conduction is a natural alternative.

Children’s skulls are thinner and their bone is softer than an adult’s. The FDA has only cleared implant placement in children age 5 and up, who have stronger and thicker skull bones. However, younger children can be fitted with a BAHA sound processor with an external attachment. Until recently, only uncomfortable metal steel spring headbands were available as an option for children to use with the BAHA while awaiting surgery. Now we fit our pediatric patients with the Baha® Softband, a more practical and comfortable solution

Cochlear Implant

Cochlear implants are now approved for children as young as 12 months old. Our caring and compassionate medical team will work with you to ensure the best care for your hearing impaired child. The candidacy criterion for children is as follows:

  • 12 months through 17 years of age
  • Profound, bilateral, sensorineural hearing loss (>90 dBHL)
  • Use of appropriately fitted hearing aids for at least 3-6 months to help the medical team determine whether or not the child has the potential to benefit from conventional amplification technology
  • The minimum duration of hearing aid trial is waved if the etiology of hearing loss or the radiological findings suggest ossification of the cochlea
  • No medical or radiological contraindications
  • Motivation of the child and/or family to improve hearing
  • Appropriate expectations of child, parents, and family
  • Delayed or lack of speech and language development
  • Speech and hearing emphasis in child’s education and therapy environments

Microtia / Atresia

Congenital microtia and congenital aural atresia are conditions resulting from abnormal development of the ear. Microtia refers to abnormal development of the auricle – in classic (Grade III) microtia, there is a skin tag remnant present instead of the auricle. Aural atresia refers to abnormal development of the ear canal and results in a complete conductive hearing loss. Microtia and atresia are commonly seen together. The vast majority of cases are unilateral with bilateral microtia representing a small minority of cases.

Reconstruction for microtia / atresia is typically undertaken starting at the age of six when the child is of school age. The reconstruction for microtia is typically accomplished in stages:

  • Stage 1: Rib graft harvest and contouring of the new auricle based on a template from the normal ear (or representative ear in cases of bilateral microtia) – the cartilage framework for the new ear is buried in a pocket created under the skin
  • Stage 2: Lobule transfer – creation of the ear lobe
  • Stage 3: Creation of the post- auricular sulcus – the ear is lifted from the side of the head and a skin graft is used to line the posterior surface of the new auricle. Atresia reconstruction (creation of a new ear canal and restoration of hearing) can be done at this stage as well if the child is a candidate for atresia reconstruction.
  • Stage 4: Creation of the tragus / deepening of the conchal bowl

Recurrent Otitis Media (Ear Infection)

Otitis media is the most common diagnosis of patients who make office visits to physicians in the United States. Recurrent otitis media is most prevalent in young children as a result of poor Eustachian tube function. Risk factors for recurrent otitis media include:

  • First episode of otitis media in the first 6 months of life
  • Anatomic defects such as cleft palate or congenital immunodeficiency syndromes
  • Upper respiratory tract allergy
  • Smoke exposure in the household
  • Attendance at a day-care facility

For children with recurrent otitis media (usually more than 4 episodes within 6 months or failure of medical therapy), surgical intervention is considered. Ventilation tubes are placed in an outpatient setting in a 10 minute procedure. The chief benefits of intervention in a child with recurrent otitis media are improved hearing and a reduction in the number of subsequent episodes of otitis media.

Otitis media is the most common diagnosis of patients who make office visits to physicians in the United States. Recurrent otitis media is most prevalent in young children as a result of poor Eustachian tube function. Risk factors for recurrent otitis media include:

  • First episode of otitis media in the first 6 months of life
  • Anatomic defects such as cleft palate or congenital immunodeficiency syndromes
  • Upper respiratory tract allergy
  • Smoke exposure in the household
  • Attendance at a day-care facility

For children with recurrent otitis media (usually more than 4 episodes within 6 months or failure of medical therapy), surgical intervention is considered. Ventilation tubes are placed in an outpatient setting in a 10 minute procedure. The chief benefits of intervention in a child with recurrent otitis media are improved hearing and a reduction in the number of subsequent episodes of otitis media.

How Can I Tell IF My Child Has Otitis Media?

Otitis media is often difficult to detect because most children affected by this disorder do not yet have sufficient speech and language skills to tell someone what is bothering them. Common signs to look for are:

  • Unusual irritability
  • Difficulty sleeping
  • Tugging or pulling at one or both ears
  • Fever
  • Fluid draining from the ear
  • Loss of balance
  • Unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive

Effects of Otitis Media:

Otitis media not only causes severe pain but may result in serious complications if it is not treated. An untreated infection can travel from the middle ear to the nearby parts of the head, including the brain. Although the hearing loss caused by otitis media is usually temporary, untreated otitis media may lead to permanent hearing impairment. Persistent fluid in the middle ear and chronic otitis media can reduce a child’s hearing at a time that is critical for speech and language development. Children who have early hearing impairment from frequent ear infections are likely to have speech and language disabilities.