Friday, February 11, 2011

ENT visit and next steps

Our visit to the ENT wasn’t a total disaster. Ava was pleasant to everyone as long as they weren’t sticking anything into her ears. She said, “hi”, and “bye” appropriately and adorably to everyone who went by. She also picked the ENT’s office as the time to learn the difference between calling every man “dada” and every woman “mama” and starting to call the men “man” and the women “lady.” Neither of those words is pronounced correctly, but it was still adorable to have her say “ma” (man) or “yea, yea” (lady) to categorize every person who went by.

When the doctor wanted to look in her ears she pulled a complete Dr. Jekyll / Mr. Hyde and screamed the whole time. I had to hold her head to my chest as she wailed and her whole head turned bright red. Seriously. I do not exaggerate. The child’s face looks like a cherry when she’s pitching a fit. Complete with alligator tears.

He said that her eardrums were retracted (indicating that there was probably fluid in the middle ear space) and that he’d send her down the hall to their pediatric audiologist to see what they could find out. They did tympanograms again which were still flat two weeks after the first time. (Because this involved more things entering the ear we had a repeat of the cherry head/alligator tears/restraint episode.) Then they tried to assess her hearing and even though she was fairly cooperative they weren’t able to get any more information than the last time. I really think she can’t hear the quieter noises and that’s why she won’t reliably respond to them. It’s likely that the fluid in her ears is impacting her hearing. Given that she still has fluid in her ears two weeks after the first time and that she no longer has a cold it is likely that she often has fluid in her middle ear space impacting her hearing.

So, the recommendation is to put in PE tubes. While they have her under sedation they’re going to do an ABR to assess her hearing. That way, in one day we’ll be able to fix the middle ear fluid problem and find out for sure if she can hear or not. PE (pressure equalization) tubes are tiny tubes placed in the eardrum. They allow any fluid in the middle ear space to drain out into the ear canal. They are often put in ears of children who have chronic ear infections. In our case, we’ve got a child with a documented language delay that has fluid in her middle ear space in the absence of an infection so the ENT feels PE tubes would be prudent. An ABR (automatic brainstem response) test is a hearing test that can be done while a child is asleep. It measures the brain’s responses to sound stimuli and can tell you if a child has a hearing loss when you can’t find out with a traditional hearing evaluation. So, all in one day we can address the middle ear related hearing loss and find out if she has any other hearing loss at the same time.

I hate the idea of having to put my baby under a general anesthetic. It will scare me even more as the day draws closer. But I don’t really feel like I have a choice. We need to clear up the middle ear fluid and we need to know if there’s any other hearing loss. She won’t fully benefit from her therapy until she can hear well.


  1. Our son has ear tubes. He was born with a cleft so he had lots of ear infections. It took 10 min for the procedure but we had it done while under for cleft repair. He has not had an ear infection since, and not fluid. I agree putting your child under is really difficult. My husband was allowed to go in the room when they put him under to comfort him and he said it was painless. Hang in there. Getting the fluid out will be helpful for her.

  2. Did they have to put in an IV? Well, silly question I suppose. I would assume he had an IV with the cleft repair. Was the cleft repair successful? Will he need any follow up surgery? It's great that the tubes completely cleared up his ear infections.

  3. Our ENT also suggested tubes (fluid in one ear), but I was extremely hesitant to go forward with that. We tested a month later - still fluid and then a month after that - no fluid. Our pediatrician currently does not recommend going forth with the surgery.

  4. I'm nervous that we're being too aggressive about the tubes too. And we only know that she had fluid in both ears three weeks apart. If it were just the tubes/fluid I would probably wait another month and check again. But we've also had two unsuccessful attempts to get a hearing evaluation and we can do an ABR while she's out. So, with one sedation we can put in tubes and be absolutely positive that any future colds won't result in fluid related hearing loss for weeks at a time. And we can also check for any other hearing loss. So I think I'm going to stick with the plan. Doesn't mean I'm not second guessing myself though. Thanks for the comment. I should call our pediatrician and get her opinion.

  5. Our son had an IV and was in the hospital for a few days after the cleft repair. It was successful, he is an amazing little fellow His surgeon was super anal and I loved that about him. Follow up surgery when he is 5. I think the tubes were the right choice for him and I am a no medicine kind of gal so surgery has to be really necessary for me to go for it.


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