University of Virginia Health System

U.VA. SURGEON GIVES CHILDREN THE GIFT OF HEARING

In children with this condition, the outer ear is small and underdeveloped; however, the inner ear, deep within the skull, is usually normal. So while the child's ears don't look like regular ears, with surgery, we can often help them hear, said Dr. Robert A. Jahrsdoerfer, professor of otolaryngology-head and neck surgery at the University of Virginia Health System.

Where Kenny's left ear should be, he has only a small flap of skin. On the other side of his head, he has a place for an ear but no opening to the eardrum. He wears a headband-like device that vibrates his skull, producing a distant, echoing sound similar to what the average person hears underwater.

There are currently only a few surgeons in the world with significant experience performing surgery to correct congenital ear atresia. On May 3, Kenny and his mother will travel to Charlottesville, so Jahrsdoerfer can try to restore Kenny's hearing.

Jahrsdoerfer has operated on more than 1,200 patients with congenital ear atresia, making him unique in his specialty. Because of this experience, patients come to him from all over the world. Jahrsdoerfer, a former chairman of the Department of Otolaryngology at the University of Texas Houston Health Science Center, also sees patients a few days a month at the Texas Ear Institute in Houston.

We were lucky because we knew about Dr. J. from the time Kenny was born. We waited until he was old enough and then took Kenny to a support group meeting in New York where he was examining kids. Then we learned that Kenny was a candidate for the surgery, explained Kenny's mother, Lori Barringer.

Before patients are accepted for surgery, there is an extensive screening process. Jahrsdoerfer sees hundreds of X-rays each year, but the surgery is not right for everyone. Children must be at least five years old and have, in Jahrsdoerfer's opinion, a strong potential for successful surgery. This is based on a consultation with Jahrsdoerfer and a plastic surgeon, in addition to a CT scan and a battery of audiologic tests.

Surgery to correct congenital ear atresia is very complex, Jahrsdoerfer explained. He makes a new ear canal by drilling though the bone, down to the middle ear. Once the middle ear is reached, he can assess what needs to be reconstructed. Jahrsdoerfer reconstructs a new eardrum as well as any small bone structures as needed. He then uses a skin graft from the patient's arm to line the bare bone in the ear canal. Next, he aligns the external ear with the new opening he has made. This may mean moving the external ear as much as an inch. Finally, he makes a new opening in the external ear.

Jahrsdoerfer sees patients again one month after surgery. At that visit, part of the skin graft is removed and a complete hearing test is administered.

It can be very emotional in the examining room, said Jahrsdoerfer. For the first time, the child can hear things that other children normally hear: a cat purring, sneakers slapping against the ground or the hum of an air conditioner. It's dramatic.

For Kenny Willis and his mother, the trips to U.Va. are only part of their journey to correct Kenny's congenital ear atresia. This summer they will begin a series of four two-week long visits to California to see plastic surgeon Burt Brent who will restore the external ears as much as possible. Brent also saw Kenny at the New York screening. Jahrsdoerfer works in close cooperation with Brent on many cases, he said.

While this process isn't easy, we would do whatever had to be done because we only want the best for Kenny. We've been waiting for this for almost seven years. It's scary but also very exciting, his mother said.

April 28, 2000