New Type of Hearing Implant Surgery Performed on Children at Wolfson Children’s Hospital | Families

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New Type of Hearing Implant Surgery Performed on Children at Wolfson Children’s Hospital
Families, Health
New Type of Hearing Implant Surgery Performed on Children at Wolfson Children’s Hospital


Jacksonville, Fla. -- When Orange Park resident Natasha Rich gave birth to twin boys, Benjamin and Sawyer, she and her husband Trent received unexpected news: Benjamin was born with microtia atresia, an underdevelopment of his right external ear. His left ear, while it appeared normal, also had atresia, a condition in which the child’s middle ear canal is underdeveloped or closed. Because of this combination of issues, he was severely hearing-impaired in both ears.

However, Natasha seems to have been uniquely prepared to have a child with congenital hearing conditions. Before having her twins, she had spent 10 years contracted as an early interventionist with the Early Steps Birth through 3 Program. In her position, she counseled parents of hearing- and vision-impaired children on their treatment options; she currently works as a parent advisor for the Florida School for the Deaf and Blind in St. Augustine.

“I worked with children with various disabilities from genetic disorders, autism, cerebral palsy, hearing impairments and vision impairments,” she says. “I worked closely with speech and pediatric therapists and was very familiar with the Early Steps program, as well as therapies and services for children with hearing loss.”

Natasha made an appointment with pediatric audiologist Christine Cook, MS, CCC-A, at Nemours as soon as she could after learning of her son’s condition. “He had a speech therapist by three months of age,” she says. “That was also around the time we met Dr. Horlbeck.” Drew Horlbeck, MD, with Nemours Children’s Clinic, Jacksonville, and Wolfson Children’s Hospital, is the only pediatric otologist in the state and one of only a few nationwide.

Dr. Horlbeck offered hope to the Rich family. Although Ben’s left ear canal eventually opened on its own, although he never regained hearing in that in that ear due to a malformation of the middle ear; he also had very little hearing in his right ear.

Because his hearing is a result of a bone conduction malfunction rather than nerve-related, Ben had a special conductive hearing aid that was held against his head with a large, soft band. “This type of  hearing aid must be used under pressure, so that is the reason for the  soft headband,” says Dr. Horlbeck. “It’s not ideal as the child gets older and there is more of an impact socially.”

Previously, one of the few options for children with Ben’s condition and at his age was a surgical implant called the BAHA surgical implantation device. “The BAHA is comprised of a\a titanium implant that is screwed into the skull behind the affected ear, which is then connected to an external device to hold it to the head and a sound processor,” explains Dr. Horlbeck. The system works by enhancing natural bone transmission as a pathway for sound to travel to the inner ear, bypassing the external auditory canal and middle ear. For hearing, the sound processor transmits sound vibrations through the external abutment to the titanium implant. The implant sets up vibrations within the skull and inner ear that stimulate the nerve fibers of the inner ear, allowing hearing.

“The problem with the BAHA is that there is always an external screw, so it must be cleaned frequently to prevent infection,” says Dr. Horlbeck. “Healing from the BAHA surgical implantation can take anywhere from three to six months.”

Dr. Horlbeck told Natasha and Trent about a newer device called Sophono that was completely under the skin, except for the sound processor, and didn’t require cleaning. Not only is the Sophono used for children like Ben, but also for children born without ears or with certain genetic conditions like Treacher Collins syndrome. For some children, it could be their best hope for hearing as normally as possible.

Once Natasha and Trent researched the Sophono device, they were eager for Ben to have the minor surgical procedure that would significantly enhance his hearing. Ben was the first child in Northeast Florida to have the Sophono device implanted. The device was approved by the FDA in June 2011.

“We implant a magnet into the skull behind the ear in an outpatient surgical procedure,” explains Dr. Horlbeck. “The externally worn sound processor, activated by a pediatric audiologist after healing is complete, contains a battery and microphone and attaches to the head via the magnet under the skin. This two-inch external device sends sound energy through the bone directly to the inner ear.”

“Even though Ben has very light blonde hair, you can’t even see the incision unless you’re looking for it,” says Natasha. “He’s done great with the Sophono. He puts the external device right on, adjusts it and wears his alligator clip to keep it in place.”

She adds, “My husband and I, as parents, and I, as a parent advisor, are so appreciative of Wolfson Children’s Hospital, Nemours Children’s Clinic, Dr. Horlbeck and Christine for their help with the entire process, from diagnosis to implantation to follow-up. We truly feel that this has been the best hearing aid option for Ben and will help him continue to thrive and to be a confident and successful person.”

Both Ben and his twin, Sawyer, now five years old, are in separate preschools and are receiving speech therapy for articulation issues. Sawyer, who has normal hearing, helps Ben with his speech, and Ben helps Sawyer with his. “They teach each other,” says Natasha. “It’s like they’re doing therapy with each other.”

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