Monday, December 7, 2009

Breathing Easier with the Help of K. Hovnanian Childrens Hospital













Dr. Samuel Engel, MD, MPH

Ryan Dunckley, 3, of Whiting was a constant worry to his parents. Born with a congenital condition called laryngomalacia, Ryan had an underdeveloped voice box that lacked structural support.

But when he developed a strange breathing problem that wouldn't go away, his mother, Karen, grew concerned. "His breathing sounded like a motor boat, especially when he was exerting himself or sleeping at night," she says.

She videotaped the noises and brought him to Mary Mitskavich, MD, a board certified otolaryngologist affiliated with Jersey Shore University Medical Center.

Because the majority of children outgrow laryngomalacia by age 2, Dr. Mitskavich at first took a watchful approach. But Ryan was slow to crawl, walk, and talk, and his breathing became more labored. At the next appointment, Dr. Mitskavich, introduced her new colleague in the practice, Samuel Engel, MD, MPH a pediatric otolaryngologist at K. Hovnanian Children's Hospital at Jersey Shore University Medical Center.

Dr. Engel, who has a special interest in pediatric airway obstruction, recommended a sleep study to make sure Ryan's breathing was not stopping during sleep, which is an associated condition called sleep apnea. The study was done in an overnight sleep lab, close to Ryan's home in Brick, at Ocean Medical Center.

After determining that Ryan did not have sleep apnea, Dr. Engel recommended surgery known as supraglottoplasty to fix the breathing problem. "I endoscopically corrected the structure of his voice box, which had collapsed," Dr. Engel explains. "The entire surgery was performed transorally so there are no scars. At the same time, Ryan had his adenoids removed and ear tubes placed for recurrent ear infections."

Ryan spent one night in the hospital before going home. As a precaution, he stayed in the pediatric intensive care unit. "The nurses and staff there are so friendly," Karen recalls. "We weren't as severe a case as the other children in the unit that night, but we go the same care. I swear it was just about the next day when Ryan started running around at home. His life changed right there."

Ryan's follow-up care involves speech therapy, but he's "a big, happy, healthy kid," Karen says. "And I can't say enough about Dr. Engel. He is just such a nice guy and talks in a way you understand. He made Ryan very comfortable, too." -Ryan Younger



Toys on Santa's Naughty List


With the holidays upon us, you are probably wondering what gifts to give the little ones. How about the gift of hearing? Each day, a child's ears are bombarded with loud and possibly damaging sounds; why continue that assault by giving a loud toy?

For the last 12 years, Minnesota's Sight and Hearing Association and the University of Minnesota, have teamed up to purchase and test readily available toys for potentially dangerous sound levels. This year, 15 out of 19 tested toys were deemed loud enough to damage precious hearing in 15 minutes. The top offender? Iron Man Mobile Headquarters Action vehicle by Jada Toys, Inc., which came in at a whopping 119.5 dBA! You must realize that a lawn mower produces about 90 dBA of noise and anything over 100dBA poses hearing risk in 15 minutes. Second and third place offenders go to the Fischer Price Learning Letters Mailbox (113.9 dBA) and Sesame Street Help Along Sing a Song (112.1 dBA), respectively.

How do you know if a toy is too loud for children? Try it out. Hold a toy next to your ear and give it a go. If you find yourself flinching at the sound, it is too loud. Noises can be harmful at all ages. However, a child's ears are more fragile due to the smaller size of the ear canal and the increased sound pressure placed upon the eardrum.

Take the time to inspect the toys children already have. If the toys are too loud, control the volume by taking out the batteries and putting packing tape over the speaker to muffle sounds, replace toys with less noisy toys, or restrict use to outside play areas.

Remember to enjoy your holiday season and protect the ones you love!

Candice E. Ortiz, AuD, CCC-A, FAAA
Audiologist
Coastal Hearing and Balance Center
3700 Rt 33
Neptune, NJ 07753