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