Hearing Loss

Technology, Ingenuity & One Operation Erase A Lifetime Of Hearing Loss For This Young Patient |

It’s amazing that she can now hear normally!

By the time Caitlin Echave was a high school sophomore, she and her family were resigned to the fact that her hearing loss, which began when she was 11 years old, would never get better. She had reluctantly started wearing hearing aids, but still hid that fact from everyone except for close friends. After moving to Charlotte, Caitlin never imagined that a trip to yet another otolaryngologist would change her life forever.

Caitlin was referred to CornerStone Ear, Nose & Throat after complaining that her ears felt stopped up during an office visit with dermatologist John VanGurp, MD. She had her first appointment with Bill McClelland, MD, FACS, on May 17, 2006, and her mother remembers that day well.

“He examined Caitlin’s ears under a microscope, which her former ENT didn’t have,” said Mrs. Echave.
A CT scan (actual scan pictured above) indicated that a thick plug of bone and skin was obstructing Caitlin’s ear canal, but the space behind the ear drum and the bones in her ear were normal.

Dr. McClelland observed an abnormal anatomy in Caitlin’s left ear and ordered a CT scan. He also diagnosed her with chronic otitis media and chronic mastoiditis of the left ear, prescribed a course of antibiotic drops, and recommended an audiogram and tympanogram at her follow-up visit.

A CT scan (actual scan pictured above) indicated that a thick plug of bone and skin was obstructing Caitlin’s ear canal, but the space behind the ear drum and the bones in her ear were normal.

A CT scan (actual scan pictured above) indicated that a thick plug of bone and skin was obstructing Caitlin’s ear canal, but the space behind the ear drum and the bones in her ear were normal.

The CT scan revealed that the space behind Caitlin’s ear drum and the bones in her ear were normal, but a thick plug of bone and skin was obstructing her ear canal, causing the hearing loss in her left ear. Surgery would be required to remove it, but for the first time in years, there was hope that Caitlin’s hearing could be improved.

On July 7, 2006, Dr. McClelland performed a left ear canal reconstruction on Caitlin. He used specially designed drill burrs from Stryker® to clear away the obstruction.

“As I drilled away at the bone that was blocking the ear canal, I found that the original cause of the problem was a myringotomy tube that had been left in place from the procedure she’d had as a young child,” Dr. McClelland explained. During the surgery, the tube was removed and Caitlin’s ear drum and canal were both repaired.

Caitlin’s Pre & Post-Op Audiology Results. Results Pre-Op (RED) • Results Post-Op (BLACK)

Caitlin’s Pre & Post-Op Audiology Results. Results Pre-Op (RED) • Results Post-Op (BLACK)

Caitlin’s recovery time was minimal. She saw Dr. McClelland several times during the weeks following the surgery. As the final packing was removed, Caitlin experienced normal hearing for the first time since she was 11.

“I wanted to jump up and down right there in the office, but I waited until I got on the elevator,” said Caitlin.

Her chronic ear infection had resolved, and an audiogram confirmed that Caitlin had normal hearing in her left ear. Things that other people take for granted, like going to the movies, hearing a whisper, or swimming were now accessible to her.

“We couldn’t be happier,” said Mrs. Echave. “After believing that Caitlin’s hearing would likely worsen, it’s amazing that she can now hear normally!”

Infant Hearing Screening Is Critical in Avoiding Impact on Speech and Social Development |

Hearing loss is one of the most frequently occurring congenital disabilities, affecting approximately three in 1,000 people. Without early detection and intervention, hearing impairment in infants and young children can negatively impact speech and language acquisition, academic achievement, and cognitive and social development. It is a potential source of liability for the patients’ physicians if the problem is not caught and addressed in a timely fashion. If detected and treated, however, these negative impacts can be greatly diminished and even eliminated through early intervention.

In 1993, the National Institutes of Health (NIH) recommended that all infants be screened for hearing impairment at birth, preferably prior to hospital discharge. Since then, there has been a rapid increase in the number of universal newborn hearing screening (UNHS) programs. CornerStone Ear, Nose, & Throat pioneered UNHS in our region by starting the first program in the Charlotte area in 1997, long before the state mandated this testing.

There are two types of hearing tests that are used to evaluate infant hearing:

  1. Otoacoustic emissions (OAE) measure the response of outer hair cells within the cochlea to a particular stimulus. The hair cells must be healthy to produce robust sound emissions, allowing us to know that the cochlea is working properly and hearing is within normal limits.
  2. Auditory brainstem response (ABR) testing measures the brain’s response to a “click” delivered through earphones, much like an EEG of the brainstem. Sensors measure the baby’s entire hearing pathway to determine if the sounds are heard normally.

Both tests are non-invasive and require no action by the patient (a key quality for a newborn test). Currently CornerStone Ear, Nose, & Throat performs all of the newborn hearing screenings in CMC-Union hospital and provides follow-up testing and care for patients and their families across the Charlotte region. All infants who do not pass the original hearing screening in the hospital should be referred for re-screening or diagnostic testing. Ideally, audiological evaluations on infants who fail the newborn hearing screening should be performed before three months of age, or as soon as possible after discharge. Infants with confirmed hearing loss should receive early intervention services before six months of age.

Parents and health care providers should understand that a “pass” on the newborn hearing test does not rule out later development of hearing problems in infancy or early childhood. Speech and language development should be continuously monitored as an indicator of hearing difficulties. Infants who are at risk for progressive or late-onset hearing loss should be tested more frequently than those with no known hearing loss risks. These elevated risks may include, but are not limited to:

  • Toxoplasmosis
  • Syphilis
  • Maternal Rubella
  • Cytomegalovirus
  • Hyperbillirubin
  • Low birth weight
  • Recurrent ear infections before three months of age
  • Strong family history of congenital hearing loss

At CornerStone Ear, Nose & Throat, our staff of otolaryngologists and audiologists is well trained to meet the hearing rehabilitation and diagnostic needs of your patients, as we continue to provide the most technologically advanced care available for congenital hearing loss. Follow-up screenings do not require a physician appointment. For more information, call CornerStone Ear, Nose & Throat at (704) 752-7575 in Charlotte, (704) 289-8220 in Monroe.