First ENT visit for a baby with Down syndrome

I'm still laid up with this ankle but going to the doctor today. I had this post in waiting so i figured i would post it. Sorry if there are mistakes. Posting from an iPhone is a different experience.

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Upon our arrival, we were first whisked back to the hearing test booth.  If I only had a sound proof both at my house.  I would use it every day, but that's a different story.

First, they use something like this:

To perform a Otoacoustic emission test (OAE).  The small probe with a tiny microphone and speaker inside is placed in the baby's ear and  measures a sound response by causing the sound to bounce back.  The sound that bounces back from the inner ear is recorded and plotted onto a graph.  The audiologist determines whether the response from the test indicates normal hearing or indicates hearing loss.

Then, the audiologist shuts the sound proof doors and goes into the adjoining room.  She speaks into a speaker that is located on either side of the room to see if the child will turn toward the sound.  If the child turns toward the sound, there is a visual stimulant that is activated, which in our case was a squeaking bunny.

Next, the ENT does an examination and evaluation.  The ENT will look into the child's ears and examine the ear drums and check for fluid behind the ears.  Then, they will look up the nose and into the mouth to examine the tonsils and adenoids.  They are checking to see if either of these are enlarged, because complications can include breathing difficulties and sleep apnea among other things.

The ENT will finally review the results from the hearing test performed by the audiologist and discuss the plan for your child.


Kamdyn's pediatrician actually has a machine in the office that they have used on her.  After administering their test, her pediatrician said that he was worried about her hearing, because her results on the graph did not appear normal.

I learned from her ENT, however, that due to Kamdny' tiny ear canals, her test results appear different from that of a child with larger ear canals.  While another child's graph would come out like a mountain peak, Kamdyn's plots like a small hill.  Due to narrow passage ways, this is a common finding in children with Down syndrome.  Kamdyn's ear canals are particularly small, and while the ENT believes she requires tubes to prevent further infections, her ears are TOO small.  When her ears are examined, one ear drum is not visible, and the other is only visible by a sliver.  For Kamdyn this means that it is difficult to even diagnose her with an ear infection, because they cannot see her ear drum.  The ENT recommended that I ask the pediatrician to do the hearing test in the office if they suspect an ear infection.  Since her ears test differently, her results would have to plot as a flat line to indicate that there is fluid behind the ear drum. 

After first ENT appointment:

Findings:
Kamdyn needs tubes to prevent reoccurring ear infections and continuous antibiotics.
Kamdyn's ear drums, however, are too small for tubes to be placed. 

The Plan:
Wait 6 months to see if her ear canals get any bigger and reevaluate.