Ear Problems...

Once again we have fallen into the area of trying to do the best for Mikayla and other things have happened instead. As I have mentioned before, we have been feeding her the organic formula, giving her the organic solid food, not letting her have sugary food until she is around two or three. But no matter how hard you try, life decides that it has other things planned. Now this may sound dire, but I assure you that it is all in my head. Nothing terrible has happened to Mikayla. I just look at the worst possible things that can happen and start t get depressed.

Mikayla has (in layman's terms) an "congenital ear pit". You are probably asking the same question that I did, "What?". The medical term is "Preauricular Sinuses". What is preauricular sinuses you may ask (because I know I did). Here is a definition:

Preauricular sinuses are common congenital malformations first described by Heusinger in 1864. They are frequently noted on routine physical examination as small dells adjacent to the external ear, usually at the anterior margin of the ascending limb of the helix. However, they have been reported to occur along the lateral surface of the helicine crus and the superior posterior margin of the helix, the tragus, or the lobule. Anatomically, they are lateral and superior to the facial nerve and the parotid gland.

(via eMedicine)

Our pediatrician wanted us to get an ultrasound done. The reason was to determine the depth of the "pit". The problem that Mark and I had was putting a 1-year-old under anesthesia. It didn't feel right. We had canceled the appointment that they had set up for us and we did some research. The information that follows is from a friend. We are also going to be talking with our pediatrician as well as the anesthesiologists. Here is what we found out:

The three issues I saw repeatedly were hearing loss, infection and possible link to kidney dysfunction.

Hearing loss
I would ask about this. Measurement is not invasive and should not be too expensive.

Infection
It looks really important to avoid infection. The infection itself can cause pain and disfigurement. Surgery would be recommended if infections occurred frequently. However, once chronic infection happens, it could continue after surgery (something like a 40% chance). If the pit is deep, I could see the recommendation for surgery before multiple infections so the surgery would have a chance to be more effective (does this make sense?) This looks like the most probable area of difficulty. Infections could be painful, occur frequently, and cause scarring/disfigurement.

Kidney Issues
I might ask for information about symptoms of kidney dysfunction so that I could keep an eye out for them. If there is a problem, it might be wise to investigate treatments sooner so that future kidney damage could be avoided.

Ultrasound
The ultrasound would give you information about the depth of the pit, which relates most closely to potential infections, and a look at the structure of her kidneys. If the pit is not deep and kidneys are fine, then no action would be needed (as far as I can see). If the pit is deep, then it might be time to consider what to do (if anything). The kidney issue seems like a long shot, but having the information sooner may be helpful.

So as a quick recap and my opinions:

1. I would be most concerned about the potential for frequent infection and want to know the depth of the pit. I would also want to know what to look for so that I could recognize an infection quickly. Although infection is not life threatening (as far as I can see), it could be a serious hassle for her in terms of management and her physical appearance.
2. I would want to know what to look for to signal kidney dysfunction and what would happen next so that I could act quickly if needed
3. I would ask about hearing loss and probably have a hearing test at some point
4. I would consider the ultrasound so that I had more information about what to expect. I might not do it tomorrow, but plan for it while I wait and see if infection or kidney issues develop. In planning for it, I would ask about cost management.
5. Overall, I would try to do what would cause her the least amount of pain (physical and emotional), considering today and tomorrow (as best that I could judge).
6. So there could be no impact, a hassle with infections ranging from mild to serious, or scary kidney stuff (which probably isn’t likely).

So needless to say, I have been tossing things around in my head for the past week now and I hope all is well. We will be talking with our pediatrician this week and try to figure out how urgent the ultrasound is. Mikayla has not had an infection in the "pit" as of yet, but I don't want to wait to long if the possibility is great.