Thursday, September 23, 2010
The Surgical Learning Curve in Aural Atresia Surgery
Tuesday, September 14, 2010
But first I have to get a referral from Molly's primary care to go to Dr Cravens.
Wednesday, September 8, 2010
Now the work is back on my shoulders, I need to schedule an appointment with Molly's local ENT, Dr Cravens, to get his referral to Dr Roberson.
If anyone wants to see the letter, here it is...
Molly's Letter from CEI
Tuesday, September 7, 2010
Tuesday, August 31, 2010
We're anticipating Molly getting atresia repair and BAHA implants combined in the next 4-6 months so at least we will have one of her BAHAs covered until then.
Monday, August 30, 2010
I think I'm going to try and get her some headphones, either wired or wireless and have her use those until we can get the BAHA fixed. Even after the BAHA is fixed, this should be a good compromise when she gets tired of the BAHA and just wants to watch a movie, or use the computer.
Friday, August 27, 2010
She has two BAHA Divinos. Her first one is also damaged, the post connecting it to the softband has a tiny piece broke off and the battery door has a piece of plastic broke. So now she is without any assistance at all. We're going to bite the bullet and send the first one off for repair, $495 flat fee to fix. Yikes.
Hopefully I can revive the second one myself. We can't afford to fix two right now.
Thursday, August 26, 2010
Wednesday, August 25, 2010
Tuesday, August 24, 2010
Update: Erin has called the list and is waiting on call backs from a few.
Confirmed do not perform 8-24-10
|Mindy Ann Black||520-498-1800|
|Randall Scott Cohen||520-694-8888|
|Robert Cravens||520-694-8888||Refers to Roberson!|
|Robert L Dean||520-694-8888|
|James Roy Carlson||520-795-8777|
|Thomas Sunil Kang||520-795-8777|
|Jonathan Ray Lara||520-795-8777|
I called Aetna and the lady on the phone will email me a list of ENTs in our area, I just have to call and work my way down the list.
She also suggested that wne we make our request to Molly's primary care for an out of network authorization, that we include information that Dr Roberson does around 125 of these per year.
Otolaryngology Head & Neck Surgery, University of Utah, Salt Lake City, Utah 84132, USA.
OBJECTIVE: The objective of this retrospective case review is to examine the effect of surgical learning on hearing outcomes and complications in congenital aural atresia surgery.
PATIENTS: Sixty-four consecutive ears (in 60 patients) operated on during the period of 1994 to 2004 at a tertiary referral center were studied.
INTERVENTION(S): Intervention consisted of aural atresiaplasty through an anterior approach by the same surgeon (C.S.).
MAIN OUTCOME MEASURE(S): Hearing outcomes and complication rates were compared between four temporally sequential groups of 16 ears. Acceptable hearing and complication rate outcomes were defined as results comparable to larger series in the literature.
RESULTS: Hearing results, in the short term, comparable to larger series were achieved during the first group of ears (nos. 1-16). A plateau in the learning curve for short-term hearing outcomes was achieved after the first two groups, that is, after 32 ears. Hearing outcomes, in the long term (>1 year) comparable to larger series, were achieved in the second group of ears (nos. 16-32). The learning curve for long-term hearing demonstrated a significant improvement in outcomes in the final group of 16 ears compared with the first 48 ears. Long-term hearing results for the final group show closure of the postoperative air-bone gap to less than 30 dB in 94% of cases. Postoperative complication rates were equivalent to larger series in the first group of 16 ears and showed no statistically significant difference between the four groups. There was one patient with sensorineural hearing loss after surgery; there were no anacoustic ears and no facial palsies in the study group.
CONCLUSIONS: A learning curve of at least 32 ears was required to achieve stable short-term hearing results. To achieve stable long-term hearing results required a learning curve of at least 48 patients in our series. Complication rates remained stable throughout the study period.
PMID: 17202933 [PubMed - indexed for MEDLINE]
She was adopted from an orphanage in Huzhou City, Zhiejang, China at 2.5 years old and has bilateral microtia and atresia. We're going through the process of getting her hearing restored via atresia repair by Dr Roberson in Palo Alto CA.