For the first time in his young life, Kyle Figuray finally has a right ear that matches his left.
To correct a birth defect that prevented his right ear from developing properly, the 6-year-old from Wadsworth had a new ear crafted out of rib and skin grafts during three operations at Akron Children’s Hospital over the past year.
The hope is Kyle won’t just see the results of his operations. If all goes as planned, he soon will be able to hear on the right side, too.
Kyle was born without an ear canal and with an exterior ear that was underdeveloped.
During the last of three plastic surgery procedures in December to create his new exterior ear, Kyle also underwent the first of two operations for a bone-anchored hearing aid.
The device, known as a BAHA for short, will allow amplified sound waves to travel via the skull directly to the cochlea, bypassing his missing ear canal.
His parents, Mark and Barbara, opted for the bone-anchored hearing aid after his kindergarten teacher noticed he was talking louder than his classmates.
“We just thought he might be having some trouble,” his father said.
The device, which costs about $4,000, not including the surgery, is covered by the family’s health insurance plan.
During the outpatient procedure, Children’s Hospital ear, nose and throat specialist Dr. Marc Nelson secured two titanium screws into Kyle’s skull behind his ear. Over the next few months, the bone will grow into the screws and lock them in place.
This summer, Kyle will undergo a second procedure, during which Nelson will add an abutment on his skin that will be used to attach a removable sound processor to one of the screws, allowing him to hear more clearly.
“It’s very comparable to a hearing aid,” Nelson said. “It’s never going to be as perfect as a normal hearing ear.”
More than a year
Kyle’s surgical journey began in January 2011, when Children’s Hospital plastic surgeon Dr. Ananth Murthy and his team cut into Kyle’s chest and removed rib cartilage from near his sternum through a 2›-inch incision. Murthy carved and sewed the rib cartilage into a shape that matched Kyle’s unaffected left ear.
Murthy then removed Kyle’s malformed ear cartilage, slipped the framework for the new ear under the skin and secured it with sutures.
The results, though ear-like, were two-dimensional. The ear was held by the skin flat to Kyle’s head without the typical separation from the scalp.
So during a second, hourlong procedure last summer, Murthy cut around the edge of Kyle’s new ear to free the cartilage from the boy’s head.
The surgeon used a thin, 2-inch-by-2-inch skin graft taken from Kyle’s upper right hip to cover the exposed back of his new ear. The skin on his scalp was stretched behind the ear to create the natural fold. Kyle was required to wear glasses after the second operation, even though his vision is fine, so the groove between his ear and head didn’t close.
The kindergartner underwent a third, hourlong outpatient procedure during his winter break in December so that Murthy could add small, but important details to the ear.
Like an artist perfecting his creation, Murthy did what he calls “fine-tuning” to adjust the new earlobe, which had pulled away slightly because of scarring.
He also took some tissue from the central portion of Kyle’s new ear to create the appearance of an ear canal. In addition, he placed a small piece of cartilage in front of the simulated ear canal opening to replicate the small tab before the lobe.
The hospital billed the family’s insurance $76,000 for the three operations and related doctors’ visits, according to his parents.
At a recent follow-up visit, Kyle strained to peek out of the corner of his eyes as the surgeon poked and prodded the new ear.
“It looks like an ear,” Murthy said. “I don’t think you’d even think twice about it.
“I’m happy with the whole thing,” he told Kyle. “How about you, buddy? Are you happy?”
“Yes,” Kyle replied.
Over the next year, the ear will look more and more natural as residual swelling subsides, Murthy said.
After three operations, Kyle is understandably protective of his new ear.
“I can’t sleep on this ear,” Kyle told the doctor.
“It’s all healed up, buddy,” Murthy assured him. “You have nothing to worry about.”
“No trouble wearing a batting helmet?” his father asked, thinking ahead to baseball season.
“He can do anything he wants,” the doctor told them.
Cheryl Powell can be reached at 330-996-3902 or email@example.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.