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New Directions - Complex Middle Ear Surgery Gets Eight-Year-Old Back in the Game

New Directions Winter 2016

Complex Middle Ear Surgery Gets Eight-Year-Old Back in the Game

Date: December 22, 2015

Dr. Chien examining patient.

If you plan on spending the day with 10-year-old Liam Kren, you need to have a good breakfast. And put on your running shoes. Keeping up with this rambunctious Rockville resident isn’t easy. With a passion for lacrosse, swimming, cross country, taking care of animals and designing his own video games, Liam keeps his parents, Carrie and Mark, on their toes. The third of their three children, Liam failed the hearing test at his eight-year checkup, but they were only mildly concerned.

Much to their surprise, Liam’s problem wasn’t a simple one. After consulting several otolaryngologists, Liam was diagnosed with a cholesteatoma, an abnormal skin growth in the middle ear behind the ear drum that had left him with a 75 percent hearing loss. The Krens learned that while the mass was benign, if left untreated it could lead to further hearing loss, infection, and in rare cases, facial paralysis and meningitis. There is no medical treatment for a cholesteatoma; surgery is the only option.

Finding a physician to surgically remove the cholesteatoma took some time. Because of Liam’s young age, many of the doctors they consulted didn’t want to conduct the procedure or proposed putting Liam through several operations. The Krens were thrilled when they were referred to Wade Chien, M.D., a fellowship-trained neuro-otologist and a member of the Johns Hopkins Otolaryngology-Head and Neck Surgery team practicing at the Johns Hopkins Healthcare and Surgery Center in Bethesda. 

Dr. Chien specializes in complex ear procedures, such as the tympano-mastoidectomy he performed on Liam. Opening the affected ear, he removed the diseased tissue and repaired the eardrum. Dr. Chien performed the surgery at Suburban Hospital, and after a few hours in Suburban’s Shaw Family Pediatric Emergency Center, Liam was able to go home to his mom, dad and older sister and brother. 

“We met with several physicians, both locally and out of town, and got multiple opinions,” said Carrie Kren. “It was important for us to feel extremely comfortable with a surgeon before we subjected Liam to such a delicate procedure. We appreciated the way Dr. Chien explained everything on a level that even Liam understood. In fact, much of our decision to choose Dr. Chien was based on Liam’s opinion. ‘I like the way he made me feel better,’ Liam told us. Coupled with his experience and excellent outcomes, we knew our son was in good hands.”

A second outpatient surgery was done at Suburban to make sure that the cholesteatoma hadn’t grown back and to reconstruct the hearing bones. It didn’t take long for the lacrosse-playing, video game-designing, future veterinarian to get back to the activities he loves. 

Dr. Chien couldn’t be more pleased with Liam’s recovery. “I’m happy that the Krens caught the cholesteatoma early enough that it didn’t cause any irreversible damage to their son’s health. He’s a great kid with an exciting future ahead of him.”