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When Surgery Is Music to Her Ears : In Inglewood, Privately Supported Centinela Hospital Fund Offers Medical Care to Needy Children


First came the painful ear infections, starting when Rocio Alcala was only 8 months old. The pain kept recurring, and by the second grade, tests had discerned that her hearing had started to fade.

Then doctors discovered large holes in both her eardrums.

At first, her father, Raul, feared he had caused the holes by cleaning her ears with Q-tips. But doctors concluded that chronic middle-ear infections had caused a buildup of pus, rupturing the eardrums' delicate tissue.

Surgery was needed to repair her ears, but her family had no health insurance, and Rocio had already lost 40% of her hearing.

Now, thanks to Centinela Hospital Children's Fund, a 10-year-old program that provides medical care to Inglewood-area children who lack health insurance, Rocio is on her way to recovering her hearing.

Earlier this week at Inglewood's Centinela Hospital Medical Center, Rocio, now 12, underwent surgery on her left ear. A second operation on her right ear will follow in a few weeks. The cost of the procedures is being paid by the hospital Children's Fund.

Experts say Rocio is one of thousands of children nationwide for whom ear infections have led to hearing loss.

Recurrent infections can damage the eardrum and the tiny bones in the middle ear that transmit sound vibrations, leading to hearing problems. That, in turn, can hamper a child's speech development and learning.

Studies show that middle-ear infections rank second only to the common cold as the most common health problem in preschool children, according to the American Speech-Language-Hearing Assn., based in Rockville, Md. Fully half of all children suffer at least one infection by their first birthday.

In an interview at her Inglewood home last weekend, Rocio described a world in which people are forced to talk loudly or scream to make sure she hears them.

"When I was 4 or 5 years old, I could hear things better, and then they didn't scream at me," said Rocio, a slender girl with long, dark hair and a soft voice.

She said she misunderstands song lyrics, and her younger sister corrects her. Schoolmates sometimes tease her, and she has difficulty hearing her teacher.

"I miss what she says, and I can't learn well," Rocio said. Her favorite subjects are health and science; she dreams of becoming a doctor, specializing in children. But her grades are average or below average, and her parents suspect her poor hearing is hurting her performance.

A standard school screening first detected Rocio's hearing problems in 1988. Her mother, Maria Alcala, says she took Rocio to a series of doctors who told her the problem could not be resolved until she was older. Then Rocio's father lost his job last year as an inspector at a water-heater manufacturing company that moved out of state, and the family no longer had health insurance.

"Her parents were having her treated as long as they could have her treated," said Brenda Young, school nurse at La Tijera Elementary School in Inglewood, where Rocio is now in the sixth grade.

Young and another school nurse helped put the family in touch last fall with the hospital Children's Fund, which decided to pay for surgery.

The first stage of that surgery came Monday, when Dr. Abraham Tzadik of Westchester performed a tympanoplasty an operation to repair the hole in Rocio's left eardrum, using tissue taken from an area above her ear.

The operation, performed at the hospital's day surgery center, took about 75 minutes.

First, Rocio was placed under general anesthesia and draped with blue blankets and towels until only her ear was visible. Tzadik readied a large microscope above the ear and looked inside.

Tzadik made an incision above Rocio's ear and used tweezers to remove a small piece of tissue. He laid it flat to dry on a silicon block while he stitched up the incision.

Next, Tzadik began work on the ear itself, slightly enlarging the ear canal. He lifted the eardrum forward and inserted the tissue underneath and behind the eardrum, supporting it in place with gel. He then put the eardrum back in place.

The tissue will serve not only as a patch on the eardrum, but also as a support for eardrum tissue to grow around it, Tzadik explained.

"At this point, she probably has a 90% chance of a good take (of the graft)," said Tzadik.

Rocio will return to Centinela in about six weeks for surgery on her right ear. That could prove more complex if the infection has eroded tiny bones inside the ear, requiring a bone graft, Tzadik said.

He said he will get an early indication at a checkup next week of how the graft has worked and if her hearing is improving.

Such procedures are costly: The bill from last week's surgery alone came to $5,913 at a discounted rate available to the Centinela Hospital Children's Fund. The cost of all Rocio's surgeries, which could amount to $20,000, will be paid by the fund.

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