Top Five Child Procedures

The Doctors count down the top five medical procedures performed on kids. Are they all safe?

5. Newborn Testing
Newborns are screened for metabolic disorders with a blood test. The disorders are often difficult to diagnose on their own until it’s too late, so the tests are meant as an early diagnostic tool. Pediatrician Dr. Jim Sears explains, “If you find out early, often there are simply dietary changes that you can make.”

Sometimes the tests are incorrect, such as a false-negative or a false-positive, which can be misleading. Actor Scott Baio’s newborn daughter tested positive for GA-1, a rare but serious metabolic disorder, which required doctors to take a skin biopsy for further examination. Grief-stricken, Scott and his wife waited 10 agonizing weeks for the results. “How do you love a child that’s potentially going to die?” Scott asks.

 Happily, the couple learned that they had received a false-positive test. “Well, we went through hell, now we’re going through heaven!” his wife concludes. Though the potential for misdiagnosis can deter parents from the screening process, The Doctors implore that it is vital to have these tests performed.

4. Open Wide!
Jaw widening is an orthodontic procedure that expands the upper and/ or lower jaw to create more room for permanent teeth. The expansion takes several weeks to complete and is relatively painless. Orthodontist Dr. Atoosa Nikaeen says that once the metal contraption is fitted and in place, a key is turned every other day to stretch the jaw at .25 mm intervals.

Jaw widening acts to prevent future extractions of permanent teeth or other potential surgeries that arise from an over-crowded mouth. Nine-year-old John had a jaw widening device placed in his upper jaw a few days ago and reports that he feels fine. “I’m talking a little weird, but overall, it’s not hurting,” he comments.

Dr. Nikaeen notes that the American Association of Orthodontists recommends that all children should have an orthodontic evaluation at the age of 7. 

Signs that Jaw Widening Might Be Needed: 

• The upper jaw is very small and narrow

• Teeth are crowded

• Cross-bite

• Trouble breathing

• Large tonsils

• Large adenoids

• Hereditary problems

• Tongue thrusting habits

• Thumb sucking habits

3. Ear Tubes

Ear infections occur more frequently in children because their Eustachian tubes -- the funnels that link the pharynx to the middle ear -- are shorter, narrower and more horizontal than in adults. This particular alignment can impede the flow of air and fluids through the tubes and lead to infection; the fluid pools and bacteria grow.

If children are plagued by frequent ear infections, physicians can surgically insert ear tubes, or shunts, into the ears to alleviate the problem. The tubes ventilate the area behind the eardrum and equalize the pressure in the middle ear.

Although the surgery takes approximately 15 minutes, general anesthesia is required, so talk to your doctor about the risks and benefits of the procedure.

Symptoms of a Middle Ear Infection:

• Pulling or rubbing ears

• Fever

• Fussiness or irritability

• Fluid leaking from the ear

• Changes in appetite or sleeping patterns

• Trouble hearing

2. Circumcision
Circumcision comes under the knife; is it a necessary medical procedure or purely cosmetic? A circumcision removes the foreskin from the tip of the penis.  Dr. Jim maintains that circumcision is a cosmetic procedure and a boy should have the option to choose whether he wants it performed or not. Dr. Lisa maintains that circumcision is a type of preventative medicine and is the better hygienic choice; it also reduces the risk and rate of sexually transmitted diseases and penile cancer. Dr. Jim then demonstrates a circumcision on a banana tip.

1. Tonsillectomy
Tonsils are lymph node tissues in the throat that are meant to fight infection, but sometimes they can they can turn into the source of infection. If the tonsils are regularly infected, they need to be surgically removed, which is called a tonsillectomy. A patient must be put under general anesthesia, which carries its own set of risks in children.   

Steve and Kristen were alarmed to learn that their 4-year-old son, Caden’s, excessive snoring actually stemmed from his considerably enlarged tonsils interfered with his breathing. Pediatric ear-nose-throat surgeon Dr. Nira Shapiro noted that Caden’s airway was nearly obstructed by his tonsils. She performed a cutting-edge tonsillectomy on Caden and brought the surgical tools she used to the studio.

Dr. Shapiro “operates” on a raw chicken breast to demonstrate the difference in cutting results with the old and new technology. She explains that electrocautery is the old technique, which cuts tissue by burning through it at 400 degrees Celcius; it causes a deep scarring and increases the patient’s recovery time. Conversely, the new technology, coblation, uses a cooling technique that simultaneously emits saline and irrigates the surgical area. The coblation wand operates at only 40 to 70 degrees Celcius, which greatly reduces tissue damage and lessens recovery time.