Meet Peyton

“Glasses help you see; the Ponto helps me hear.”

Peyton Franklin is nine years old and lives in Ontario, Canada. She was born with bilateral atresia. Her right ear only had a pinhole-sized opening, while the left was completely sealed. Peyton underwent surgery on her right ear canal opening combined with implantation of a left-side bone anchored hearing system (BAHS) abutment and a backup “sleeper” implant. She later had work done on the left ear canal. While the surgery on the right successfully opened the canal, it was determined her left side still required a BAHS, so she was unilaterally implanted on the left side with a Ponto™ device. Her mother, Regan Franklin, shares Peyton’s story and how she is faring with her Ponto system.

Finding a hearing solution that works for atresia

We didn’t originally know that a bone anchored hearing solution was an option, as that information was not provided by the hospital. Peyton’s right ear was initially assessed as having a mild hearing loss, while her left ear had moderate to severe hearing loss. She was referred into the Infant Hearing Program (IHP). Although she had atresia in both ears, she did not have microtia. 

Unfortunately, it was determined that hearing aids were not an option because they couldn’t be fit with her ear canals. However, once we discovered that BAHS was a possibility, Peyton was put on the fast track at around 12 months of age. I reached out to two companies, and Oticon Medical was the one that got back to me. 

We were connected to the Hospital for Sick Children (more commonly known as Sickkids) and Peyton was aided at around 18 months. She started with an older loaner aid from another company but switched to Ponto once we heard from Oticon Medical.
Peyton underwent surgery on her ear canals at around 5-and-a-half, which completely opened her right ear. At the same time, the left-side abutment was placed. Unfortunately, her left-side ear canal could not be completely opened, and her middle-ear bones weren’t vibrating well, so the BAHS was still required.

The Oticon Medical representative I contacted let us trial a Ponto device. As Peyton got a bit older, she tried out a competitive device but chose Ponto. Her father and I also noticed much clearer sound compared to the competitor’s device when we listened through the two options. We could tell that Peyton was noticing more sounds and make more sounds herself when wearing the Ponto. Before, Peyton wasn’t speaking much. Three to six months after she started wearing the Ponto, she started to talk a lot more, and had a huge increase in listening and awareness. She engaged more with music and with us. 

We also started to receive feedback from school that Peyton was more engaged. They did some language testing, and she was catching up more on prior receptive and expressive language delays.

Our friends and family noticed a significant increase in engagement with Peyton, too. She was more expressive, even though she was always a timid child.

Implantation concerns relieved by minimally invasive Ponto surgery

The surgical process and recovery went great! The first one involved opening her right ear canal and placing the left abutment at the same time. Placement was really smooth and was conducted at a surgical site per our preference. We strongly advocated for getting the Ponto system despite the hospital not normally using it. 

Peyton stayed overnight for the first surgery. She was up and watching her iPad® within the hour—didn’t even need pain meds by the next morning. She bounced back to her normal self very quickly. She stayed home from school for a few days but barely needed it. She was running around our backyard and playing soccer by the second day post-surgery. It really was no big deal!

Before surgery, we were worried about how Peyton would react to being put under general anesthesia. She had previously had another surgery for her eyes, so she had some experience with general anesthesia, but not a ton. 

With atresia correction as part of the surgery, her doctors were worried about whether the opening would even stay open after and told us it may close again. After, there was some packing in Peyton’s ear canal that kept falling out and so we kept going back to hospital to get it re-packed. However, there were no issues with the abutment placement, and it was ultimately a small price to pay for getting to that better hearing.

As for managing the abutment, maintenance-wise it has been amazing. We did change to a longer abutment, but otherwise, the maintenance has been extremely minimal. I had learned the type of abutment was important because there are different types of materials that could be used. I was aware of this and heard stories of issues with other types of abutments. Nevertheless, I have been pleasantly surprised with the Ponto abutment.

What parents exploring bone anchored hearing solutions should know

I would ask clinicians to explain more about the basics of bone conduction hearing and how it bypasses the canal. They should talk about the outcomes for patients with BAHS and about how patients get an average of 10-20 dB boost in output with implantation and enjoy better speech clarity. They should also highlight that it’s a minimally invasive procedure.

I would tell other families considering a Ponto for their child that it’s just worth it. Try the devices and see what the best options are for your child. Most parents are passionate about researching the options. I encourage them to do their own research and try the devices on themselves to hear the difference in sound quality. 

Knowing that we should have had some sort of hearing device on Peyton from the beginning would have been helpful. We didn’t know anyone with hearing loss and didn’t know importance of early access to hearing or of hearing with two ears. It feels like there’s 18 months of opportunity she missed out on for language development.

I wish I had done even more research and more digging in terms of finding alternative solutions. With that in mind, I started a Facebook group, Microtia and Atresia Ontario, to help parents avoid these same pitfalls. 

In the future, I hope the technology includes a lower profile, and even less visibility. Having something less obvious would help children with confidence.

We have given Peyton the language around how to tell kids about her Ponto: “Glasses help you see; the Ponto helps me hear.” We also made a book about Peyton’s journey and her surgery for her to take to school to simplify the explanation around her Ponto. She is starting to get to that age where she feels a bit different, but she knows that the Ponto helps her.