Patient Stories

Arkansas Children’s Hospital Offers 6-year-old New Life, With a New Ear

Until this summer, this 6-year-old rock star in training had only one ear. He was born that way. Jodie’s birth defect is called microtia, or the failure of formation of the external ear and the external ear canal. He has always had a semblance of an ear lobe - about 15 percent the size of a normal lobe - which he and his mother, Brenda, always referred to as his “little” ear. He never complained, never worried and asked about it only once. To which his mother replied, “God made you special so he gave you a special ear like no one else.” That answer – was good enough. From then on, there were guitars to be played, drums to be beaten and the ordinary duties of a young boy to be fulfilled.

Six years ago, the news of Jodie’s one ear was somewhat of a shock to Brenda – and her doctors. Around the six month of her pregnancy, an ultrasound suggested that Jodie’s intestines might not be forming correctly. Pediatricians in Springfield, Missouri soon determined baby Copenhaver was just fine. And he was. But there was no indication, no hint, of what Brenda was told just minutes after delivery.

“The doctor said ‘Well, he has 10 toes, 10 fingers, but only one ear,’” remembers Brenda. “At first I didn’t realize he was serious, then I thought how all of my life I had complained about my big ears – I thought ‘What have I done?’” Brenda was perplexed and her doctors weren’t quite sure what they were dealing with, either. To their knowledge, there had not been a child in Carroll County born with only one ear. Before Brenda was even moved from the birthing room, her doctors had made an appointment for Jodie at Arkansas Children’s Hospital, to make sure there were no other problems and to get an accurate diagnosis.

“This failure of the ear to form is not that uncommon,” says Michael Key, M.D., a pediatric facial plastic and reconstructive surgeon at Arkansas Children’s Hospital and associate professor and director of Facial Plastic and Reconstructive Surgery at the University of Arkansas for Medical Sciences College of Medicine. “It occurs in approximately 7,000 to 10,000 live births. In Jodie’s case, his inner ear and some of his middle ear are formed and they do work, but they work at such a low level compared to his good ear, that he probably doesn’t get much input from it.” Jodie was four days old when he made his first trip from Berryville to Little Rock. After that initial visit, he would have a date twice a year with Dr. Key, who would monitor the normal hearing in his right ear.

So, for the next five years, Jodie and Brenda lived their lives. There was no teasing to cope with, except for one inconsiderate adult, and Jodie always managed to adapt to situations and make up for his lack of hearing. Then, came the long-awaited age of 5. It was the point when Jodie’s life would change, but little did he know how much.

“We talked about it and Jodie always knew that when he was big enough, Dr. Key was going to fix his ear,” says Brenda. “I occasionally had my doubts about it over the years, but for the most part I wanted Jodie to have the surgery. His little ear wasn’t that noticeable, I just wanted Jodie to feel like a normal boy.”

“To have a deformity of the face, whether it be of the ear, eye, nose, lip, or even just the skin alone – significantly gives a stigma to a child,” says Key. “They never blend in, they’re always asked ‘what happened’ and their whole persona never knows what ‘normal’ is. To change any form of an ear, to an ear that is more significant, literally transforms the child and that’s why it is so important for children to have this surgery.” Before surgery can take place, the ear and head structure of a child must be close to an adult size, since the artificial ear will not grow. This point in growth is usually between 5 and 7 years of age.

It is the morning of May 13 at Arkansas Children’s Hospital. A very brave and excited little boy waits for the doctor who he has come to know as a friend. He looks forward to what he has to gain, but is concerned about losing his special little ear. When Key walks in the room for a pre-op visit, he assures Jodie that his ‘little ear’ is part of the bigger plan. As Key leaves the room, the reality of what is about to happen unsettles Jodie, who breaks out in tears as he curls up in his mother’s lap, wrapping his slender little arms tightly around Brenda’s neck.

“I was terrified, but I knew it was the right thing to do,” says Brenda. “I’ve honestly thought all my life that God gave Jodie his ear for a reason and the ear would have something to do with what Jodie is going to do with his life. God gave us Dr. Key for a reason.” Jodie is wheeled into the operating room and put under anesthesia. It is at this point that Key’s artistic ability begins to show. He takes a thin, transparent sheet of plastic, outlining a template from Jodie’s right ear. He carefully measures how the new ear, and Jodie’s ‘little ear’, will fit together in the reconstruction.

After creating a pocket on the left side of Jodie’s head, Key gently harvests one of Jodie’s ribs and rib cartilage, which will form the new ear. While a surgery resident closes the opening on the 5-year-old’s right side, Key sits down to literally create Jodie’s new left ear.

“I guess you could say I am part surgeon, part artist or sculptor,” says Key. “I think of myself as a person who works with the medium of skin, cartilage and living tissue. I use my medical knowledge to make sure that it works; to make sure that I’m not creating something that can’t survive. The artist in me has to make sure it’s the right shape and size.” Key sits at a carving table where he measures the rib bone and cartilage against the template he created earlier. After sewing the cartilage to the bone, which will form the upper and outer curve of Jodie’s new ear, he trims away excess material with a scalpel, frequently referring to the template to ensure the measurements are exact. Key’s experience spans 15 years, but his skill and precision indicate he is creating a masterpiece.

The new ear is inserted into the pocket. A small tube will temporarily drain excess fluid and the new ear is covered with a cap to help avoid infection. After two-and-a-half hours in the operating room, Jodie and Brenda are reunited. Both have made it through the first of four surgical procedures, with no idea of the progress that lies beneath that small, white cap.

Days passed and it was now time to get a first glimpse at Key’s handiwork. Despite their curiosity, neither Brenda nor Jodie was prepared for what lay beneath the little white cap.

“I cried! I don’t know what I was expecting,” remembers Brenda. “Dr. Key said not to expect too much, but it was so much more than Jodie ever had before!” Jodie shared his mother’s excitement. The boy who feared the unknown was now counting down the days until he returned for his second surgery. In Brenda’s words, “He was ready!”

The two surgeries that follow reveal less dramatic results, and it is typically the final outcome that brings on feelings such as Jodie and Brenda’s first response.

“It is very difficult to see the newly created ear and all of its aspects until approximately one year has commenced from the time of the original surgery,” says Key. “It’s a four stage process, separated by at least three month intervals.” Those intervals are needed to give the tissue that coats the ear, the ear graft, and other elements used in creating the ear’s shape, time to develop a new blood supply. This also ensures the tissue around the ear is soft enough to work with, and has the best chance of survival through the next step. While some families dread repeat surgeries, this was not the case for the Copenhavers.

“All I could think of was how great it looks now, and to think of what it will look like down the road is unbelievable,” smiles Brenda. For the next three months, Jodie put his new ear to the test. The fact that it was healing didn’t slow him down and the fact that he had an ear, even a partial ear, meant there were experiments to conduct.

“One day, he came running through the house screaming, ‘Mommy, Mommy!’ and it scared me half to death,” laughs Brenda. “I thought he had ripped his ear off or something and he said ‘I can wear sunglasses! I can be cool!’” The pair of useless, black sunglasses which never had a purpose for Jodie, would become a permanent fixture on his face, day and night, until school started in the fall. Every day, Jodie requested a countdown report on the number of days until his second procedure. When the day arrived, it wasn’t hard to spot Jodie in the waiting area. He was the boy with the big smile and the sunglasses that were on even before the sun came up. Although short on words, he had a high-five and a big smile for everyone who checked in on him. He also mentions that he thinks Dr. Key is awesome and he’s excited to get to the next stage.

When Key enters the room, the reality of Jodie going back to the operating room sinks in. Once again, he returns to Brenda’s lap, as fear takes over. Both are confident though, and know they want this surgery. The second procedure is much shorter, as Key introduces Jodie’s little ear to its permanent location. After healing and a three month interval Jodie will return for step three, around Christmas break, followed by the grand finale in the spring.

Until then, Jodie will attend Kindergarten with this ear. Fortunately, Jodie’s teacher knows what he has been through and can position him accordingly in the classroom. Her name is Ms. Copenhaver…Brenda Copenhaver…who is beginning her first year of Kindergarten as well. So far, the school year is going well and no one noticed Jodie’s different ear until months later, at naptime. After the questions, came the fascination. Jodie and Brenda can relate.

“They took my rib out and made me a new ear,” says Jodie. “It’s awesome!” The most exciting part to Jodie is, “I’m gonna have two!” He can’t boast enough, walking up to complete strangers to show them his new ear. Brenda remembers Jodie approaching a man whose arm was in a sling, saying ‘Did the doctor make you a new arm? He made me a new ear!’ with complete satisfaction.

“It makes everything worthwhile,” says Brenda with gratitude in her voice. “I never questioned the surgery, but it makes the long trips to Little Rock and all the worrying worthwhile, just to see him so happy and know that he can be a normal little boy.” Jodie’s experience will, no doubt, influence what he does with his life. One minute he wants to be a doctor so he can help people, the next minute he’s playing the guitar singing his favorite song, ‘Great balls of fire!’ It is yet another aspect of how physicians can change children’s lives.

“Some of my patients have gone into areas in which they would not have been allowed because of their physical condition,” says Key. “To that end, I feel rewarded in working at Arkansas Children’s Hospital, so I can help someone get past their problem as a child and go on to help others as an adult.” With plenty of time to decide on his future, one thing is for sure. It is definitely brighter for Jodie Copenhaver…shades on, or off!

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