Brain surgery helps relieve ear infections

PHILADELPHIA -- TE is a defect in the part of the skull that separates the brain from the ear. This can cause brain fluid leakage and even meningitis. Now, an innovative endoscopic operation is minimizing the incision and impact on the brain; repairing the problem in little more than an hour of surgery.

Agnes McFadden, mother and grandmother, loves to travel and cook. But three years ago, when her ear began leaking massive amounts of fluid, she had to put her life on hold.

McFadden told Ivanhoe, “My pillows every night were completely covered by the morning.”

Agnes was diagnosed with TE, meaning a hole in her temporal bone, which forms part of the skull, had to be surgically repaired. The pulsating of her brain had created just enough pressure for cerebral fluid to go where it shouldn’t--- through a hole in her skull.

Kadir Erkmen, MD, Vice Chairman of Neurosurgery at Temple University explained, “It actually has a shelf and the brain sits on top of it and it’s through that shelf bone that is oftentimes very thin; the brain can have a defect and the bone can have a defect, and so the brain material and fluid from the brain can get into the ear space.”

As soon as her ear infections stopped, Agnes underwent groundbreaking endoscopic keyhole neurosurgery. This unique operation uses tiny cameras inserted through an incision, less than two inches long, to repair the skull.

Pamela Roehm, MD, PhD, Professor; Director, Division of Otology and Neurotology, Department of Otolaryngology at Temple University School of Medicine explained, “Before, we had to make a very large incision, and shave half the head, and then put in retractors that really pushed the brain down, in order to repair these areas.”

This approach using the endoscope was the brain child of Doctors Erkmen and Roehm. It offers better visualization and has very little impact on the healthy tissue. The keyhole surgery uses bone, muscle, and a suture to seal up the hole. Doctors say the defect can be present at birth, caused by a severe head injury, or even be the result of numerous ear infections. But no matter how it happened, Agnes is back to business as usual.

McFadden said, “Wonderful. Like nothing ever happened.”

Doctors say that because a major risk of this condition is the possibility of spinal fluid entering the ear, meningitis can occur. So, if you have recurrent ear infections and antibiotics haven’t worked, be sure to ask your physician about other possible causes, like TE. Agnes’ total recovery time was around three months.

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