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Hearing Disorders Message Board

Hearing Disorders Board Index

[QUOTE=marktodd99;4091247] There are only three bones in the middle ear (maleus/incus/stapes) and it is 99.9999% that the stapes has grown bone into the opening into the inner ear in which it should vibrate freely, common sense really. [/QUOTE]

Turns out in my case, preoperative diagnosis for me is left conductive hearing loss. But during my scheduled stapedotomy surgery, the post-operative diagnosis is left congenital cholesteatoma. So i have a cholesteatoma medial to the incus. I had a CT scan to confirm that extend of the cyst. The cholesteatoma was not visible due to the position of it. Normal tympanic membrane and no facial sign of syndromic hearing loss. And I've not shown any of the symptoms of typical of cholesteatoma (dizziness, muscle weakness on one side of face, feeling of fullness or pressure in the ear, drainage, hearing loss, pain behind or in the ear)

I guess if it didnt opt for the surgery, like i had been doing for the past ten years, the cholesteatoma would not have been discovered. It is very dangerous since the cholesteatoma would eventually grow bigger and bigger and would erode the entire middle ear. The bone erosion would cause the infection to spread into the surrounding area, including the inner ear and brain. if untreated, deafness, brain abscess, meningitis and rarely death can occur. For me, my incus and staples super structure were markedly eroded.

The decision i opt for the surgery in the first place, is due to several reasons. one of them is due to the limit of hearing aid. at my hearing level, i was told hearing aid would get a lot of noise. with the high rate of success of the surgery, plus an experienced surgeon, i am confident that stapedotomy would be a better suit for me. Plus i read lots of academic studies show that peroperative factors that influence the outcome of stapedotomy (ABG>30 db and age < 50 yrs.) which classified me as a good candidate for the surgery.

I also read another interesting academic paper that i would like to point out, which detailing the failures in stapedotomy for otosclerosis. this article reviews results of 78 revision stapedotomies, determining the causes of failure and the predictors of surgical success. it was found that the most common causes of failure were prosthesis displacement, incus necrosis, and oval window fibrosis.

Okay, back to details of the surgery itself. i was put under local anesthesia care after identifying the site of the surgery (left or right, which it really important here, since my right ear is perfect) my surgeon elevated the tympanomeatal flap. upon exploring the ossicles, there was a cystic mass that was identified. since they dont have my consent to excise the cyst, they stopped the surgery. the tympanomeatal flap was placed back in the native position. i was taken to the recovery room where i was alert the situation. i decides to have the excise the cyst on the same day. i had a CT scan to explore the cholesteatoma, since the extent wasnt known thru the ear canal.

I then had a second surgery, a mastoidectomy with cartilage graft tympanoplasty. They found i have a significant amount of cholesteatoma in the sinus tympani. they made a incision behind my ear to gain access and to eradicated of all cholesteatoma. There is a lot of details here, which i am not going into. at the end, a total ossicular reconstruction prosthesis was a dornhoffer head was placed due to my incus and stapes eroded. the goal was to excise the cyst, hearing preservation or restoration is the secondary goal. Since they were able to do both, i am pretty happy with the surgery.

It has been 9 days since my operation, which i have to admit, is my first surgery i ever had (and the first CT scan, too!) For the most part, i am feel fine except stiffness in the neck and shoulder. I usually get a mild headache at night. i am also experiencing some ear pressure. I had my packing (a floxin soaked oto-wick) taken out yesterday, I don't recognize any sound coming in. It was expected results to be 10 db less than what was originally planned to be the goal. but the result is still largely depend on how well i heal. there are pretty much a chance the cholesteatoma would come back, so a second surgery might be necessary. i was told we will determine that in a year by looking at my hearing results and clinical exam. I guess my journey doesn't end here.

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