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Operation Corrects Bad Ear

Unique Ear Surgery Brings Harmony Into Organ Tuner's Life

HOUSE CALLS
Condell Medical Center
March, 1992

0rgan tuner, Joe Poland of Round Lake Beach was beginning to feel job insecurity. As an organ tuner, he depended on good hearing but the hearing in his right ear was becoming impaired. Poland had a bony overgrowth in the middle ear, which proved so thick that conventional procedures and equipment were unable to penetrate it. Finally, he learned that nothing more could be done to restore hearing to his ear.

That meant problems on the job since an organ tuner works progressively along the line of pipes in an organ listening to the tone of a correctly tuned pipe with one ear while the other ear distinguishes the tone of the next pipe being tuned. Since Poland enjoyed his profession, he wasn't looking forward to the prospect of doing anything else.

However, harmony returned to Poland's life this winter when William Gatti, MD, a board certified otolaryngologist on Condell's Medical Staff, diagnosed Poland's condition as obliterative otosclerosis, a rare condition which leads to a severe hearing loss. A special microdrilling technique would be necessary to restore hearing.

Dr. Gatti explained that 10 to 12 percent of the general population experiences an irregular bone growth in the middle ear, but only a small percentage develop noticeable hearing loss. Called otosclerosis, the condition causes hardening of inner ear tissue and can impede the movement of the Stapes bone, one of three small bones that help conduct sound through the middle-ear space. Hearing loss depends on the size of the growth and the degree of Stapes bone fixation.

Poland's condition was unique and had led to a severe hearing loss requiring a special surgical approach.

Dr. Gatti explained that sound was unable to reach the cochlea (a spiral tube of the inner ear containing nerve endings essential for hearing) because the Stapes footplate through which sound waves pass was itself overgrown. In most cases of otosclerosis, the growth is five or six layers thick. In comparison, Poland's was 25 to 30 layers thick.

In 1989, Poland had surgical treatment called a "Stapedectomy" done elsewhere. The procedure involved picking at the overgrown footplate with tiny tools attempting to make an opening so that sound waves could pass through. This method proved unsuccessful because of the thick footplate.

Dr. Gatti advised Poland that a revision of the Stapedectomy could result in total deafness - possibly a 30 to 40 percent chance. Poland consented to the surgery. Since his hearing was already so impaired, he decided it was chance worth taking.

The Operating Room Staff at Condell obtained a special drill called a "Skeeter" drill, which is about the size of a large pencil. During the surgical procedure, a 1 mm hole was drilled in the blocked middle portion of the middle ear at the footplate of the Stapes bone. Dr. Gatti then inserted a platinum-piston, which helps transmit sound waves into the inner ear and maintains movement through the hole in the bone, preventing possible future growth of the bone. Post- operative tests revealed excellent hearing in the right ear with almost 100 percent restoration of hearing.

Although the piston could become fixed by future bone growth, Poland isn't too concerned at this time. He's too busy tuning church organs and listening to the world around him!

     Reprinted from House Calls, March 1992, Condell Medical Center
    900 Garfield Avenue, Libertyville, Illinois 60048-3119, (708) 362-2900

     E.N.T. Consultants of Lake County, Ltd.
     William M. Gatti, M.D.
      755 S. Milwaukee Avenue, Suite #181
     Libertyville, IL  60048
     (847) 816-1228