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Tuner's Bad Ear Revived In Operation

Surgery on organ tuner's bad ear avoids a sour note in his career

The Daily Herald
Libertyville / Mundelein / Vernon Hills Edition
Thursday, January 16, 1992

Adam Bartsch
Daily Herald Correspondent

Joe Poland's career as an organ tuner depended on having two good ears. 

However, in August 1989, he was told that further efforts to restore hearing to his right ear would be futile. Surgery to pierce a bony overgrowth in the middle ear section had run up against a growth so thick that conventional methods and tools were inadequate.

"Not being able to hear (in one ear) prevented me from "climbing the ladder" of my profession, said Poland, a Round Lake Beach resident.

He faced being relegated to only constructing and rebuilding organs for as long as he stayed in the business.

Tuning with only one good ear, "wouldn't work because the way organs are set up, you tune from one pipe to the next," Poland said. To progress along the line of pipes at the same time, one ear must be able to distinguish the tone of the correctly tuned pipe, while the other ear focuses on the pipe that is being tuned.

Poland said he likely would have been given other work by his employer - Fabry Inc. of Fox Lake but organ tuning is what makes the business interesting. At age 28, he had been with the company nine years.

"It's an art," Poland said of tuning. "More of an art than a career."

The future appeared grim until a second doctor picked up Poland's medical file this past year. After reading the file, ear specialist Dr. William Gatti knew that Poland's problem was "unusual."

According to Gatti - who practices at the Condell Medical Center in Libertyville - 10 to 12 percent of the general population has an irregular bone growth in the middle ear that can lead to hearing impairment. The condition, called otosclerosis, causes hardening of inner ear tissue.

The growth, which rarely gets large enough to impair hearing, can impede the movement of the stapes bone, one of three tiny bones that help conduct sound through the middle-ear canal. The greater the immobilization of the stapes bone, the greater the hearing loss.

Gatti determined that Poland had a condition that was much rarer and led to a more severe hearing loss. Called obliterative otosclerosis, it's different because the fixation of the stapes bone itself is not the cause of the hearing loss.

Instead, sound is unable to reach the cochlea of the inner ear, the most important of the car components, because the "oval window" through which sound waves pass is itself overgrown.

"Ordinarily the stapes footplate (oval window) is five or six layers thick (in cases of obliterative otosclerosis," Gatti said. "But Mr. Poland's was 25-30 layers thick. The footplate had increased in size."

Conventional methods of surgery were to pick at the overgrown footplate with tiny tools to break through and thereby allow sound waves to pass through the newly created opening. 

It was revealed in Poland's surgical notes that this is what the first doctor had unsuccessfully attempted in an operation known as a stapedectomy.

Gatti told Poland there was a 30 to 40 percent chance that a new operation would result in total deafness, but Poland was eager to try it.

Dr. William Gatti checks Joe Poland's ears in Gatti's office at the Condell Medical Center in Libertyville. Successful surgery to remove a bony overgrowth in Poland's right ear enabled him to continue his career as an organ tuner. (Daily Herald Photo/John Konstantaras)

"It was so bad already," Poland said of his hearing, "that it (deafness) really wouldn't have mattered."

The tool that made the difference for Gatti was a small pen-sized "skeeter drill" made by Xomed, a medical tools manufacturer. Gatti said Poland's footplate was "so thick that only a drill would get through it."

The 1 millimeter drill bit allowed Gatti to pierce the many layers of bony overgrowth in a controlled manner. After opening the eardrum, "just like you'd peel open an envelope," he drilled the hole, then took a very fine pre-formed platinum wire and put it in the place of the stapes bone.

One end of the wire was crimped onto the second of the three small bones that previously had been connected to the stapes bone. The other end was connected to a tiny piston that now performs two functions: it helps transmit sound waves into the inner ear and maintains movement through the hole in the bone, hindering further growth of the bone in the future.

"I've done several other jobs like this," Gatti said. "This rated among the most difficult. It's a very ticklish procedure, because the facial nerve passes right through the same area. If anything happened to that nerve there would be facial paralysis."

Had the nerve been damaged, Poland would likely have lost some, perhaps all, of the control of the muscles in one half of his face.

Fortunately, Gatti has very steady hands.

"What was a big disappointment a couple of years ago turned out very well," Gatti said. "I think I'm as happy as he is."

"I don't know how to put it in words," Poland said. "Just to be able to hear people talk is amazing. It's so hard to describe."

At a recent post-operative meeting, sound tests determined that Poland had regained almost 100 percent of his hearing. While part of the meeting was painful because Gatti had to pick away at the ear drum which was largely covered with scab - Poland said that he had confidence in the doctor.

"He came across so positive and knowledgeable that I had faith in him. I've already started tuning organs again," Poland said.

While future bone growth of the footplate could immobilize the piston in the future, both Poland and Gatti are ecstatic at the results achieved so far and will tackle future problems when and if necessary.

Poland said that he doesn't consider that a major concern, and added, "I wouldn't hesitate to have it done again."