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Apollo Specialty Hospitals, OMR performed a rare surgery on a patient whose brain tissue was oozing out through a hole in the ear

02 Jan 2019

Mr. Loganathan, 54-year-old, an auditor in a private company in Erode, was suffering from severe periodical headaches and right ear pain/block for the past one year. Though the patient visited several hospitals in and around Tamil Nadu, the reason for his head or ear ache could not be diagnosed. One of the hospitals even performed a tympanomastoidectomy for Right Chronic Otitis media considering this as an ear infection. Few months later, the patient started developing further complications including a clear watery discharge from his right ear and persistent headache. Patient later consulted a couple of other hospitals before presenting himself to Apollo Hospitals OMR, Chennai.

On investigating the patient Dr. Krishnakumar, HoD, ENT, Apollo Speciality Hospitals OMR, identified a pink, pulsatile, soft, insensitive mass, which did not bleed on touch filling the external auditory canal. A CT scan and a Brain MRI revealed a huge defect(hole) in the upper wall of the inner ear (right side) through which a small portion of the brain's temporal lobe was prolapsing out.

On observing this condition Dr. Krishnakumar K, HoD, ENT, Apollo Speciality Hospitals, OMR and Dr. Joy Varghese, Senior Consultant, Neuro Surgeon & Interventionist, Apollo Speciality Hospitals, OMR performed a procedure to close the defect (hole) in the ear's acoustic canal containing the brain tissue that was exposed. Dr. Joy Varghese, Neurosurgeon opened/removed a small piece of the skull and peeled out the inner softer portion of the skull (the hard part was replaced from where it was removed from) and used it to seal the hole (10mmx6mm) in the ear, after removing the prolapsed part of the brain. ENT surgeon Dr. Krishna Kumar meticulously removed the prolapsed brain tissue and sealed the defect from below. Efforts of both the expert surgeons saved the 54-year-old man from a life-threatening problem.

Dr. Krishnakumar HoD, ENT, Apollo Speciality Hospitals, OMR explained, "It was an eight-hours long complicated surgery that saved the patient. Such occurrence is incredibly rare in adults, but the tough membrane around that part of the brain can occasionally rupture under pressure. The cause of this hole in his ear might have been a result of an accident that the patient met with 10 years ago or even a prolonged ear infection. If left untreated the patient might have had sequence of seizures and eventually collapsed."

Speaking about the procedure, Dr Joy Varghese and team at Apollo Speciality Hospitals, OMR, said. "In this case, the protrusion was a part of the temporal lobe, that is responsible for memory and emotions, removal of this would not affect the patient because it was such a small area and it was anyway scarred. Post-operative period was uneventful, with a very smooth recovery from anesthesia and complication free postoperative stay. Patient has recovered well and was discharged, a week after surgery."

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