Simple surgery helps many with hearing woes

November 19, 1990|By Sue Miller | Sue Miller,Evening Sun Staff

William Cook, 75, a northern Anne Arundel County retiree, felt he could no longer live "this way."

He never knew when he would start reeling, everything would go topsy-turvy and he would fall to the ground. He was afraid to get behind the wheel of his car or venture out. His independence was slipping away.

Once, after a sudden attack of spinning dizziness, he found himself flat on his face in a supermarket parking lot in Glen Burnie. The worst part was that "nobody even stopped to see if they could help," he said.

Strangers might have thought he had been out on a binge, but Cook was cold sober -- struggling with Meniere's disease, a vexing problem caused by an excess accumulation of fluid in the inner ear. The disease almost always affects only one ear; it rarely is found in both ears.

The buildup of fluid causes acute attacks of the disease that come and go, lasting minutes or hours. Vertigo is but one symptom. Sufferers hear weird sounds, like that of a waterfall, in their ears, have pressure in their ears and a hearing loss that can lead to deafness. Meniere's disease plagues millions of Americans.

A few months ago, Cook read about a new and simple surgery that promised good results, especially for the elderly. It was developed by Dr. John J. Shea Jr., of Memphis, Tenn.

Cook took the news clipping to Dr. Lewis Newberg, a Baltimore ear, nose and throat surgeon, and said, "Learn how to do this. I want to be your first patient. I can't go on living this way."

But, Newberg was one step ahead of Cook. The ear surgeon had already studied under Shea, who heads the Shea Clinic in Memphis. Early last month, Newberg operated on Cook at the Harbor Hospital Center, which is one of about 40 centers around the world that perform the operation. He turned out to be patient No. 2.

"The only problem I have now is a slight pressure in the ear and I think that will go away with time," Cook said. "The dizziness has stopped. My equilibrium is better. I haven't fallen since the operation and the ringing in my ears is gone."

The technique involves the insertion of a drop of streptomycin, an antibiotic used mainly in tuberculosis, into the lowest of the three semicircular canals of the inner ear, Newberg said.

"In this disease, the inner ear has too much fluid in it and it is stimulating its motion detectors and making the patient dizzy," Shea said. "The brain gets the wrong messages and the body goes haywire.

"This operation does two things: it destroys the motion detectors and it destroys the cells that produce the excess fluid."

The patient requires a little while to recover from the loss of the motion-detectors, so, he or she will be unsteady for a few weeks. But, after that, the patient should not have any difficulty in getting around, the two specialists said.

This week, Terra Fitzgerald, 73, a widow who lives in Brooklyn, is scheduled to be the fourth patient to undergo the same surgery in Baltimore. The procedure takes 60 to 90 minutes and requires general anesthesia and a one-night hospital stay.

Fitzgerald has lost the hearing in her right ear due to Meniere's disease and has "all these bad noises" in her ears and head all the time, she said. She also suffers from dizziness.

One night she and some friends went to a Randy Travis concert at the Baltimore Arena where there was "lots of noise and screaming that nearly drove me crazy," she recalled.

She could not sleep that night. "I was in bed and it was like someone had turned a tape recorder loose in my head," she said. "It was playing back the whole thing, including the crowds screaming and everything. That's what happens after I've been in crowds."

Fitzgerald said the roar of the sea in her ears is a constant companion, but she has learned to live with that. She hopes to get rid of the frustrating noises in her head and ears, the dizziness and possibly have some of her hearing restored.

"I wanted to do this operation because I felt it could help a lot of people and it's an easy operation -- as long as you don't slip," said Newberg, a board-certified ear surgeon. "You have to be careful because you're working in an area where you can do a lot of damage with a drill.

"The brain, the seventh nerve -- the nerve that we use to smile with -- and the cochlea, the hearing mechanism of the inner ear, are all nearby."

Newberg was also interested in this procedure because it seems to be particularly beneficial for the elderly, many of whom have failed other surgical remedies for Meniere's disease.

"The endolymphatic sac, the place where the excess fluid in the inner ear is supposed to drain to, tends to degenerate as the years go by and it gets smaller and smaller -- sometimes you can't find it," he said. "With the streptomycin technique, we don't have to worry about the sac. This is a more direct approach for patients over 65.

"We use this technique if the disease is limited to one ear, if the hearing is totally gone and the patients are still dizzy."

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