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HeadLines - Giving a Patient a New Life
Giving a Patient a New Life
Date: May 1, 2014
Last February, John Carey received an ultrasound image that none of his medical training as neurotologist had prepared him to interpret. But the accompanying letter made its significance very clear.
“Due to your repair surgery,” wrote his patient, Jennifer Hanna, “I no longer have nausea when I roll over in bed or have the car’s windshield wipers on the highest setting. As you will see from the attached ultrasound, I have a new miracle that is my current source of nausea! I can’t even fathom being pregnant without the SCD repair.”
SCD, short for superior canal dehiscence, is a rare condition caused when one of the skull’s temporal bones—the bone directly over the temple, near the ear—develops a hole, leaving the ear’s superior semicircular canal relatively uncovered.
Because this canal is responsible for controlling balance but is also coupled to the hearing part of the inner ear, the cochlea, patients like Hanna develop an array of confusing symptoms. These include hearing the body’s quietest sounds, such as eyes moving around, and dizziness and nausea when they hear a loud sound.
Hanna’s odyssey started in October 2010, when she noticed that her voice sounded funny, like she had a cold. After months of this sensation, Hanna saw her primary care physician, and later, an otolaryngologist. Neither could tell her what the problem was.
The following June, she met with another specialist, who diagnosed her with SCD and told her it was something that she’d have to live with.
But her symptoms were worsening by the week. Hanna had developed sound-induced vertigo, so she couldn’t attend church without earplugs or listen to the radio in the car. Sudden loud sounds, like a dog barking, “almost brought me to my knees,” Hanna says.
Turning her head made her dizziness and nausea worse, so she couldn’t drive more than 20 minutes at a time. “I started losing my independence,” she says.
Hanna was desperate for help, but only an operation that involved opening her skull to plug up the hole and resurface the temporal bone would fix the problem. In November 2011, she asked her doctor for a referral to a surgeon experienced in treating SCD. He suggested Carey.
Carey quickly realized that Hanna’s SCD problems were muddled by frequent migraines, making it difficult to confirm the cause of her nausea and dizziness. Because the SCD operation can make migraines worse, he first worked with Hanna to reduce the number and severity of her headaches.
Once they were confident that her lingering vertigo would improve with SCD surgery, they scheduled the procedure for September.
When Hanna woke from surgery, she knew she was better right away. “It was an immediate end to my problem,” she says. “I felt normal again, and when you have this disease, all you want is normal.”
Before the operation, Hanna and her husband, Gregory, couldn’t imagine bringing a baby into their lives. But with her SCD resolved, they felt comfortable moving on with their long-held plans to have a family. Hanna learned she was pregnant in February 2013, and her daughter, Mary Elizabeth, is now 5 months old.
“I don’t think I realized until she sent me that letter how profound an impact her condition had on her life,” Carey says. “This is why I went into otolaryngology–head and neck surgery—the ability to make that kind of difference for someone.”