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School of Medicine
HeadWay - A Resounding End to Otosclerosis
HeadWay Winter 2013
A Resounding End to Otosclerosis
Date: December 12, 2012
By removing diseased bone and replacing it with a prosthesis, Matthew Stewart restored his patient’s hearing.
Claudia Dewane first noticed that her hearing was fading more than two decades ago, when she was pregnant with her first child. By the time she was expecting her second, the decline was much more obvious—enough to finally drive her to see an otolaryngologist-head and neck surgeon.
“He said, ‘Didn’t anyone ever tell you not to get pregnant?’” she remembers. He diagnosed her with otosclerosis, a condition in which the body’s smallest bones become inflamed and covered with abnormal growths of spongy bone. More women than men develop otosclerosis, which is often progressive with pregnancy. In Dewane’s case, the stapes—the smallest bone in the chain that conducts the mechanical energy of sound—bore the brunt of her disease.
For years, Dewane made the best out of her hearing loss and buying progressively more powerful hearing aids. It wasn’t until her job as an associate professor at Temple University’s School of Social Work began to suffer—enough that she thought about retiring early—that she started to seriously consider seeking treatment. “I couldn’t hear my students,” she says. “It was really a sad time for me because I thought I’d have to give up what I love.”
Thinking it was now or never, Dewane called Johns Hopkins and made an appointment with otologist Matthew Stewart. Topping Dewane’s list of options, Stewart says, was surgery. “Otosclerosis is one of the few types of hearing loss that we can help with surgery rather than hearing aids,” he says.
But Dewane just wasn’t ready. The procedure had a small risk of causing vertigo—a problem she’d struggled with before, for unrelated reasons—as well as a small risk of worsening hearing. Over the next year, Stewart helped her explore other potential treatments, including trying out a demonstration of a bone anchored hearing aid, which improves hearing by bypassing the bones in the middle ear.
However, nothing was effective. Eventually, Dewane told Stewart that she was ready to set a date for surgery in August 2010.
Because her otosclerosis was bilateral, the two agreed that the operation would be on her worst side, the right ear.
Stewart led a team of surgeons as they entered Dewane’s ear canal, lifted up a small flap of her eardrum and removed the majority of her diseased stapes. They replaced it with a prosthesis attached to the incus, another hearing bone, creating a new chain in the middle ear to conduct sound.
When Dewane woke, preliminary tests showed that her hearing was already better. More proof came over the next several weeks. As she showered one morning, Dewane noticed a strange noise. It was water trickling—a sound she hadn’t heard in years. Eventually, she could once again talk on the phone, appreciate music and distinguish bird calls, reigniting an interest in birding she shared with her husband.
The change was so dramatic and life-changing that Dewane decided to proceed with surgery on her other ear two years later. The recovery was even faster this time around, quickly giving her the ability to hear in stereo and distinguish from which direction sounds come.
Now, Dewane says, she’s able to continue doing the things she loves, including teaching, playing the dulcimer and chatting with her husband.
“When I first met Dr. Stewart, he wanted to get to know me as a person, not just as a hearing problem,” she says. “Now I have a second lease on life.”