Surgical solution: Ear specialist helps her hearing, balance problems
They weren‘t life-threatening, but the symptoms that plagued Jolie Bower were so debilitating she had to stop working.
She had a spinning sensation of vertigo and nausea that would come on without warning. Her head would feel like a bowling ball and her neck a toothpick. She was laid out on the floor for hours at a time.
Today the Onondaga Hill Middle School health teacher is back to a job she loves – and she credits Upstate otolaryngologist Charles Woods III, MD.
“I‘m so fortunate that we have him here in Syracuse,” she says. “What he did for me was huge.”
Bower, of Liverpool, developed vertigo in 2006. Her primary care doctor sent her to an ear, nose and throat doctor who diagnosed Meniere‘s disease and prescribed motion sickness medicine, a low-salt diet and a medicine to help reduce the fluid from her inner ear.
Those measures over the years did not relieve her symptoms. Eventually Bower took medical leave from her job and got an appointment with Woods, an Upstate otologist, an ear, nose and throat doctor who subspecializes in disorders of the ear. He is an assistant professor of otolaryngology and communication sciences at Upstate.
He explains that Meniere‘s can affect hearing and balance, both of which are controlled in the inner ear.
“I always tell patients I don‘t like the name ‘disease‘ because it‘s an inner ear that‘s not functioning correctly,” says Woods. “The inner ear is made up of both the hearing side of things and the balance side of things.”
Patients can experience progressive hearing loss as the hair cells in the cochlea (part of the inner ear) are damaged, and they may report a feeling of fullness in the ear. Woods says that sensation comes from increased pressure within the fluid spaces of the inner ear.
No one knows what causes the increased pressure, but he says it‘s similar to the eye disease glaucoma. Increased fluid pressure inside the eye can lead to retinal damage, while increased fluid pressure in the inner ear can cause progressive neural damage.
Tinnitus is also a common symptom, with sounds ranging from high-pitched hisses to the sound of a seashell cupping the ear.
The most debilitating symptom is vertigo, a sense that the world is spinning.
“If we can at least alleviate that symptom for people, the disordered ear is much more bearable,” Woods says.
In Bower‘s case, Woods initially operated to install a shunt in her right ear, which spared her hearing. For two years, Bower says, she felt better. “Then it came back with a vengeance,” and her hearing in that ear was distorted.
Woods describes a variety of treatment options ranging from steroid and antibiotic injections to the severing of the balance nerve in the inner ear.
Bower opted for another surgery called a labyrinthectomy, in which her inner ear was removed. This meant she would lose her hearing in that ear, and physical therapy would be part of her recovery as she worked to retrain her brain, regain balance and recalibrate her vision.
“The brain is pretty amazing in what it‘s able to do,” she says. “My good side took over for my bad side.” Bower felt like she was back to normal about three months after the surgery.
She is deaf in her right ear, but Bower hopes to get a bone-anchored hearing aid that will send sound through bone to her good ear.
Woods says more than three-quarters of people with Meniere‘s disease control their symptoms with a low-salt diet and diuretic medication.
“Because the disease is intermittent, we‘re not sure exactly how long and what period of time we need to treat people,” he says. “Oftentimes, it‘s at least intermittent treatment, lifelong, because the disease is not going to go away. It‘s going to plague the patient, intermittently, through their life.”
Patients are likely to have quiet periods of several years where they don‘t need treatment. When symptoms become debilitating, Woods says it‘s time to consider other treatment options.
Reach Woods and other providers in Upstate‘s Ear, Nose and Throat Clinic at 315-464-4678.
This article appears in the winter 2018 issue of Upstate Health magazine. Hear Woods discuss Meziere's disease in a "HealthLink on Air" podcast interview.