Wednesday, December 19, 2018

Medicine 

TN man undergoes rare surgery after insensate tissue from the brain was found oozing out of his ear

 
It was found that the fluid that kept oozing out through his ear was the cerebrospinal fluid while the pink mass on the external ear was insensate tissue from the brain.

Anjana Shekar 

 
Tuesday, December 18, 2018 - 19:38
 
L to R: K Krishnakumar, Loganathan and Dr Joy Varghese



Since 2012, 54-year-old Loganathan, an accountant from Tamil Nadu’s Namakkal district, has been suffering from intense bouts of headaches accompanied by a sharp pain in the right ear. This would then be followed by a fluid discharge from his right ear. “Sometimes, the cotton ball in my ear would soak up all the fluid and some would even drip onto my shirt. I wondered where all this water came from,” says Loganathan.

Loganathan, who met with a road accident in Erode in 2010, escaped with a head injury and a few months after the accident, he underwent surgery for tympanomastoidectomy (surgery to treat infections) in his right ear. This could perhaps have been the reason behind his intermittent ear pain and fluid discharge from the ear, opine doctors.

In 2012, when Loganathan reported his condition to his doctors in Erode, he was given ear-drops to “dissolve” the mass in his external ear.

In 2017, Loganathan’s ear pain and headaches intensified and this time, he had to deal with a constant, pulsating sound that he kept ringing in his right ear. “The sound would just not stop. It felt like I was living with two hearts - one in my chest and the other in my ear,” he shares.

After much deliberation, Loganathan was referred to ENT specialist doctor K Krishnakumar, who works at the Apollo in Chennai, where he underwent another surgery recently. Dr Krishnakumar found that the mass in his ear was actually a part of his brain.

Speaking at a press conference, Dr K Krishnakumar said, “I found that the fluid that kept oozing out through a hole in his ear was the cerebrospinal fluid, the pink mass on the external ear was a part of his brain and the pulsating sound was actually the brain’s pulse.”

Fungus Cerebri, as this rare phenomenon is called, is an unusual term, given that there is no connection with the clinically defined fungus. This actually refers to the brain herniating into the ear, which occurs when a part of the brain is squeezed across structures in the skull and as a result, high pressure builds up within the skull.

Dr Joy Varghese, Neurosurgeon at Apollo, who operated Loganathan shares that the condition could have worsened and caused severe complications if was not treated immediately.

“The cerebrospinal fluid (CSF) that surrounds the brain matter was the fluid that was dripping through his ear. Also, the pink and insensitive mass that was filling his external auditory canal was actually a portion of the temporal lobe. This could have caused severe infections in the brain if left unchecked. He was highly fortunate that he did not develop any complications,” he shares.

After the surgery on November 26, which lasted up to eight hours, Loganathan was closely monitored for post-op complications.

Dr Joy clarifies that the mass, which was removed from his ear, would not cause any brain damage to the patient.

“In this case, the protrusion was a part of the temporal lobe, which is responsible for memory and emotions. The removal of this would not have affected the patient because it was such a small area and it had scars,” he tells us.

Dr Joy also remarks that this could have been the first of its kind surgery in the country. “We checked available records of similar instances but while it is common for such prolapses in the middle lobe, cases of such a mass in the external lobe are extremely rare,” he shares.

The doctors also stressed how unwise it would be to introduce an object such as cotton buds or Q tips, usually meant to clean the ear, especially since the ear is an extremely sensitive and tender body part. Its proximity to the brain and the thickness of its walls make it one of the most delicate body parts and any minor accident could pose danger to the brain.

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