At least after the MRI, I wasn’t left wondering about the unknown. A vascular tumor like a Glomus Tympanicum could be more authoritatively ruled out. My ear problem also wasn’t as simple as just blood, it was in fact a Cholesterol Granuloma – a rare and benign cyst. These are also found to occur at the tip of the petrous apex (the part of the skull next to the middle ear). In my case, the granuloma formed in my middle ear and is luckily more accessible. The cyst is an expanding mass filled with fluids, lipids, and cholesterol crystals (which is what gives off the characteristically bright T1 and T2 images). It’s likely I’ve had this granuloma for many years, but the root cause is hard to accurately determine due to the condition’s heterogeneous nature; however, my previous bouts with chronic ottis media is certainly a suspect.
I asked Doctor K to submit for me a second opinion with another ENT at a different location. Now on my third Doctor (who was thankfully genial and adept), I went to another follow up appointment to review the results of the MRI, and to discuss the surgery plan. Surgery was inevitable by this point, but the path was now fairly clear. A full tympanomastoidectomy was still an option, although I obviously preferred not to undergo such an invasive surgery. Due to the more viscous and liquid-like nature of a Cholesterol Granuloma, as opposed to being a solid vascular mass, utilizing a transcanal method to drain and evacuate was deemed not unreasonable. My eardrum would need to be cut and lifted up to allow access.
After the appointment, my surgery date was set. I had 2 more weeks to wait out, and I did my best to keep my mind off the subject. Ever since I first found out that there was something abnormal inside my ear, I sort of lived in limbo. I stayed off my bikes and refrained from physically strenuous activities. Essentially, I went through the day to day motions, while slowly seeking an answer to this problem. Now with a course of action in place, all I wanted was to get this over with and return to a normal life.
With surgery day upon me (01/24/12), I went into the hospital feeling decently in control. It wasn’t until I was fitted in the gown and laying on the table in the pre-op area that the anxiety started to build.
I had a delicate last-minute discussion with my Doctor/Surgeon to clarify the procedure, and then it was go time. A nurse buried an IV needle into my left arm and I was slowly pumped up with an impressive arsenal of drugs, from morphine to who knows what else. They wheeled me off into the operating room. The last thing I can remember was observing one of the large over hanging lights, and pondering a trivial detail (like where it was made, since it looked rather intricate) to myself. The next thing I knew, I woke up and felt like I hadn’t slept in years. The surgery was done, and I snoozed off for another hour in the holding area. I eventually got back home, took a Vicodin pill, and went back to bed.
The whole surgery experience was quite thorough, the hospital had a whole team of people with different responsibilities catering to me. I still need to go over the details of the surgery with my Doctor next week, but I know that a Myringotomy was also done with an ear tube to provide further ventilation. As for the day after surgery, I could really feel the side effects of the general anesthesia. I felt worn down and my neck and jaw muscles were very sore. I also had a sore throat from the Endotracheal breathing tube placed in me. My ear has moderate pain and pressure, but is otherwise manageable. Currently, I’m bumming it at home and taking it easy until I can recover more. I have to watch out for discharge from the ear and my hearing is muffled.
Although my problem wasn’t life-threatening or a huge deal in the scheme of things, it still underlines the importance of good health. A bump in the road like this can throw off your quality of life measurably. I am eager to put an end to this experience, and to continue life with healthier and more productive objectives for 2012.