November 9, 2015

In the long run

A U study evaluates whether a certain surgical technique to remove acoustic neuromas can preserve hearing in both the short and long term

Sally Rothmeyer still remembers the day in 1994 when she started feeling a little “off.” The Apple Valley, Minn., resident had recently returned home from a Twins game in Baltimore, so she attributed her dizziness to the previous day’s travel.

But when Rothmeyer tried to get out of her bed that morning, “it was as if someone slapped me back down,” she says.

She immediately went to see her primary care physician, and later a community otolaryngologist and a neurosurgeon, but she kept having dizziness episodes that sometimes included falling. Her friends insisted that she get another opinion.

Rothmeyer wanted to go somewhere “big,” so she chose the University of Minnesota.

“I remember being in the office at the U and calling one of my friends,” she says. “I told her, ‘I think I’ve been shopping at Kmart, and I’ve landed at Saks Fifth Avenue.’”

Her care team at the U included neurosurgeon Stephen Haines, M.D., and otolaryngologist Samuel Levine, M.D. Using fairly new imaging technology for the time, they detected an acoustic neuroma—a tumor that arises in the ear’s internal auditory canal, the tunnel through which balance, hearing, and facial control nerves run.

Because of the tumor’s placement and the nerves involved, there was a chance that if Haines and Levine used the standard procedure to remove it, Rothmeyer could lose hearing in that ear.

Fortunately for Rothmeyer, Haines and Levine had been researching a new neuroma-removal technique.

“When we switched to the new approach, our results immediately improved,” Haines says. “About 70 percent of our patients retained their hearing.”

Rothmeyer would become one of the earliest patients to have surgery using this technique, which is still used today. She came out of surgery with her hearing intact.

And now, more than 20 years later, Rothmeyer is helping the University team gather evidence to answer another important question: Do patients whose hearing was preserved using this technique undergo a natural age-based hearing decline, or do they lose their hearing more rapidly?

Haines and Levine had initially published the improved results they were getting using the new surgical technique in 1993. As more patients had the procedure, Levine kept adding them to a database he’d started. “The thing that’s powerful is when you get 25 to 30 years’ worth of data,” he says.

As part of the current study, Rothmeyer went back to the U to have her hearing and facial control evaluated. Her information was added to Levine’s database.

“If it turned out that we preserved hearing right after surgery, but it was all gone in five years, that wouldn’t be a strong reason to have the operation,” says Haines. “But if it’s going to last the rest of their lives, it would make a huge difference in indication for the surgery. It made a big difference for Sally.”


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