Surgery performed on man after brain prolapses via ear

“It was like living with two hearts,” 54-year-old Loganathan of Namakkal summed up how his life has been for the last few years. The non-stop pulsating sound in his right ear resounded with that of his heart. Little did he or his surgeon realise that it was the brain that had prolapsed into his right ear through a hole in the upper wall of the inner ear. A road accident in January 2010, in which he sustained a head injury, and an ear surgery three months later, impacted his life quite seriously. Two years after the surgery, he started experiencing severe ear pain and a watery discharge. “If I applied three drops of ear drops, at least 20 drops of fluid leaked out. My shirt used to get wet and this puzzled me,” he said. Continuous treatment did not help, and frustrated, Mr. Loganathan sought help in Chennai. A CT and MRI scan found that the brain had slipped or herniated into the ear, doctors said. When a surgical intervention was planned in Erode, doctors diagnosed him with hepatitis B, and referred him to Apollo Speciality Hospitals. K. Krishnakumar, head of department, Ear Nose and Throat, Apollo Speciality Hospitals said he has not seen such a case before. “We found a pink, pulsatile, soft and insensitive mass in the right ear. It did not bleed on touch and on gentle probing all around, we found it was not attached. We were sure we are dealing with brain tissue in the ear. The discharge was actually the cerebrospinal fluid. Fortunately, it was intermittent, and hence did not cause any complication,” he told reporters on Tuesday. Mr. Loganathan had a huge hole in the upper wall of the inner ear via which a small portion of the brain’s temporal lobe was prolapsing. Joy Varghese, senior consultant, Neuro Surgeon and Interventionalist, said the brain always pulsates with the heart, and hence, the patient kept hearing the sound of two hearts beating. “This part of the brain carries some of the fibres of the vision. More prolapse could have caused more damage leading to vision disturbances,” he said. Elaborating on the eight-hour surgery, Dr. Varghese said, “The skull has two layers. We split the bone, using one layer (inner part) to block the hole, a split calvareal graft.” Dr. Krishnakumar removed the prolapsed brain tissue and sealed the defect from below.

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