Subtle Symptoms Point to Benign Brain Tumor
March 03, 2017
Her tongue tingled and her hearing was muffled, like a radio station with a fuzzy signal. And that was only on her right side. Her left eye was itchy, inflamed and continually irritated.
Those seemingly minor symptoms hinted at a larger problem: a brain tumor.
“I was blaming things on being older, but subtly, in retrospect, it all led to the tumor,” said Ellen Snider, 50, an audiologist with 25 years of experience who trusted her instincts to seek a professional opinion.
The Lakewood woman had developed a slow-growing tumor on the main nerve leading from the inner ear to the brain. Branches of this nerve influence balance and hearing. Pressure from this type of tumor can cause hearing loss, ringing in the ear and unsteadiness. While this meningioma is non-cancerous, it can cause a multitude of problems as it expands.
Otolaryngologist Cliff Megerian, MD, and Neurosurgeon Nicholas Bambakidis, MD, in a collaborative surgery typical of specialists at University Hospitals Cleveland Medical Center, performed the precision surgery to remove the large tumor from Ellen’s brain stem.
“It is a very vital area,” said Dr. Megerian, Chairman of the Department of Otolaryngology Head and Neck Surgery at UH Cleveland Medical Center. “This is the epicenter for many important life functions of the central nervous system, including breathing and swallowing. Any tumor, even a non-malignant one, can be dangerous in this location.”
Skull base surgery such as that performed on Ellen requires a high-tech operating room using real-time neuronavigation to track progress in removing the tumor. Through a small incision in the base of the skull about the size of a quarter, the surgeons use microinstruments to reach the cerebellum and brainstem. The patient recovers for a few days in the Neurosurgical Intensive Care Unit.
“This precise surgery is best done at a high-volume tertiary center, with all the specialties in one place,” said Dr. Bambakidis, Director of Cerebrovascular and Skull Base Surgery at UH Cleveland Medical Center, adding that gamma knife technology, proton radiation therapy and rehabilitation services are all available on UH’s main campus. “Ellen’s problem was unique because she had a large, benign tumor, but it was close to a lot of delicate structures.”
In carefully removing the tumor, surgeons hope to preserve the patient’s hearing and the nerves that give a person’s face expression.
“At the time of discovery of the tumor, everything was functioning,” Ellen said. “Without these nerves intact, there’s no smile, no eyebrow lift. It could be very disfiguring. The risk of losing that was real, and the risk of losing hearing was even greater.”
Dr. Megerian, who specializes in conditions of the ear, nose and throat, was pleased that they were able to completely preserve Ellen’s hearing – vital to her work as an audiologist, as well as mother of two teenagers. In less than two months, Ellen had returned to work and was attending her children’s cross-country meets with her husband, Al.
The stuffiness and static in her ear has abated. The only lingering effect is minor numbness on the right side of her face, which may take another 18 months to resolve. “I feel very blessed,” said Ellen.