Lorraine Poppleton saw 24 doctors in the course of a year, but they were dismissive of her bouts of dizziness, ringing in her ear and the intrusion of an occasional whistling and tapping sound like Morse code.
“They told me I was crazy, that it was just in my head,” says Poppleton, a legal secretary at an international law firm in midtown Manhattan. “I couldn’t walk straight. I would veer to the right and was unsteady when standing and dizzy when sitting. Then one day, I was getting up and it felt like someone who weighed a ton flattened me back into the bed.”
She credits New York neurologist Joseph C. Casarona, M.D., for being the first doctor to take her condition seriously. He prescribed medication for her vertigo, but it only gave her relief for two days. Casarona then ordered an MRI which revealed Poppleton had a tumor growing on her auditory nerve — an acoustic neuroma.
Poppleton’s situation is a classic example of a patient whose quality of life would have been unnecessarily damaged by the most widely used surgical approach to remove an acoustic neuroma. There are options out there that can preserve hearing in a large percentage of acoustic neuroma cases.
Poppleton’s tumor remained stable for about a year and a half, but a follow-up scan in 2009 showed it was growing.
“They told me, ‘It’s on the move,” Poppleton recalls.
She sought out three opinions from doctors at major New York medical centers. They all recommended removing the tumor using a translabyrinthine approach, which enters the auditory nerve canal through the mastoid bone behind the ear. The technique always results in a complete loss of hearing.
“They all told me the same thing,” she says. “I’d lose my hearing. I could expect facial paralysis. My life would never be the same. I was told by one very prominent doctor that if his colleague who had undergone this surgery could live with the side effects, so could I.”
Poppleton thought she had no choice. The young, active grandmother either had to undergo surgery that she was told might put her into a wheelchair for the rest of her life or risk the tumor spreading to her brain.
Two weeks before her scheduled surgery, however, her son-in-law, a house officer in U-M’s Department of Dermatology, informed her of an interdisciplinary program at U-M skilled in newer techniques. The team offers an innovative approach that studies have shown has an 80 percent success rate for preserving hearing.
The middle fossa microsurgical technique, as it is called, approaches the tumor from above the ear. Doctors at U-M have refined this technique over time, innovating the use of a wider opening that gives the surgeon more room and a better angle from which to attack the tumor, and employing sharper tools allowing for the preservation of the auditory and facial nerves.
Not long after contacting U-M, Poppleton flew to Michigan, where she had a series of preoperative tests on a Thursday and Friday. On Monday she had surgery.
She was released less than a week after the successful operation by Doctors Telian and Thompson. She was able to hear normally and soon was back at work full time, and back to jogging, playing tennis, dancing and trying to keep up with her five grandchildren.