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For patients unsuitable for surgical intervention, careful attention should be payed to keep the ear clear of infection, which may require antibiotics. Surgery aims to completely remove the cholesteatoma; the keratinised squamous epithelium and its surrounding cyst-like structure must be completely excised.
Exactly how the virus remains latent in the body, and subsequently re-activates, is not understood. Therefore any surgical procedure must aim to get clear excision margins, while preserving important local anatomical structures.
This involves making an incision behind the ear in order to gain access to the middle ear and mastoid bone. The initial infection with varicella zoster virus (VZV) causes the acute, short-lived illness chickenpox which generally occurs in children and young adults. Herpes zoster ophthalmicus involves the orbit of the eye and occurs in approximately 10% to 25% of cases. It is thought to result from the virus spreading from the facial nerve to the vestibulocochlear nerve.

Eric Slattery is a board-certified otolaryngologist who joined the ENT Center of Utah in 2015. Slattery graduated with High Distinction from Wayne State University School of Medicine in Detroit, Michigan and was inducted into the Alpha Omega Alpha Medical Honor Society. This usually involves removing the cholesteatoma itself, as well as the tympanic membrane and mastoid bone if they are involved. Once  resolved, the virus is not eliminated from the body, but remains dormant in the root ganglion cell. The pain may be mild to extreme in the affected dermatome, with sensations that are often described as stinging, tingling, aching, numbing or throbbing, and can be interspersed with quick stabs of agonizing pain. Antiviral medications, such as acyclovir or valacyclovir, can be given for 7 - 10 days, although the benefit of antiviral medications is uncertain. Sometimes strong painkillers are also needed if the pain continues even with steroids. Slattery’s interests include ear and skull base disorders such as chronic ear infection, cholesteatoma, acoustic neuroma, hearing loss, benign paroxysmal positional vertigo, temporal bone cerebrospinal fluid leak, paraganglioma (glomus tumor), tumors of the facial nerve, Meniere’s disease, cochlear implants, Bell’s palsy, bone-anchored hearing aids, vestibular neuritis, otosclerosis, superior semicircular canal dehiscence, and temporal bone encephalocele. If there is not much damage to the nerve, then you should get better completely within a few weeks.

Slattery conducted research on inner ear regenerative medicine and was published in numerous scholarly journals.
If damage is more severe, you may not fully recover-- even after several months. Overall, chances of recovery are better if the treatment is started within 3 days of when the symptoms begin. If treatment is started at this time, 70% of patients make a full recovery. However, when the treatment is delayed more than 3 days, the chances of complete recovery drop to about 50%. Slattery also completed a fellowship in neurotology, otology and skull base surgery at the Michigan Ear Institute. Children are more likely to have a complete recovery than adults. Recovery may be complicated if the nerve grows back to the wrong areas (synkinesis), which may cause inappropriate responses, such as tears when laughing or chewing (crocodile tears).

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09.10.2013 admin

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