The left eardrum has a substantial tear which has been there for years. The examining doctor today was able to see right through it into the inner ear (using his normal scope.) The drum membrane is scarred and brittle, so it's not doing its job of vibrating when sound hits it and sending those vibrations into the little bones of the inner ear which are wired up to the brain. No idea what the cause of the tear was; obviously it wasn't there when she had tubes put in back in September 2007. Sometimes there can be a weak spot in the eardrum tissue and once a hole develops it can tear just like in a piece of fabric.
Surgical repair is the plan. There are two options - but we probably won't know which one we have to use until Wynn is on the operating table and the surgical team is attempting the repair:
1. "Patching" the tear using a small amount of tissue they would harvest from Wynn's jaw muscle. This would be a very thin layer of course, and it would serve as a base for her eardrum tissue to grow into. This surgery would take about an hour and recovery time would be a week or so.
2. A "lateral graft" - which is more like a total rebuild if they find there isn't enough viable eardrum tissue remaining to make the "patch" work. More muscle tissue would be needed, and the ear would need to be packed up for about 3 weeks to heal. This procedure would have her in surgery for 2 hours or more.
To make sure there aren't any other surprises hiding in her inner ear, after the exam we were sent downstairs to the Children's Hospital radiology department for a quick CT scan of Wynn's head. The rad tech was great, showing Wynn all the parts of the CT scanner, how the platform raised and moved through the machine, and what she'd need to do. (She loves to see people doing science and having scientific tools explained to her.) I put on a lead suit and stood next to my daughter as she got strapped in and the machine started its work.
Wynn was very, very good at keeping still, and the whole time she had to be strapped in was less than five minutes. No complaints, and the tech said she got good images.
We have a CD with the data, and a follow-up visit with the ear doctor next Tuesday to review it, determine the next steps, and probably get the repair surgery scheduled.
The start of the school year is coming up fast for Wynn and Ann - of course we'd like to get through this development as soon as we can to make kindergarten as enjoyable as possible.