Once more into the breach (in my skull)

Next week I’m scheduled for another major head surgery. I’ve been through this twice before, and I think the third one is going to be similar. My neurotologist says I have what’s called an encephalocele. That means that part of my brain is oozing out of the brain cavity. In my case, it’s drooping down through a hole into my middle ear, and impinging on the malleus bone, just like in the drawing below. The hole isn’t supposed to be there, but in my case, for whatever reason, the bone that supports the brain is very thin. That’s why I had superior semicircular canal dehiscence (SCD) on both sides.

Encephalocele Schematic

The encephalocele would explain the symptoms I’ve had for the past 14 months since the SCD repair on the left side in November 2013. Since then, the sound of my own voice in my ear has been achingly loud. I’ve been able to hear my pulse almost non-stop. I can hear my eyeballs move left and right, can hear my eyelid muscles close my eyes, and can hear every little internal noise my body makes — stomach acid moving around, knees popping, fluids moving through my skull, etc.

I had an encephalocele before, on the right side. My surgeon noticed it when he was operating on me to repair the SCD on that side. And so he carefully pulled my brain up out of the hole it was falling into, and repaired the hole with bone cement. Unfortunately, he also changed his surgical procedure for SCDS, and the new approach didn’t allow him to notice and fix the encephalocele. So now he’s going back in to fix that.

Dr. Gianoli

Surgery will be in Covington, Louisiana. That’s not the first place that comes to mind when you think of cities with a reputation for advanced medicine, but that’s where Dr. Gianoli lives and practices. So people visit him from all over the world for these type of surgeries. From what I can tell, he has more experience doing these operations than any other surgeon on Earth right now, so I’m in good hands.

It’s a major surgery, so recovery will be a little intense at first, but it should be easier than the first two operations I had. I’ll most likely spend two nights in the hospital (one in ICU and one in a regular room), and then a few more days of bed rest in a hotel. A week after surgery we’ll fly back to Denver, where I’ll spend at least one more week resting and recovering at home. I hope to only need to take off about two and a half weeks of work. But I won’t push it, since healing properly is a higher priority than work. For the previous two surgeries, I took off a month each.

There’s a web forum called SCDSsupport.org where I’ll be journaling my progress in more detail, for the benefit of other patients who are faced with the same issues. But for those of you who are interested in the gory medical details, here’s a good web page I found that explains what’s going on, along with some pictures.

Surgery is planned for Friday February 27, 2015. I’d love to hear from you during my recovery over the following two weeks.

Oh, and if you want to read about my skull’s whole hole history, here are all the blog articles I’ve written about my ears over the years.

Categorized as Ears


  1. Hey Todd

    That’s quite the procedure. I bet you won’t miss hearing your pulse every minute, of every day! That must be quite annoying. I’ll be thinking of you!


  2. How exhausting it must be to hear every. little. thing.
    The diagram is helpful; encephaloceles aren’t common at all, are they?
    I’m glad that you’re going to be in good hands with a skilled surgeon; still, I’m sorry that you’re going through brain surgery again.

  3. Thanks, Todd, for the details so that we can better understand. As they say, 3rd time is a charm (well, that wasn’t true for my 3rd try for a Stone’s Sheep but you’re in better hands for your situation than I was). Keeping you in my prayers.

  4. Best of luck to you, Todd – sounds like you’re in good hands. I’ve never heard of this, sounds rare – I bet you’ll pull through and recoup just fine!!

    – Helen

  5. Thanks for stopping by, everyone, and leaving a comment. I’m writing this four days after the surgery, and things seem to be healing properly from what I can tell. The surgeon did find that it wasn’t an encephalocele as he originally thought, though. You can read more about that on the next article, right here.

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