Prosthetic ear helps new mom find closure after adenoid cystic carcinoma treatment
Kellie Bramlet Blackburn and April Clayton
In June 2021, Georgie Dehnert was finally able to truly hear her 1-year-old daughter’s sweet giggle for the first time. Seven months into her pregnancy, Georgie had discovered a mass that would later be diagnosed as adenoid cystic carcinoma, more commonly called ear canal cancer. She lost her hearing in her right ear, and every cry, every coo from her daughter was at best quiet or muffled
But after five surgeries, 30 rounds of radiation and the loss of her right ear, Georgie is now cancer-free. And thanks to a permanent hearing aid, she’s able to hear her daughter at full volume. She was recently fitted for a prosthetic ear.
“It hasn’t been easy,” Georgie says. “But it has taught me to be grateful for the good things in life.”
An adenoid cystic carcinoma diagnosis
In May 2020, Georgie began experiencing ear pain. In addition to the discomfort, she noticed her right ear canal seemed to be closing. Her doctor assumed she was suffering from an ear infection and prescribed her antibiotics. When the symptoms didn’t change, Georgie had an MRI, which revealed a mass. She would need surgery, but she decided to focus on the upcoming birth of her first child. She postponed the surgery and monitored the mass through her last trimester of pregnancy.
On July 2, 2020, Georgie gave birth to a healthy baby girl named Margot. Three weeks later, she had her first surgery to remove the mass at a hospital in Houston. A biopsy revealed the mass was cancerous. Her doctor referred her to MD Anderson.
“I know there are other places to receive care, but I’d just heard about MD Anderson so much,” she says. “When I talked to people about cancer treatment, the common theme was MD Anderson.”
Her first day at MD Anderson started at 7 a.m. Due to visitor restrictions put in place to protect patients from COVID-19, Georgie’s family was unable to accompany her. She felt overwhelmed, until she met Paul Gidley, M.D., a neurotologist who specializes in ear canal and temporal bone cancers.
Right away, he put Georgie at ease. He explained that Georgie had a rare cancer in a rare location. Ear canal cancers only occur in about one person out of 1 million each year. Adenoid cystic carcinoma accounts for only 10% to 20% of ear canal cancers. But Gidley knew just how to treat it: surgery to remove the area surrounding the original mass and six weeks of radiation therapy to ensure the cancer was gone and wouldn’t return. He took time to talk to Georgie and listen to her questions. Together, they fawned over pictures of baby Margot. He suggested they place a video call to Georgie’s husband, Aaron, to see if he had any questions. Gidley explained that the location of the mass would leave Georgie partially deaf and she would need a hearing aid, but MD Anderson’s experts would help her find the right one and adjust to using it. He was confident she would overcome cancer. There was a chance she would lose her ear, but her care team would do everything they could to avoid that.
A second surgery
Five weeks later, Georgie underwent a second surgery. Gidley and head and neck surgeon Neil Gross, M.D., removed the bones in Georgie’s ear that had surrounded the mass, along with her ear canal and ear drum. Plastic surgeon Rene Largo, M.D., then relocated skin and soft tissue from her thigh to the skin surrounding her ear by connecting this flap of tissue to the blood vessels in the neck. Finally, a small titanium fixture – part of a Baha implantable hearing device – was put behind her ear. Later, Georgie would attach her hearing aid to this fixture, and it would transfer sound across her bone to her cochlea, allowing her to hear at full volume again.
Georgie stayed in the hospital for five days after the surgery. She missed Margot and her husband, but her friends and family helped by setting up frequent video calls. Understanding how hard it was for her to be away from her family, nurses stopped by regularly to talk with Georgie.
“They were so sweet,” she says. “I always felt like someone was around to visit with me.”
Completing two types of radiation treatment
Becoming a first-time mother and undergoing cancer treatment in the middle of a pandemic was a heavy load.
“We totally focused on Margot and my treatment. Everything else dropped off,” Georgie says. “When you’re in the moment and you have no other choice, you just figure it out.”
By Christmas that year, Georgie had completed treatment and was cancer-free. Best of all, she got the gift she most wanted: celebrating Margot’s first Christmas as a family. Her family even had a bell for Georgie to ring, marking the end of her treatment.
“After the year we had, this was a very special moment,” Georgie says.
Creating a prosthetic ear
Georgie wasn’t completely satisfied with the appearance of her reattached ear. It seemed to stick out too far and didn’t look as even as she had hoped. In June 2021, she underwent an additional procedure to improve the appearance and continue the process of implanting the Baha hearing aid system. The surgery went well, but Georgie later suffered an infection because the skin around her ear wasn’t receiving enough blood. She had an additional surgery in July 2021 to try and save her ear, but unfortunately there had been too much trauma to her ear at that point. She started to consider having her ear removed and replacing it with a prosthetic ear.
To help make this difficult decision, Georgie and her husband met with Pattii Montgomery, a senior anaplastologist. Montgomery reassured Georgie that the ear would look just like her other one and showed her photos of prosthetic ears she had created for other patients. Georgie decided this was the best option for her.
Montgomery began working with Largo to create the perfect ear for Georgie. Together, they determined which parts of the ear they would need to remove and what would need to remain. They wanted to ensure that it would be easy for her to take on and off, since she wouldn’t be able to wear the ear while sleeping or get it wet. Then, Montgomery created an illustration of what the ear would look like and sent it to Largo and Georgie for approval.
Once they had settled on the design, Georgie underwent another surgery in October 2021 to prepare her ear for the prosthetic. Meanwhile, Montgomery continued creating the prosthetic ear. She used a CT scan to create and 3D printed model, then a wax pattern mold that she injected with silicone to create the ear.
Georgie returned for several more appointments to undergo fittings and see how the ear was coming along. During these appointments, Georgie spent hours in the clinic while Montgomery worked. About every 20 minutes she would try the ear on Georgie to see what it looked like, then return to her lab to make the necessary changes, adjusting the shape to fit and painting it to match her exact skin tone.
On Feb. 25, Georgie received her prosthetic ear, along with a backup. Now she could finally wear earrings and sunglasses and not worry about an awkward stare from a stranger if she wore her hair in a ponytail.
“It's taken a bit of practice to glue it on in the right place and then take it off at the end of the day, but I am slowly getting there,” Georgie says. “It looks amazing, and I'm so happy with the result.”
Gratitude after cancer
Becoming a cancer patient just three weeks into motherhood had a profound impact on Georgie. She learned to ask for help when she needed it and to let others know what she was feeling. Cancer made her unafraid to share so she could let others in and let them know she was struggling. But most of all, it made her more grateful.
“Even though Dr. Gidley assured me I was going to beat cancer, I couldn’t help but wonder sometimes if I wouldn’t be there to see Margot grow up,” Georgie says.
When she had to do chores she would have dreaded in the past, she instead focused on how lucky she felt to be there to care for Margot.
“I would think, I get to wash her bottles, or I get to pack her backpack,” Georgie says.
Now Georgie’s no longer focused on cancer treatment. Instead, she’s thinking about baby-proofing and chasing around an energetic 20-month-old. She’s grateful she gets to see – and hear – it all.