Mix the pork sausage ingredients and reserve. If you have time, do it the night beforehand for the best flavor.
Pasta
In a large skillet, heat the oil and add the sausage. Cook over medium-high heat, breaking the sausage up with a spoon and scraping the bottom to remove browned bits.
When the sausage is cooked, add the onion and garlic and a little extra oil if the pan threatens to dry out. Cook for 2-3 minutes, until the onion is translucent. Add the wine and cook down by half. Add the truffle cream and bring to a simmer until slightly thickened, a couple minutes.
Bring a large pot of lightly salted water to a boil. Cook the pasta until al dente and add to the pan. Reserve some pasta water and add a few splashes to the pan to keep it juicy.
Meanwhile, rub a paring knife with a cut clove of garlic. Thinly slice the truffle and cut into half inch strips.
Cook the pasta with the sauce for a minute or two on medium heat, then add half of the truffle. Turn off the heat, add the cheese, truffle butter if using and stir. Add another splash of paste water if needed to make a creamy pasta. Double check the seasoning for salt and pepper and adjust until it tastes good to you.
Serving
Serve the pasta in heated serving bowls, garnishing with as much extra truffle slices as you can spare.