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Having hearing problems. Report showed Right ear:Profound hearing loss, Left ear: moderate severe hearing loss. Suggest?

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Practicing since : 1991
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Hello Sir,

I'm XXXXXXX Mishra. My brother is having hearing loss problems.
Here is his bera report comments:

Empression:

A click stimulus was presented to the both ear at intensity level of 99 to 40 dB and it was observed that there was presence of wave till 99 dB in left ear & absence of all wave in right ear.

test Comments: Right ear: Profound hearing loss
Left ear: moderate severe hearing loss.

Sir I'm also a MBBS student from KGMC lucknow, my HOD suggested me for a new test of IQ level.
Which is found 35% of IQ level. My brother was having VSD since birth, which has been overcome.

Now I was suggested there is no treatment for hearing loss.
I'm very lost sir, if there is 1% of change for any of the treatment, can you please suggest?

It would be very helpful sir. At this point, I have no idea, what to do, from where can we start.
Please suggest sir.

Thanks,
XXXXX
Posted Fri, 11 Oct 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 24 minutes later
Brief Answer:
ASSR, aided SDS, BA, Hearing Aid, BAHA, CI

Detailed Answer:
Hi,

Thank you for your query.

1. Get an ASSR (Auditory Steady State Test) done. Get an aided Speech Discrimination Score (SDS) done for the left ear. Try Behavioral Audiometry (BA) for evaluation if his IQ is low.

2. If he has a profound hearing loss in the right ear since birth with no auditory input to the brain for 14 years, it is unlikely that a Cochlear Implant (CI) will help in the right ear.

3. If his hearing loss was gradual, then the may benefit from a hearing aid in the left ear. If his hearing reserve in the better (left) ear is above 50 dB, he may benefit from a Bone Conduction Hearing Aid (BAHA) fitted on the left side. If his aided SDS is low, he may benefit from a Cochlear Implant on the left side.

4. A BAHA will not interfere with his present hearing but a cochlear implant may destroy any residual hearing. Also the issue of compliance with a low IQ score exists.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having hearing problems. Report showed Right ear:Profound hearing loss, Left ear: moderate severe hearing loss. Suggest? 28 minutes later
Hello Sir,

Thanks for your reply.

I have uploaded all the test reports. Before 1 year, his hearing capacity was quite normal, but according to "Audiometric evaluation report":
Right Ear: above 90dbhl:profound hearing loss
Left Ear: 80 dbhl: severe loss of hearing

As I have also mentioned, IQ level is 35-40%. I was thinking about Cochlear Implant, Can you please let me know what would be risk and success rate for this solution? And from which center, we can get the proper treatment for implant?

As my HOD of ENT, KGMU Lucknow, "Dr. S.P. Agrawal" has suggested me that there would not be much benefit of implant for such patent as due to poor communication and low IQ.

Hope to hear from you soon.

Thanks, XXXXXX
 
 
Answered by Dr. Sumit Bhatti 17 hours later
Brief Answer:
HBOT, Hearing Aids, Evaluation for CI

Detailed Answer:
Hi,

Thank you for writing back.

1. HBOT (Hyper Baric Oxygen Therapy) may have been effective for both his hearing loss (if it is slowly deteriorating) and his mental status.

2. He needs to start using hearing aids as soon as possible.

3. If there is non communication due to the hearing loss, he may benefit from the treatment.

4. From his audiogram, he seems to be beyond the reach of a BAHA. If his aided audiogram and SDS is good, he may continue using the hearing aids.

5. You may get him to Pune for evaluation and counselling for a CI.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having hearing problems. Report showed Right ear:Profound hearing loss, Left ear: moderate severe hearing loss. Suggest? 1 hour later
Hello Sir,

Many thanks for your reply.
Now, I'm feeling, we have an option for the treatment.

1. Can you please let me know if there is any side effects or complications for HBOT? Which centre should be suitable for this therapy?

2. As patent was having hearing loss gradually, can you please let me know, what causes may effect hearing loss? And what precautions, we can follow for preventing further loss?

3. Please help me, which hospital would be suitable for the treatment and counselling for CI in Pune.

4. Which type of hearing aid, you prefer for this severe hearing loss, if idea, please help?

Hope to hear from you soon.

Thanks,
XXXXX
 
 
Answered by Dr. Sumit Bhatti 3 hours later
Brief Answer:
HBOT safe, Fortis C-DOC Delhi, Phonak Naida Q70UP

Detailed Answer:
Hi,

Thank you for writing back.

1. HBOT (Hyper Baric Oxygen Therapy) does not have major side effects. The nearest center from Lucknow, with the latest Stryker equipment run by Innovative Healing Systems, India is in Fortis C-DOC Hospital Opp. Nehru Place, Delhi. Their other centers are in Pune, Mumbai and Ahmedabad.

2. He will require an MRI + CT Temporal Bones, genetic work-up. Does he have any history of a major illness preceding the onset of hearing loss? It is not possible to locate the cause or prevent the progress of the hearing loss in every patient.

3. His CI evaluation can be done on an OPD basis and does not require admission to any hospital. He may be treated at any hospital out of the following: KEM Hospital, XXXXXXX Hall Clinic, Sahyadri SPeciality Hospitals or Inamdar Multispeciality Hospital.

4. The best hearing aid will be the Phonak Naida Q 70 UP. Each is priced at about 87,750/-. If he can hear and communicate well with these, he may not require a Cochlear implant.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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