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Suggest Treatment For Hearing Impairment In An Infant

Posted on Fri, 31 Jul 2015

Question: Hi, I have a daughter of 7 months old, actually she is having TORCH infection from her mom to her body during pregnancy, after birth there were rashes in her body, so doctor asked us to do the TORCH profile, in that Rubella, CMV all came +ve with huge range. So doctor asked us to do the MRI immediately & we did the MRI when she was 7 days old & we found delayed Myelination problem is there, we had been referred to Paediatric Neurologist Dr XXXXXXX XXXXXXX Arror,Parijma Clininc XXXXXXX during 13days of age we did the BERA test in that centre & that time it came mild hearing loss, but paediatric doctor has referred to us to another ENT after sometime to do the BEAR test again & today we did the BERA test in Apollo & the report came - SEVERE/PROFOUND ..there was no response. We have consulted with the ENT doctor & it is been advised to put the hearing aid ASAP & after 2 years to go for implant. Please suggest....now she is 7 months old. During 4 months of age we did the TOCRH profile test ..but those ranges were not going up ..those are coming down so doctor asked not to test again at least those ranges are not going up. Now the main concern is for hearing loss..please suggest..........

Thanks
XXXXX

Answered by Dr. Tushar Kanti Biswas (1 hour later)

Brief Answer:
TORCH infection in newborn

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Your daughter has hearing impairment,caused by vertically transmitted TOCRH infections as BERA reports profound/severe hearing loss.Please upload the BERA report with wave forms,if possible. Your ENT doctor has rightly advised ASAP Hearing Aids .Sensorineural deafness is permanent problem and has been caused by congenital rubella out of torch organisms.No specific treatment is available.Cochlear implant is done at specialized centers.
Congenital infection results in persistent progressive infection .Serum IgM antibodies may be present for up to 1 year after birth but serial measurements of specific antibodies are not going up in your daughter's case .Usually the expected rate of decline is a twofold dilution per month.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Tushar Kanti Biswas (2 days later)

Sir,
I have uploaded the BERA report.
In the report they have tested till 100dB, but results are not good. So if we are putting hearing aid will it help her to hear sounds? One of the doctor suggested may be using hearing aid also she could not hear. If we go for implant - what is the success %? Will it help her life long? Even after few years once she grow her head size also will grow then how the electrode which will be planted will keep synch with the size and all? How it is - or after 8/10 years again surgery will be required. Please clarify.

Answered by Dr. Tushar Kanti Biswas (11 hours later)

Brief Answer:
TORCH and sensori-neural deafness.

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
BERA in your daughter does not show any distinct wave form and absence of peak V wave, more so on the right side.
Whether the child will response to hearing aid alone or need subsequent cochlear implant is difficult to comment upon as she is too young and subsequent growth and development will have impact on use of any device.
An expert on the subject (cochlear implantation) will be the best person to give correct answer.
A second opinion on this from CMC,Vellore ENT department ,(if you are from southern India) can be obtained.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Tushar Kanti Biswas (12 hours later)

Thank you Sir, presently we are staying in XXXXXXX we are going to consult 2 other ENT surgeon & based on that may be we will go to CMC as you advised.

Answered by Dr. Tushar Kanti Biswas (9 hours later)

Brief Answer:
TORCH & sensori-neural deafness

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

You are most welcome to ask any further query.

Regards

Dr. T.K. Biswas M.D. XXXXXXX
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar