Taking steroid medication for senorineural hearing loss. What is the best possible solution?
User rating for this question
we are looking for a treatment for a family member, F 30 years, who had sudden senorineural hearing loss. It has been close to 6 months now. At the time of the incident, ENT doctors prescribed steroid shot through the ear drum, which she didn't want to do. she preferred to take medication for a while which were again some steroids. this didnt work then she switched to homeopathy. This has been very difficult for her to cope with emotionally, hence we haven't been able to convince her for further treatment of procedures. she is willing to revisit this now, looking for the best possible solution. Can provide the audiometry and other test results as required. please help.
Posted Mon, 2 Dec 2013 in Ear, Nose and Throat Problems
Answered by Dr. Prahlad Duggal 28 minutes later
Brief Answer: Option of cochlear implant in right ear Detailed Answer: Hi, Thanks for your query. Sudden sensory neural is usually treated with heavy doses of steroids and intra tympanic steroid injections are also given. Treatment is usually started as early as possible. The results can be encouraging in some patients but it is not always successful. There is no other treatment which has shown success 6 months after the onset of loss. Her reports show a profound Sensory neural hearing loss (SNHL) in right ear and mild SNHL in left ear. This means that she is able to do her daily chores as her left ear hearing is in socially acceptable levels. In left ear if she feels the need for supplementation of hearing, she can go for hearing aid. As far as right ear is concerned, this needs evaluation for the cause of hearing loss and I suppose the doctor treating her must have worked her up to rule out any other cause. Many a times it is not possible to find a cause to which the loss can be attributed and we call it idiopathic. Her hearing in the right ear can be restored with a cochlear implant but she needs a complete work up including need to under go CT and MRI if head with special focus on inner ear. Seeing her PTA, the right ear does not seem correctable by a hearing aid. Also she needs to avoid any ototoxic drugs, noise trauma as she has only one working ear. Another thing worth mentioning is that there are no medicines as of now which are effective for a developed SNHL. A competent ENT surgeon will know abut all these process. If feasible I recommend that she visit the specialist and plan the right treatment forward. I will be available to assist you online. Feel free to ask another query. Regards
Follow-up: Taking steroid medication for senorineural hearing loss. What is the best possible solution? 8 hours later
Doc, thank you very much for your response. I have attached the latest audiometry report that we did today, please review and give us your opinion. As per the technician there seems to be some improvement, could you please advice? He was suggesting that we go for the Baha - Bone conduction implant. would like to seek your advice based on the recent reports.
Answered by Dr. Prahlad Duggal 10 hours later
Brief Answer: Indications for BAHA are different Detailed Answer: Hi, Thanks for your query. Your second PTA also shows a profound sensorineural hearing loss, a little less than the previous one but still profound. If it is improvement, it is minimal and as she is having good hearing in the other ear, you can wait further if you want but this improvement will occur naturally (if it occurs) and not with any medicine. There can be an inter-operator variation in PTA, so please get the PTA done by the same person in the same sound treated chamber. Still both the PTA's show SNHL and I wonder how a BAHA is going to help in such settings. For that matter, with the present status of hearing, if your audiologist says that BAHA will be effective, then a conventional digital hearing aid will also be effective. BAHA is meant for conductive hearing loss or mixed hearing loss and most of the candidates which go for BAHA have some difficulty in wearing the conventional aid usually because of an issue with external auditory canal. In your case, it is not there (you have not written about that). Still if you want to go for a BAHA instead of a conventional hearing aid, go for trial of BAHA with a head band and then if satisfied, for surgery. But still my opinion is- your patient is having profound SNHL, she has two options, a hearing aid or a cochlear implant. If a hearing aid trial is effective with this much SNHL, then go for hearing aid (and a conventional hearing aid is cheaper that BAHA and will be equally effective in your patient). If no hearing aid is effective (as is a frequent finding with profound SNHL), then cochlear implant is the option and not BAHA. The indications for BAHA and cochlear implant are different and a BAHA can not be a substitute for Cochlear implant and vice versa. Please consult an ENT and discuss with him/her and he/she can explain you. With kind regards