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Having Hearing Problem. BERA Test Showed Profound Losses In Both Ear. What Treatment To Be Done?

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Posted on Wed, 25 Jul 2012
Question: i have one daughter not hearing from both ear. but not seen any problem in MRI(inner ear),CT scan,EEG but problem in BERA test ,what to be done.we dont have sufficient money for cochlear implant.she have having hearing losses from past 7 month and before this she is hearing well from both ear,as per BERA test she is having profound losses in both ear..kindly guide us further
doctor
Answered by Dr. Naveen Kumar Nanjasetty (2 hours later)
Hi

Thanks for the query

The sudden loss of hearing could be due to deformities in the inner ear apparatus, damage to the nerves and the inner ear apparatus.

According to BERA there is profound hearing loss in both ears. It is almost impossible to correct the profound hearing loss with medicines.

Also, the advantage of the BERA is, it shows where exactly the nerve has been damaged starting from the inner ear up to the brain. Hence keeping this in mind, we can go for the corrective surgeries depending upon the level of damage.

At present Cochlear Implant (CI) has shown promising results. The sooner you get the implantation done the better is the result. This is because of the neural plasticity. During infanthood, the auditory center in the brain tries to recognize the external sounds but, once it crosses 3 or 4 years of age, the function of the auditory centre is taken over by the adjacent visual centre. Later on, whatever stimulation is given to the auditory centre in the brain it will not recognize sounds and the surgery will become a failure. Finally, the child will remain deaf for the rest of its life. Hence you need to act fast.

The costs of the CI depends upon the selection of the device, you can go for the basic version which will cost you around 7 lakh rupees package (including surgery and rehabilitation).

You can contact Jindal Company; they are sponsoring CI for those who are not affordable. Apart from that, you can contact some local NGOs or trusts for the monetary help. Also, try to contact Dr. XXXXXXX Kirthane a pioneer in CI working for Nanavathi Hospital, Mumbai, he can be helpful to you.

Hope I have answered the query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (4 hours later)
But what MRI,EEG and CT scan says,everything is normal in these report.then why surgery is required.tell me other option available,i am living in yamunanagr-haryana,tell my any nearby location for further consultation and help.

rgds,
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Follow up: Dr. Naveen Kumar Nanjasetty (2 hours later)
Dear Sir,
I am send u Bera test report,one was conducted by private hospital doctor while other one was by Govt hospital,pls have a look and tell whether is it accurate or not.
rgds,
doctor
Answered by Dr. Naveen Kumar Nanjasetty (4 hours later)

Hi XXXXXXX

Thanks for writing back

Let me explain to you in detail:

1. Your child had fever for about five weeks, following which; the child had loss of hearing. The prime cause could be damage to the nerves in the inner ear secondary to the longstanding fever or the medicines administered.

As the actual cause of fever has not been mentioned in the report, it can be presumed that the child had meningitis sort of infection. There are few reports which claim that those who sustain hearing loss secondary to meningitis should be observed for 6 months before implantation. The reason being, substantial number of patients has regained their hearing in at least one ear.

In your child's case, it is more than 8months without any improvement in hearing and the recent BERA also shows worsening of the nerve damage. So, that could be the reason your doctor has advised for cochlear implantation.

2. The CT/MRI was done to rule out any problems in the cochlea. Meningitis may lead to ossification (chalky deposition) of the cochlea, which is usually identifiable on CT scan. MRI is often better at delineating patency of the cochlea. Early cochlear implantation may be indicated if any evidence of ossification of the cochlea is noted.

3. BERA is one of the important investigation tools for the assessment of the brain stem potentials in response to audiological click stimuli. As there is absence of wave V in lower frequencies, it indicates damage to the auditory pathway.
The hearing can be restored with the external stimulation of cochlea.

4. All the above mentioned investigations were performed to rule out any problems in the brain and inner ear apparatus. As all the investigations are normal except for BERA, the rate of success following Cochlear Implantation (CI) is very high.

5. As you have already got all the investigations done at PGI Chandigarh, it is better to follow it up at the same hospital as it is one of the premier institutes in our country and they do a fantastic job over there. To be XXXXXXX there are no other alternatives left except for CI, the sooner you get the surgery done the better it is for the child.

6. Finally, the BERA conducted at a private hospital and PGI shows worsening of the nerve damage when compared with the former report. Both the reports can be confidently taken into consideration.

Hope I have cleared your doubts; I will be available for the further queries, good luck.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (7 hours later)
Dear Sir,
In these days,several hearing Aid available for Profound loss,pls suggest from where in chandigarh i take it and of which compnay whose battery life is ok,should i go for analog or digital one ,i am thinking of pocket hearing aid for my child as it is less expensive,pls suggest..IS there is any specilist docotor private at chandigarh who can check with hearling aid,whether it can be benefictional or not.

rgds,
doctor
Answered by Dr. Naveen Kumar Nanjasetty (5 hours later)
Hi XXXXXXX

Welcome back

Q: In these days, several hearing Aid available for Profound loss,pls suggest from where in chandigarh i take it and of which compnay whose battery life is ok,should i go for analog or digital one.

A: If you want, you can try multichannel - digital hearing aids. The providers usually give a trial for a month depending upon the company and the model you purchase.

You can go for either Seimens or Phonak, both are equally good. There are various types of hearing aids behind the ear, in the canal, completely in the canal, etc. For your child you can go for behind the ear, which would be ideal. Digital is always better than analog: I wish you could give the best for your child.

Q: IS there is any specilist docotor private at chandigarh who can check with hearling aid

A: Hearing aid are usually dealt by audiologists, doctors will not have much knowledge regarding the functionality of the hearing aid.

To mention a few hearing aid centers at your place:

SENSO HEARING CENTRE - CHANDIGARH
SCO 3, Ground Floor,
Sector 20 D, Tribune Road,
Chandigarh - 0000.
Phone: +91-172- 0000
E-Mail : YYYY@YYYY


Indian Audio Centre
Mr. XXXXXXX Kamboj (Director)
Floor & Cabin No. 3, S.C.O. 78- 79,
Sector - 17 - C,
Above Old Punjab & Sind Bank
Chandigarh - 160 017, India
Telephone     :     +(91)-(172)-0000/ 0000
Mobile     :     +(91)-0000
Fax     :     +(91)-(172)-0000


Allied Rehab - Hearing Rehabilitation Clinic
SCO 910, NAC, Manimajra
Housing Board Chowk
Near Hotel Solitaire
Chandigarh, India
Email: YYYY@YYYY
Cell: 9216 747 747, 9216 748 748
Fax: +91-172-0000     


Q: whether it can be benefictional or not.
A: Before Cochlear Implant (CI) is fitted, usually a trial with hearing aids is done for a period of six months, if the child does not pick up speech within that period, only then the implant will be inserted.

Just go through this link mentioned below, it can give you some picture of merits and demerits of both CI and hearing aids.

WWW.WWWW.WW
I wish your child good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (54 minutes later)
I choose two one is:-
Indian Audio Centre
Mr. XXXXXXX Kamboj (Director)Floor & Cabin No. 3, S.C.O. 78- 79, Sector - 17 - C, Above Old Punjab & Sind BankChandigarh - 160 017, IndiaTelephone : +(91)-(172)-0000/ 0000Mobile : +(91)-0000Fax : +(91)-(172)-0000
and other is Amlifon india pvt ltd,pls tell where should i go ,which out of these have better audiologiest and out of these whose response is good.
thanks, XXXXXXX
doctor
Answered by Dr. Naveen Kumar Nanjasetty (5 hours later)
Hi XXXXXXX

Welcome back

The information I gave was of the best audiology clinics in Chandigarh. You can contact any of them, all are equally good.

All the best

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2540 Questions

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Having Hearing Problem. BERA Test Showed Profound Losses In Both Ear. What Treatment To Be Done?

Hi

Thanks for the query

The sudden loss of hearing could be due to deformities in the inner ear apparatus, damage to the nerves and the inner ear apparatus.

According to BERA there is profound hearing loss in both ears. It is almost impossible to correct the profound hearing loss with medicines.

Also, the advantage of the BERA is, it shows where exactly the nerve has been damaged starting from the inner ear up to the brain. Hence keeping this in mind, we can go for the corrective surgeries depending upon the level of damage.

At present Cochlear Implant (CI) has shown promising results. The sooner you get the implantation done the better is the result. This is because of the neural plasticity. During infanthood, the auditory center in the brain tries to recognize the external sounds but, once it crosses 3 or 4 years of age, the function of the auditory centre is taken over by the adjacent visual centre. Later on, whatever stimulation is given to the auditory centre in the brain it will not recognize sounds and the surgery will become a failure. Finally, the child will remain deaf for the rest of its life. Hence you need to act fast.

The costs of the CI depends upon the selection of the device, you can go for the basic version which will cost you around 7 lakh rupees package (including surgery and rehabilitation).

You can contact Jindal Company; they are sponsoring CI for those who are not affordable. Apart from that, you can contact some local NGOs or trusts for the monetary help. Also, try to contact Dr. XXXXXXX Kirthane a pioneer in CI working for Nanavathi Hospital, Mumbai, he can be helpful to you.

Hope I have answered the query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon