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Surgery For Ear Discharge. Using Hearing Aid For Hearing Loss. Can Any Reconstruction Be Done?

Posted on Thu, 4 Oct 2012

Question: Hi,
I was having a severe ear discharge and a hole in the ear drum in the right ear. I have undergone a surgery 3 years back , after which the discharge has been stopped by 92 % but I have lost around 60% of my hearing as the 2 Oscicles were removed as they found to be infected.

Currently sometime I noticed a sudden improvement of hearing as if I have not lost anything but again after few mins/hours It again comes down.Currently I am using a SEIMENS BTE hearing aid to overcome the situations, but fluctuation of hearing again bringing trouble for me in my day to day work.I am attaching here my post surgery report which describes the details. I am looking for a permanent solution and a surgery for reconstruction to avoid using hearing aid and start leading a normal life.

I am writing here with a great hope, as I have lost some precious thing in first event of surgery, cannot afford any second loss. Kindly suggest if any reconstruction can be done and who will be the best person whom I can trust.Please find the details of audiometry report post surgery for reference.
P.T.A - 60 DB
S.R.T- 75 DB
S.D.- 85%
M.C.L - 75 DB
U.C.L> 100 DB
This reading is with Audiometer- GSI-61

Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)

Hi

Thanks for the query

First of all, I would request you to mail me the audiogram. Even though you have mentioned in brief about the audiogram results, it is not sufficient to comment. Only after examining the graph I will be able comment about whether you will be able to regain your hearing or not.

If the hearing loss is of conductive in nature due to damage to the ossicles, then with ossicular reconstruction the hearing can be regained. But, if there is a sensori-neural hearing loss then you might not benefit from the ossicular reconstruction.

If you can mail me the audiogram, I will be able to help you in a better way.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (2 days later)

Hi Dr. XXXXXXX

Thanks for your early reply. I have attached the scan copy of my post surgery discharge report which summarizes all the procedure done and the audiometry test report. Kindly help me providing the suggestions for below questions.

1. What is the percentage of damage ?

2. Can we do a reconstruction surgery for middle ear,if yes how much percentage we can improve the hearing power ? My report says it is a conductive hearing loss.

3. As I am based at Bangalore, whom should I consider as the best person to deal with my case. If we perform any surgery then how long it will take me to re gain my hearing- post surgery achievements.

It would be of great help if you can spend some time going through my graph and the surgery report. Kindly suggest what best can be done, I badly need to gain back my hearing power. Could you please share your personal email id for any future reference.

Thanks & Regards, XXXXXXX XXXXXXX XXXXXXX

Answered by Dr. Naveen Kumar Nanjasetty (2 hours later)

Dear XXXXXXX

Thanks for writing back

Let me explain to you in detail:

1. You have been operated by Dr. XXXXXXX XXXXXXX who is one of the best ENT surgeons in Bangalore. Obviously, he would have done his best for you.

2. What is the percentage of damage? Can we do a reconstruction surgery for middle ear, if yes how much percentage we can improve the hearing power? My report says it is a conductive hearing loss.

A: In the discharge summary, the PTA report mentions a mild conductive hearing loss, but the PTA report given in your query shows 60dB which does not fall under the category of mild conductive hearing loss. If you are having a mild hearing loss, then, why do you wear a hearing aid? So, there is lots of confusion regarding this. If you can mail me the graphical report of the recent audiogram done post surgery, it will be very helpful for me to guide you appropriately.

3. As I am based at Bangalore, whom should I consider as the best person to deal with my case. If we perform any surgery then how long it will take me to re gain my hearing- post surgery achievements.

A: I am also a Bangalorean; hence I can guide you to one of the best ENT Surgeons for the ossicular reconstruction. You can contact:

Professor Dr. XXXXXXX Prasannaraj
+91-0000
Department of ENT and Head & Neck Surgery XXXXXXX Hospital
Coles's Park
Bangalore

If it is only the conductive hearing loss, then after an ossicular reconstruction you can achieve around 80% hearing gain.

I wish you good luck.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (8 days later)

Dear Dr. XXXXXXX

Thanks for your quick reply. I have attached the audiometry report, it is having 3 copies, one is most recent which I have done last week end and rest two are post surgery in different clinics. Kindly have a detail look and suggest.

My surgery was performed by Dr. NandaKumar, not doctor XXXXXXX XXXXXXX . I have contacted dr. nandakumar last week, but he didn't encourage me for reconstruction surgery, though post surgery he suggested that we will go for second surgery to re gain my loss.

Currently I am also contacting dr. XXXXXXX Dutt from Apollo. He has suggest few test and scanning which I will be doing this week. I have also decided to visit Dr.Prateek/Dr. XXXXXXX BEST clinic, kindly suggest if I am on right track ? Please suggest if anything else I need to take care and how much recovery can be done as I am really mentally depressed due to what has happened. Thanks

Regards, XXXXXXX

Answered by Dr. Naveen Kumar Nanjasetty (7 hours later)

Hi

Thanks for writing back

I did examine your audiometry reports. I have noticed that there is some amount of nerve damage in the inner ear, which is evidenced by the dip in the bone conduction curve at 2K in the (R) ear.

There are hundreds of ENT doctors in Bangalore. I wanted you to get the best of the treatment and thus referred you to one of the best doctor who can really help you without giving a run for your money.

Could you please let me know, what was the reason quoted by Dr. XXXXXXX Dutt from XXXXXXX Apollo regarding CT scan?

I wish you get the best of the treatment and that is the goal of all the doctors working for XXXXXXX There is no point in visiting various doctors, most of them will try to extract as much as from you and ultimately let you down.

Regarding regaining of the hearing, there will be definitely more than 50% improvement in your hearing with ossiculoplasty even though there is a dip in the bone conduction at 2K.

Finally, depression will not give you any benefit, but it will make the things worse. My advice to you is to consult Dr. XXXXXXX Prasannaraj; he is good in this reconstructive surgery.

I wish you good health.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (14 days later)

Dear Dr. XXXXXXX

Thanks for all your valuable feedback. As suggested I visited dr. XXXXXXX last week.
He told it can be done and hearing would improve, however he told he need to explore it after opening that what best could be done. This particular word put little questions in my mind regarding the guarantee of success.

I got another reference from this website is Dr. Mahadevaiah, I visited him too yesterday, as per his conversation he has done many similar surgery and he gave a kind of assurance. But he is doing it in his Nurshing home and I feel little bit lack in infrastructure.

Another name I have received is Dr. Vajaendra.

Though you have suggested Dr. Thomas's name, I just want to hear one more time from you, who among all is the best to deal with my problem. As you are the best person to judge, your honest opinion will help me finalizing my treatment. Thanks

Follow up: Dr. Naveen Kumar Nanjasetty (1 minute later)

It would be of great help, if you can share some more information about Dr. XXXXXXX like how many he has performed so far and what is the success rate.

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi XXXXXXX

Welcome back

So you have done a thorough homework. You have succeeded in meeting the best Otologists in Bangalore.

Let me explain to you:

1. Dr. Mahadevaiah is known as father of otological surgeries in India. His surgeries are amazing with extra-ordinary results. He runs a small nursing home in H.B. Samaja road, Basavanagudi, which is there from past 30 years.

2. Dr. Vijayendra is also a renowned Otologist. He is Dr. Mahadevaiah's student, who has imbibed all the techniques of Dr. Mahadevaiah. He too runs a small nursing home in Malleshwaram 18th cross known as XXXXXXX ENT care center.

3. Dr. XXXXXXX Prasannaraj is an ENT professor, moreover my teacher. I too have been trained under him. His surgeries are excellent and he does his job quite well.

To sum it up, I have watched the surgeries performed by all the above surgeons including that of Dr. XXXXXXX Dutt and Dr. XXXXXXX Medikeri. All of them are experts in their work. I chose to refer you to Dr. XXXXXXX because:
1. He treats the patients as his own relatives without giving them run for their money.
2. He is not as busy as other surgeons; so he can give you personal attention and do justice for his work.
3. Above all, he is working in a medical college where he manages all the complicated cases very meticulously. His results are really encouraging.

The ultimate choice lies with you. Select the doctor with whom you feel more comfortable and confident. Whoever does the surgery, your results will be definitely better.

Good Luck

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