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So far, there seems to be no sufficient therapy for stopping the progression of hearing loss. It has been shown that a cochlear implantation is a worthwhile procedure, if the patient is almost deaf. The aim of current study is to review literature and compare them with our case study report of some of the common conditions related to the etiology of Fluctuating Sensorineural Hearing Loss (FSNHL).This is supported by similar clinical picture, outcome and is commonly considered to involve cochlear implant as a possible form of their treatment. Design: Case reporting study. Setting: Ear Nose Throat (ENT) Audiology Unit, and Endocrinology outpatient clinics of the Hamad General and Rumailah Hospitals, Hamad Medical Corporation. Case study. Full clinical, audiological and laboratory evaluation and patient follow up with comprehensive review of literature. The baby’s hearing, speech, social and mental development were reviewed and was decided that, in order to improve the state of hearing, speech performance and future education, the baby is considered for cochlear implant. Thus he started to have preparatory speech and audiological rehabilitation sessions for Cochlear implantation (CI) prior to surgery and found to score well in them. The baby was fitted with cochlear implant in both ears at consecutive dates. Following the first CI intraoperative electrical check was normal and postoperative telemetry and programming was done properly at later date and hearing remarkably improved with discrimination score (DS) score of 100% at 40 dB HTL FF. The patient continued to have the same evaluation figures till early 2007 and start to deteriorate after. The patient started medication with Steroid treatment on the account of diagnosis of AIED. He was started with prednisolone 20 mg, 4 times daily for one day followed by 20mg tds (60mg) for 3 days. The patient showed remarkable improvement that hearing improved to normal in the right ear with DS of 100% at 40 dB but to HTL of 50 dB with poor DS 40% at 100dB in left ear. All treatment showed a remarkable improvement of hearing and speech discrimination. An improvement in addition of methotrexate is done on the basis of reducing steroid dosage without hearing deterioration progressing with no registered serious side effects. All performed treatment has been revealed a remarkable improvement of hearing and speech discrimination with no registered serious side effects.
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Author(s): Ahmad H Salahaldin Khalid A Hadi Razan Alfakir Abdulbari Bener
Post binaural, cochlear implant, fluctuating hearing loss, case study