Resolved question:
Sometime back my aunt, aged 55, suffered from sudden heavy vomiting combined with acute unconsciousness, severe vertigo and headache. She was admitted to the hospital and treated for 3 days to calm the symptons. Suspecting it as a brain stroke, the doctor ordered brain MRI. The report came out normal with no siginificant issues. However there were few minor scars in the brain, that we were told as age related.
At the time she was vomiting, she suffered sudden hearing loss in her left ear. Later we went to a ENT specialist to get the ear checked. After listening to all the symptoms she went through, the doctor suspected it as a Minere's disease, and did Audiogram test to narrow it. After viewing the hearing loss pattern, he ruled out the Minieres disease.
Later she was given a Caloric reflex test. She did not respond at all, when the doctor put in ice-cold water in he left ear. No movement, nothing. Then the doctor concluded, the auditory nerves in her ear got damaged and suggested she will need a hearing aid, to compensate the loss she is experiencing.
Recently we consulted another ENT specialist. He suggested there is no need for hearing aid as the eardrum is perfectly fine. His suspicion is that, since the hearing loss happened at the time of vomiting, there could have been some vomiting deposits left in the nerves and that is causing this hearing loss. He suggests to undergo a small surgery, where in he will make a small incision on the back of the ear, check and clean the vomiting deposits if any. And during this time he will also check for the brittleness of the bone, and if it is brittle, he will replace it with plastic bone.
Now we are little bit skeptical about this new theory. Is that possible at all? Moreover, we were told that failure of caloric reflex test is an indication of nerve damage. In that case, how would this surgery help her? The doctor says its a minor surgery and will only take couple of hours. Will there be any harm in just trying it out?
I really appreciate your advise on this.
Submitted:
4 Days
Category:
ENT Specialist
Hello,
Thank you for your consult at DoctorSpring.com.
Your aunt had vomiting, vertigo, headache and hearing loss, MRI brain is normal.
The advice by the 1st ENT specialist is understandable and it make sense, most likely he is correct. I can tell more clearly if you can scan and sent audiogram report. (is there any hearing loss on right side also?, vertigo is still present or not? Now only symptom is hearing loss or any other symptom present?)
I disagree completely with advice by 'another ENT specialist'(Vomiting comes from stomach, how it is reaching to brain?).
So please don’t think about surgery and go back to 1st specialist.
Hope this helps. Feel free to ask if you have any further queries.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA
Hello Dr. Sunil,
Thank you for replying. Sorry for the delay in responding.
I have attached here, all the reports, done over time. They are named in the order and the dates, they were done.
Also, I spoke with the second ENT in detail. I was wrong with vomit accumulation. He mentioned, since the hearing loss was sudden, he suspects it is due to excessive fluid deposit behind the back of the ear. And so he suggested the minor operation to open and check, since that's the only possible way.
Thanks,
Sudheer
Hello,
I have seen all the reports. She is having left sided hearing loss(severe sensorineural).
She doesn't require any surgery in my opinion. Still no relation with fluid accumulation. Most of the time, we can't find cause for sudden hearing loss, and it doesn't improve with treatment.
Hope this helps. Feel free to ask further queries.
Regards
Hello Dr. Sunil,
Thanks for the reply.
What do you suggest our course of action be? I presume, you understand how hard it will be without proper hearing. What can we do to get the situation improved and/or correct the hearing loss?
Thanks,
Sudheer
Hello,
I can understand that it is very difficult to manage without proper hearing. I
think best option will be using hearing aid. We are not left with many options and
hearing is not going to improve with any medication. Considering her age hearing
aid will be best option. If she is concern about appearance , she can use CIC
(Completely in the canal ) type hearing aid, which can not be visualized from
outside.
Hope this helps. Feel free to ask if you have any further queries.
Thank you.
Regards
Dr. Sunil Jalan