Her right ear has totally deaf in pure tone audiometry. CT shows the normal inner ear structure. Her left ear had sudden hearing loss 2 months ago. The left thresholds are about 55 dB HL, flat audiogram. CROS hearing aids help her a lot. But the monosyllable words discrimination is only 78% without sound localization. She wants to get cochlear implant in her right ear. But the surgeon said that CI can not help her after more than 10 years of deafness.
In general, performance is LIKELY worse with long duration of deafness, especially more than 20 years. However, we did see some CI users perform very well even with long duration of deafness. Also it will probably benefit sound localization in some degree.
In general the longer the duration of deafness, the worse of the performance of CI. However, we have experience that the patient has received the second side cochlear implant with dead ear for more than 20 years, the performance is even better the first side. The plasticity of the brain may be preserved if the the other ear has continuous stimulation. Interesting!
Having a good hearing on one side during this period changes the expectations a lot. She has lost some hearing on the left recently. She has a good chance to benefit from right comparing the patients with long term two sided hearing loss without any aid .
CI might be helpful but I think more tests are required. Long deafness makes changes in central auditory system. At least we must make sure auditory nerve is responsive. Tests like EcochG and looking for AP (transtympanic) can be beneficial. In general it is hard to predict the outcome.
More the newer investigations better is the result of operation.
This right ear has to be properly evaluated and the degree of deafness assertained. Then she may benefit from cochlear implant.
Hello Dr.Zhang
What about your patient?
Did she benefit from CI or it still undone?
We will be thankful if you tell us about her?
Farzaneh Zamiri
I am curious as to the etiology of the deafness. I cannot immediately think of a single cause for a total (non-fluctuant?) loss in one ear and sudden (fluctuant?) losses in the other. (I am assuming syphilis has been excluded).
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