case presentation beth burlage. case history, 1991 51-year-old male no family history of hearing...
TRANSCRIPT
Case Presentation
Beth Burlage
Case History, 1991
51-year-old maleNo family history of hearing loss or noise
exposureWife (then ) complains of difficulty with
his hearing and communicationBusiness man, necessary to properly hear
in meetingsAudiogram presents slightly asymmetrical
SNHL
Audiogram, 1991
ABR Results, 1991
Additional tests…
No immitance testing was performed Reflexes? SRT=rollover?
ENT referred patient for MRIPatient did not seek additional testing or
treatment for 5 yearsReturned in August 1996Audiogram presented more asymmetrical
SNHL
Audiogram, 1996
Diagnosis
MRI showed a small acoustic neuroma on the left side Acoustic neuroma –An acoustic neuroma is a benign tumor, that
is usually slow growing and expands at its site of origin. The most common first symptom is hearing loss in the tumor ear. The cause is unknown.
Continued tumor growth can be life threatening. The treatment options are observation, surgical removal or radiation.
Surgery was chosen over observation, which was initially successful, however, a few weeks after the surgery, the patient lost all hearing sensitivity in his left ear
Audiogram, 1999
Treatment
Suggested bi-CROS hearing aids Bi-CROS (Contralateral Routing of Signal) are for
people who are deaf in one ear and are hard of hearing in their other ear. The “hearing aid” on the deaf ear basically consists of a microphone and a transmitter. The transmitter sends these sounds to the “hearing aid” on the good ear.
The Bi-CROS unit combines the signals from both ears and then feeds them into the hard of hearing ear via a normal tightly-fitting ear mold, as otherwise there could be problems with feedback.
Treatment
Did not want to wear 2 hearing aids “if deaf in one ear”
Wanted the most discreet hearing aid possible Fit for 1 CIC in Right ear
Outcome
After a few programming adjustments, the patient was very happy with his hearing aid
However, found it “uncomfortable” to talk on the phone with hearing aid in
Would take out the hearing aid to talk on the phone, as a result he lost 3 hearing aids in 4 years!
Has been without a hearing aid for 1.5 years Compensatory strategies
Audiogram, 2007
Outcome
Fit with Sonic Innovations Open Fit, OTE Found it more comfortable on the phone Had issues with feedback
• Rolled off HF• Changed dome tubing and dome size
Happy with the discreet look and overall performance
Less likely to lose!