case report (hari prakash )

Subject: case report From: hari prakash <h.prakash.p@xxxxxxxx> Date: Sat, 24 Feb 2007 07:19:13 +0530 List-Archive:<http://lists.mcgill.ca/scripts/wa.exe?LIST=AUDITORY> ------=_Part_39583_31109214.1172281753922 Content-Type: text/plain; charset=ISO-8859-1; format=flowed Content-Transfer-Encoding: 7bit Content-Disposition: inline Dear list, Greetings from India. Here I report a child with Auditory Neuropathy... please give ur suggestions regarding Cochlear Implant The child had HyperBillirubinemia and blood transfusion was done, following which he developed stiffness and developmental delay. When the child was 4 months he was evaluated for Hearing... the results were... BOA - 40 dB for speech stimuli. ABR - absent OAE - present in one ear and absent in other ear CM - Robust in one ear and feeble in other (polarity reversal) LLR - Present but prolonged. Second evaluation was after a period of 6 months, and the results of the second evaluations shadows the first. Now can we suggest cochlear Implant for this child? Is there any pediatric Auditory neuropathy been implanted earlier with similar cause? Before implantation what tests can be used to confirm the functional ability of the spiral ganglion cells If u still has patience to read, here is another interesting case of auditory neuropathy... A 30 year old female had metastatic adenocarcinoma with unknown primary. CT and MRI showed, a ring enhancing lesion in the occipital lobe, but increased intracranial pressure was not present. Surgery was done to remove only the largest tumor on the occipital lobe. After the surgery she came for Audiological evaluation to establish a base line audiogram before chemotherapy was started. Audiological evaluation showed the following... PTA - R - moderate sloping HL L - Profound HL SI - 0% in both ears ABR - Absent in both ears OAE - present in both ears CM - enhanced in both ears (polarity reversal) LLR - P1-N1-P2-N2 with very good morphology, amplitude and well within normal latencies. Diagnosis: Auditory Dsynchrony. The second evaluation was done after one month and results are shown below PTA - Unchanged SI - 85% ABR - V peaks occurs consistently but prolonged, earlier peaks absent. OAE - Present CM - present LLR - same as that of first evaluation. What would be cause for such a reversible AN in this patient? we delineated hypothermia, anoxia, TIA, etc.... But either that cause has not incurred in this case or that possible conditions will not correlate with present findings.Have any one encounter such a case? Is there any other causes? -- Hari Prakash.P. Msc Audiology. Lecturer, Dept. of Speech and Hearing MCOAHS, Manipal - 4 karnataka, India. mobile - +91 9886135522 ------=_Part_39583_31109214.1172281753922 Content-Type: text/html; charset=ISO-8859-1 Content-Transfer-Encoding: 7bit Content-Disposition: inline <div> Dear list,                   Greetings from India.       Here I report a child with Auditory Neuropathy... please give ur suggestions regarding Cochlear Implant    The child had HyperBillirubinemia and blood transfusion was done, following which he developed stiffness and developmental delay. When the child was 4 months he was evaluated for Hearing... the results were...   BOA  -  40 dB for speech stimuli. ABR  - absent OAE  - present in one ear and absent in other ear CM    - Robust in one ear and feeble in other (polarity reversal) LLR   - Present but prolonged.   Second evaluation was after a period of 6 months, and the results of the second evaluations shadows the first.   Now can we suggest cochlear Implant for this child? Is there any pediatric Auditory neuropathy been implanted earlier with similar cause? Before implantation what tests can be used to confirm the functional ability of the spiral ganglion cells   If u still has patience to read, here is another interesting case of auditory neuropathy...   A 30 year old female had metastatic adenocarcinoma with unknown primary. CT and MRI showed, a ring enhancing lesion in the occipital lobe, but increased intracranial pressure was not present. Surgery was done to remove only the largest tumor on the occipital lobe.           After the surgery she came for Audiological evaluation to establish a base line audiogram before chemotherapy was started. Audiological evaluation showed the following...   PTA   -    R - moderate sloping HL                 L -   Profound HL   SI     -     0% in both ears   ABR  -  Absent in both ears   OAE  - present in both ears   CM    - enhanced in both ears (polarity reversal)   LLR   - P1-N1-P2-N2 with very good morphology, amplitude and well within normal latencies.   Diagnosis: Auditory Dsynchrony.     The second evaluation was done after one month and results are shown below     PTA  - Unchanged   SI     - 85%   ABR  - V peaks occurs consistently but prolonged, earlier peaks absent.   OAE  - Present   CM    - present   LLR   - same as that of first evaluation.     What would be cause for such a reversible AN in this patient? we delineated hypothermia, anoxia, TIA, etc.... But either that cause has not incurred in this case or that possible conditions will not correlate with present findings.Have any one encounter such a case? Is there any other causes?  </div> <div> </div> <div> -- Hari Prakash.P. Msc Audiology. Lecturer, Dept. of Speech and Hearing MCOAHS, Manipal - 4 karnataka, India. mobile - +91 9886135522 </div> ------=_Part_39583_31109214.1172281753922--

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