Expert: Harriet B Jacobster, Au.D. - 11/15/2008

Question
Dear Dr. Jacobster,

I had 3 craniotomies in the early eighty's. Two of them involved my right temporal lobe/bone. I'm fine in that regard. In 2002, I was trying to push a heavy dental chair up a loading ramp. I recall that I held my breath and grunted. I heard what sounded like a garage door slamming closed. It was raining heavily so I figured water got into my ear. Shortly, I was unable to keep my balance or turn my eyes laterally without getting very dizzy. I went to Mass General as well as very good local ENT's. I received transtympanic steroid injections which helped recover some hearing but for all practical purposes my right ear is 100% deaf. I've had an MRI and was diagnosed with having SNHL. My ENT said he'd gain nothing from a CT scan because he's sure it isn't conductive HL.

Do agree that, given my history of surgery that included the temporal bone, a CT scan is meaningless. Thank you

Answer
Dear Dr. Damiano:
Although I am not an expert per se on imaging studies, I do know that recent research at the University of Texas in Dallas has shown that MRI is better than CT scan for finding the source of a hearing loss. MRI is also the preferred technique for brain imaging so, in that sense, it would also pick up any abnormalities in the temporal lobe that could be missed by CT. So, although I would not necessarily say that a CT scan is meaningless, from this information, I do not know what additional information it can give.  From your description of your loss and your history, I do agree with the ENT assessment that this sounds sensorineural rather than conductive. Have you explored any of the options for treatment of single sided deafness (SSD)?  There are three choices which you may wish to discuss with an audiologist.  They are a CROS (contralateral routing of signal) hearing aid, a TRANSEAR hearing aid and the BAHA (bone anchored hearing aid).  They all have their advantages and disadvantages and it may be worth your while to discuss them with your audiologist.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology