Q: My daughter, aged seven, has a hearing problem. We were asked to get a BERA test done. The test was done at CMC Ludhiana. The report stated BSEP was done on both sides using alternate click stimulation, stimulating each ear separately and recording bilaterally. Each response was replicated to ensure reproducibility. On the left side even at 105db stimulation no response could be obtained. On the right side only wave V was obtained at 105db stimulation. No response could be obtained below 95db stimulation on the rt side. The findings are suggestive of bilateral severe neural deafness on both sides. We were asked to get an MRI of the brain done. The report concluded with a normal finding. She has been attending regular school and is a good student. She has apparently learnt to lip read by herself whenever she faces a hearing problem. At times she converses well on the phone and other times does not hear well and hands over the phone. Do we need to do any more tests to arrive at a correct diagnosis? Please recommend the future line of treatment we need to follw. Will a cochlear implant help? If so where can it be done aqnd how much would it cost?

A:You have not mentioned whether she is using a hearing aid or not. At 7 years, she should be able to give a reasonable response to audiometry. What is needed is an unaided, and an aid threshold. If the aided threshold is below 60 dB, and she has already acquired speech, or lost her hearing after developing speech, she is an ideal candidate for cochlear implantation.

There are two implant supplier companies. The implant itself costs about 5-6 lakhs (exact quotation has to be obtained). Intensive speech therapy is needed for at least 6 months post op. The total package is approximately 1.2 lakhs more than the cost of implant: i.e.: 6-7 lakhs, (the exact deal needs to be negotiated each time). A CT scan and MRI is also needed pre-op, which would cost about Rs. 10,000.