Q: I have a son who is 4 years and 7 months old wearing a cochlear implant in the right ear. When he was born he was having pneumothorax in NICU. Last month, he was having high fever with chest congestion, we was given Asthalin and Budecort. He was found with enlarged adenoids too. This happens with him every season when the season changes. He is still taking budecort-100 inhaler. I want to know about the left ear hearing loss. How can we diagnose for any ear canal inflammation or infection or if the eustachian tube or the ventilation tube is blocked. He was born premature at 32 weeks with birth asphyxia, pneumonia, meningitis, pneumothorax, hyperbilirubunaemia and sepsis. What is the correct way to give budecort-100 inhaler and can I give this when the child is sleeping through spacer or baby mask or direct?

A:1. The most convenient way to administer Budecort to a child is by a spacer. 2. You have mentioned that your child was born premature, 32 weeks, asphyxia, pneumonia, pneumothorax, meningitis and hyperbilirubunaemia. Any one of the above conditions could be the reason for the hearing loss. The NICU doctors must be congratulated for their ability, skill and hard work. The important task they had at that time was to save the life of the child, in which they have succeeded. They could not have prevented the hearing loss. 3. The presence of any hearing loss in the left ear is easy to diagnose. Please ask your ENT surgeon whether any BERA test is necessary. In my opinion, BERA would have been done already before the implantation. One other test is called Impedance audiometry. This simple test is done by putting a small ear phone in the ears individually and can be done as many times as necessary. This test might help to arrive at a meaningful treatment plan. 4. A good plan will be to treat any cold as and when it occurs and to concentrate on the speech training. 5. In any cochlear implantation programme, the surgical procedure itself is simple and straightforward. It is the training phase, which decides the final benefit. This speech training is an intensive task and will require a lot of time and effort on your part. As a matter of fact, it is this arduous and long drawn speech-training phase that keeps several otherwise excellent surgeons from doing a cochlear implant. 6. You have had the foresight to go in for a pioneering technology. Now, your endeavour must be to make the best use of it. Please take an active part in your son’s speech training. My best wishes to your son’s future achievements.