I'm a speech pathologist in the school system. I have a pre-school student who I recommended have a full audiological eval. based upon my hearing screening results. The findings of that evaluation were that he had a complete s.neural hearing loss in one ear. He has normal hearing in the other ear. On the botton of the audiogram, it was recommended he possibly have further testing to rule out a retrocochlear lesion. I'm assuming this would be an MRI. The parent does not really want to do this because it would mean his having to be put to sleep - and of course, there's always a risk there. My questions are: 1. Is this recommendation probably something that is written on most audiograms of this sort. This is my hunch, since it wasn't really addressed too much when the audiologist reviewed the findings with the parents. 2. How common is a unilateral s.neural loss? This little boy has had recurrent ear infections. His mother has been right "on top" of things and from what she has told me, the pediatrician seems to have a "wait and see" philosopgy. Thanks in advance!

Since you are concerned why not get written consent from the parents to discuss this case with the audiologist and find out for yourself just what all this means and just what his recommendations are regarding whether or not he feel it would be beneficial for the parents to have the further testing.

1. The child should be referred to an ENT who will then determine if further testing is necessary based on the audiogram and case history. The would probably no a sedated ABR before a MRI. It's light sedation, chloral hydrate. It is administered by a nurse and it is like a strong cough medicine. The child will sleep for about a 1/2 hour and wake with little side effect.

2. Unilateral hearing loss, in general, is not as common as bilateral loss. If he has profound sensorineural hearing loss, it has nothing to do with his history of ear infections. Most likely, he was born with the loss.

3. Educational recommendations should include:
*preferential classroom seating
*use of FM system if deemed necessary by parent, teacher, audiologist, and speech pathologist
*CROS hearing aid use if child experiences significant educational difficulties.

Hope this helps!

Jim
Audiologist

Jim and mlgable - Thanks for your replies! I think I will investigate a bit further, with parent permission, of course. I didn't think a unilateral SN loss was as "common" as a bilateral one, as far as hearing loss goes. I didn't tell the whole story the first time - just because it'd have been a much longer post - but, what had me concerned was the fact that he passed the puretone testing during his screening. I had a student doing the testing, under my direction. I don't know if she had a predictable pattern of tone presentation or if she was just not experienced enough or if there was crossover .. anyhow, he had Type B tymps and that was why I spoke to his Mother. She had been concerned about his hearing and the combo of the two prompted the referral. So, if he did actually pass puretone testing at that point because he could hear in both ears, this has progressed quite quickly. But, like I said, I'm going to investigate a bit further. Anyhow, thanks for your replies!