Saturday, December 18, 2010

SENSORY NEURAL HEARING LOSS (NERVE DEAFNESS)

Your detailed examination shows that you are suffering from verve type of hearing loss. There is no medical or surgical treatment available to improve the hearing in these cases. The aim of our management is to prevent further hearing loss and try to make the best use of the hearing which you have.
       The circumstances mentioned below are known to cause hearing defeat in susceptible individuals. It is in your interest to observe the following precautions, otherwise your trouble may get worse.
      
1.    You should avoid the use of following medicines :

       Please show this pamphlet to your family doctor when you seek his advice for any future illness.

A. DEFINITELY OTOTOXIC:
i. Aminoglycoside antibiotics e.g. Streptomycin, Dihydrostreptomycin (not used now a days), Neomycin,Viomycin Framycetin, Vancomycetin, Kanamycin, Ristocetin, Polymixin B, Gentamycin, Tobramycin, Amikacin, Chloramphenicol Erythromycin.
ii. Anti-Protozoal drugs-Quinine, Choroquine (reversible at early stages), Chimopodium may also cause deafness.
iii. Salicylates, Aspirin (reversible at early stage).

B. OTOTOXICITY AND IDIOSYNCRASY:
i. Cytotoxic drugs –Nitrogen mustard, Cisplatin, Bleomycin.
ii. Thalidomide (cause congenital abnormality).
iii. Tetanus antitoxin
iv. Topical drugs-chlorhexadine (Hibitane) in spirit
v. Heavy metals used in allopathic and indigenous drugs e.g. arsenic in the form of salvarsam, mercury, lead and gold etc., used as “Bhasmas” in Ayurvedic and “Kushtas” in Unani Systems.

C. REVERSIBLE OTOTOXICITY:
i. Beta-adrenergic receptor blocking agent, Protocol (withdrawn), Propranolol, Atenolol, Metoprolol, Oprenotol.
ii. Antiheparinising agents viz Hexadimethrine bromide.
iii. Loop-Diuretics-Ethacrynic acid, Lasix (Frusemide)

D. MISCELLANEOUS:
i. Oral Contraceptives
ii. Nicotine, Tobacco, Marijuana

E. DOUBTFUL OTOTOXICITY:
i. Drugs for control of diabetes, antithyroid drugs.
ii. Atropine
iii. Barbiturates, Dilantin
iv. Librium

       It has been proved that very often the severe ototoxic damage to the hearing organ is irreversible and treatment with any amount of drugs like B-complex, Vit-E, Vit-A etc. will not improve the hearing. If there is any impairment of hearing after consumption of the above mentioned drugs, the same should be stopped immediately with the approval of the treating physician. During the treatment with ototoxic drug if there is any tinnitus (noise in the ear) the patient should immediately report to the doctor since it may precede the onset of deafness.

2.    Avoid prolonged exposure to noisy surroundings e.g. those of lathe machines, vacuum cleaner, factory machines, discotheques etc. Exposure to high frequency noise like jet engines or firing of ammunition, Diwali crackers etc. is very harmful. Even a sudden loud sound from the telephone can damage the ear in susceptible individuals.
3.    Avoid smoking, tobacco-chewing and alcohol
4.    Avoid using hair pins, match-sticks and other sharp objects in the ear
5.    Please do not pour oil (warm/cold) into the ear unless you suspect that an insect has entered your ear and an immediate medical care is not available.
6.    Do not blow the nose hard during a cold.
7.    Get your blood pressure, blood sugar etc. checked by your family doctor periodically for diagnosis and control of hypertension, diabetes and other chronic ailments.
8.    Get your Audiometry repeated once in a year.

       Use a Hearing Aid in the better hearing ear. Practice lip reading by paying attention to people’s lips when they are talking. Buy a book of poems. Read any poem 3 to 4 times. Then as a friend to read out one line of the poem mouthing the words with his lips but not speaking them aloud. You should be able to repeat the line after him just by paying attention to his lips, without having heard the words. Practice this for ½ to 1 hour daily for 3-4 months. Just by looking at the lips of the person who is talking, you should be able to understand what he is saying without hearing a word, provided you know the gist of the conversation.

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