Dissociative Sensory Disturbance of Inner Ear Function– A Case Study

Background For patients with severe sensorineural hearing loss a Cochlear Implant (CI) is often the only hearing rehabilitation option. Patients with deafness due to Menière’s disease can achieve excellent speech discrimination with a CI.

Case Report A 39 year old retired lady with Menière’s disease and left sided severe to profound hearing loss was referred to our clinic for cochlear implantation. Due to additional moderate hearing loss on the right she was fitted with a BICROS hearing aid. Pure tone audiometry performed elsewhere showed chronically progressive hearing loss for years. Despite standard rehabilitation measures and betahistine treatment for the initial diagnosis of Menière’s disease, she suffered refractory episodes of vertigo.

Pure tone audiometry in our clinic showed left sided profound and right sided moderate (sensorineural) hearing loss.

Otomicroscopy was normal. Weber tuning fork testing did not lateralise. Rinne testing on the left side was not heard by the patient.

Stapedial reflex and OAEs were present bilaterally. Peripheral vestibular testing was symmetrical.

ABR bilateral normal wave patterns with normal absolute and interpeak latencies at 30dB nHL detectable. No abnormal findings on MRI brain.

Conclusion The patient shows a longstanding dissociative sensory disturbance with significant impact on inner ear function. The patient was counselled and psychosomatic assessment took place. This case study shows the importance of objective hearing testing prior to any CI surgery even with a series of previous tests suggesting indication.

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Publication History

Article published online:
10 June 2020