Cochlear implant in Cogan's syndrome.
Post-lingual deafness is a stressful condition which is rendered even more painful by the sudden emotional isolation that the patient suffers. Cogan's syndrome is a rare autoimmune cause for post-lingual deafness characterized by non-syphilitic interstitial keratitis, bilateral audio vestibular deficiencies and systemic vasculitis. World over very few cases of Cogan's syndrome have been reported. Cochlear implant surgery in such a patient is a challenging but highly satisfactory experience due to the multitude of clinical problems the patient faces. This demands a proper work up, meticulous surgery and stringent post-operative follow-up. Here we present a patient with atypical Cogan's syndrome, diabetes mellitus and hypothyroidism. She went into a major depression with suicidal tendency following the complete loss of hearing. We performed cochlear implant surgery in this patient, but not before facing several clinical obstacles, helped by a dedicated team consisting of a rheumatologist, endocrinologist, neurophysician, psychiatrist, anaesthetists and audiologist. The results are extremely satisfying for the patient and all the people involved. This case underlines the prime importance of hearing in maintaining the psychological well being of a human being.
Vishwakarma
Rajesh
R
Department of Otorhinolaryngology and Head and Neck Surgery, B J Medical College and Civil Hospital, Ahmedabad, India. drvrajesh@hotmail.com
Shawn
T Joseph
TJ
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001284:Atrophy / Q000150:complications / Q000473:pathology; D003054:Cochlear Implants; D003638:Deafness / Q000601:surgery* / Q000628:therapy; D048909:Diabetes Complications / Q000150:complications* / Q000175:diagnosis; D004423:Ear / Q000473:pathology; D018159:Endolymphatic Hydrops / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007037:Hypothyroidism / Q000150:complications*; D007634:Keratitis / Q000150:complications; D008875:Middle Aged; D012934:Social Isolation; D013577:Syndrome; D013701:Temporal Bone / Q000473:pathology; D013997:Time Factors; D014705:Verbal Behavior; D014717:Vertigo / Q000150:complications
D000893:Anti-Inflammatory Agents; D007004:Hypoglycemic Agents