Since Lorenzo posted his great 3 year results following his visit to Stanford several weeks ago, I thought I would recap my follow up visit with Dr. Chang today.
My last MRI and audiogram were at the 4 year milestone, so it has been two years since my last check
AN Status - Still showing on the scan as "dead"
and stable to slightly smaller in size. Current measurements are 1.8 x 1.6 x 1.6 vs. a size at treatment of approximately 2.1 x 1.9 x 1.8 . In terms of the cubic volume of the AN it is actually about 1/3 smaller.
Facial nerve Function - was 100% OK prior to treatment and is unchanged.
Hearing status - this is the one area where I got somewhat mixed results for the first time. Up to this point my hearing has been testing out as unchanged from what it was prior to treatment. I know everyone here has had many audiograms and I assume they have essentially the same elements which I call.
Word recognition - ( repeat those 20-25 tricky words back
) - scored 100% in the AN ear which is unchanged from the last 3-4 tests , so that was stable
Signal transmission - ( measure the amount of sound transmitting from one ear and heard by the other) I think this is where the idea came about being able to look through one ear and see out the other side
. At any rate, this was also stable and unchanged from previous tests.
Frequency test - ( the famous push the button when your hear the beep test) . Most of us lose our high frequency recognition as a result of the AN and have a downward sloping graph. In my case 250 through 500 Hz are normal and then it starts sloping down from there and I hear 4K HZ at 50 db and 8K HZ at 60 db. These aspects of the graph were unchanged on this test but I did show a decrease of 15-20 db in the middle range ( 1k /2k Hz) from the previous audiograms.
Overall Dr. Chang felt the word recognition score was the most important area to focus on since that is what is most noticeable to us as patients. We discussed the slight frequency test drop as possibly being due to a testing variance because of the stability of the other test elements. Subjectively, I would say that my hearing has not changed from pre-treatment levels.
At any rate, I would still grade the report as an A-. My next MRI will be 2 years from now in 2009 as is the norm. Dr. Chang and I did agree to do an audiogram only this time next year to see if the frequency hearing change was a testing aberration or an actual change
A couple of other tidbits that might be of interest:
Stanford has now done about 700 AN's with CK and had 5 failures ( slightly less than 1%).
The treatment protocols now have an added focus on limiting the dose to the cochlea to further improve hearing retention odds
It is being looked at as part of the next Stanford AN study due probably next year, but Dr. Chang feels there is a correlation between the level of pre-treatment hearing and retention after hearing. In other words, those with a high level of hearing coming into treatment seem to have less occurrence of post treatment deterioration than those who come in with marginal hearing to begin with.
Finally, I know many people on the board think Lorenzo sounds like a real nice guy. well, just in case anybody doubted that, Dr. Chang told me that when he was at Stanford for his check up he actually went over to the CK room and spent some time talking and reassuring some patients who were being treated that day. As Phyl says, Lorenzo you rawk
That's the update,
Mark