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Hearing Loss (Deafness)

  

Hearing Loss (Deafness)


Assessment

Consider likely cause

  • Could be hereditary, blocked canal, infection, perforation, otitis media with effusion (glue ear), old age, otosclerosis, noise-induced, viral, trauma, toxins (such as gentamicin, NSAIDs, chemotherapy), acoustic neuroma, Menieres, vascular, auto-immune, non-organic.
Management
  • Clear wax – very thoroughly if hearing aid required
  • Treat infection
  • Simple otitis media with effusion (OME) – wait 2-3 months then refer if not resolved.
Referral
  • Sudden onset of severe, unilateral hearing loss – contact ENT on call at UHCW.
  • Children under 16 years usually go to the Paediatric Audiology Clinic at Child and Family Services, 4th floor, City of Coventry Health Centre, 2 Stoney Stanton Road, CV1 4FS. Tel 024 7696 1364, faxes to 024 7696 1560 marked “for paediatric audiology”. However, consider referring to hospital ENT if pain, perforation, etc.
  • Between 16-18 years of age – Refer to UHCW
  • NHS Hearing Service – Eligible for all patients aged above 18 years of age.
Signposting Guide for GPs

If YES is answered to any of the following refer to Secondary Care Services, otherwise direct patient to NHS Hearing Service.

History

Persistent pain affecting either ear (defined as earache lasting more than 7 days in the past 90 days before appointment)

  • Unilateral Hearing loss
  • History of discharge other than wax from either ear within the last 90 days
  • Sudden loss or sudden deterioration of hearing (sudden=within 1 week) which case send to A&E or Urgent Care ENT clinic)
  • Rapid loss or rapid deterioration of hearing (rapid=90 days or less)
  • Fluctuating hearing loss, other than associated with colds
  • Unilateral or asymmetrical, or pulsatile or distressing tinnitus lasting more than 5 minutes at a time
  • Troublesome, tinnitus which may lead to sleep disturbance or be associated with symptoms of anxiety or depression
  • Abnormal auditory perceptions (dysacuses)
  • Vertigo
  • Normal peripheral hearing but with abnormal difficulty hearing in noisy backgrounds; possibly having problems with sound localization, or difficulty following complex auditory directions.
Ear examination
  • Complete or partial obstruction of the external auditory canal preventing proper examination of the eardrum and/or proper taking of an aural impression.
  • Abnormal appearance of the outer ear and/or the eardrum (e.g.,
  • inflammation of the external auditory canal, perforated eardrum; active discharge).

Before referring for a hearing aid, please ensure ear wax is very thoroughly cleared, to allow effective testing and fitting.

Domiciliary visits are available for patients who are housebound.

Hearing aid batteries

It will be the responsibility of the patient to fund replacement aids in the event of loss or damage unless the patient has a diagnosis of dementia, learning disabilities or blindness confirmed by the referring GP, in which case the cost of £50 will be borne by the Commissioner.

Unfortunately this criteria has to be applied uniformly across all sites, Specsavers replacement price is slightly higher as we renewed their contract recently, if the aid is over three years old then could go to Specsavers and self-refer for a new aid, if not then the replacement price will have to be paid.

Patients can collect hearing aid batteries from UHCW Out-patients Department, Clinic 8. Alternatively they can telephone the Trust on 024 7696 6444 and the batteries will be posted.

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