The root cause behind acute sensorineural hearing loss lies in the inner ear, sensory organ or the vestibulocochlear nerve. There are several potential causes although commonly no single diagnosis is offered. In younger adults, the cause is presumed to be viral.
Whatever the cause, there is potential for the auditory nerve to be permanently damaged and, consequently, the patient will suffer permanent hearing loss or tinnitus on the affected side without appropriate treatment.
NICE guidelines for adult patients suffering from hearing loss recommend that if a patient experiences sudden (over a period of 3 days or less) hearing loss in the past 30 days, an immediate referral should be made to the local ear, nose and throat service or an emergency department, and the patient seen within 24 hours.
The first line of treatment, according to the guidelines, is a course of steroids to be administered orally, by way of injections into the inner ear, or a combination of both. The principle is that steroids will reduce the acute swelling and therefore reduce any damage to the auditory nerve, thereby preserving a person's hearing. The quicker the administration of steroids, the earlier the swelling will go down.
The claims I am currently investigating contain a catalogue of errors in assessing and treating my clients. One was wrongly diagnosed with Meniere's disease, despite not suffering from vertigo (a classic symptom for this diagnosis) and was told to stop taking the steroids correctly prescribed by his GP the day before. Others came across multiple GPs simply not following NICE Guidelines and failing to urgently refer them to the local ENT or A&E department; and a nursing practitioner at an Urgent Care Centre failing to ask any questions about hearing loss or to perform a hearing test despite this being the reason for his attendance.
In complaints correspondence I have seen for one of my clients, the GPs in question actually stated they were not even aware of the requirement to urgently refer a patient with acute hearing loss to the local ENT or A&E department, as per the NICE guidelines.
All of the above represent a very concerning knowledge gap in primary care services of the requirements under the NICE guidelines to treat this presentation. This knowledge gap has had serious consequences for my three clients, and I am sure has affected many others.
All three of my clients now have permanent hearing loss in one ear, require a hearing aid and have other associated symptoms such as hyperacusis, constant tinnitus and balance issues. Their personal and professional lives have been affected and they will permanent suffer from ongoing symptoms.
I am lobbying for appropriate training so that future patients receive the right treatment and do not go on to suffer the lifelong consequences my clients have.
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