Viva on Sensorineural Hearing Loss in an Adult

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Case – A 48 year old man presents with progressive sensorineural hearing loss. He is struggling with conventional hearing aids.

Examiner: What key points in the history lead to a differential diagnosis?
I would first enquire about the nature of the patient’s pre-existing hearing loss, asking about the onset of hearing loss, whether this was congenital or acquired. What previous investigations (if any) the patient has had for their hearing loss.

It is important to ask about current problems including how long the patient has been wearing hearing aids for and whether these are worn bilaterally, the duration of worsening hearing loss, what benefit they are getting from conventional hearing aids (if any) and how this has changed. If there are any associated otological symptoms such as otalgia, otorrhoea, vertigo and especially tinnitus and the nature of this. I would also ask about any associated neurological symptoms. It is important to enquire about the extent of the patient's disability, i.e. how does the hearing impairment affect his life, both work and social. Good pointers in this regard are; can he enjoy music, use the telephone or converse in crowds. Also does he use any adjuncts to assist in communication such as lip reading or written communication?

Within the social history I would enquire about his occupation and history of noise exposure. Finally a past medical history, drug history and any relevant family history should be ascertained.

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Read 1424 times Last modified on Tuesday, 10 December 2013 14:44

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