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Short Notes on Deafness 2017 - Dr Mark Burgin

21/05/17. Dr. Mark Burgin BM BCh (oxon) MRCGP considers the elements that should be included in a primer for clinical negligence cases involving deafness.

Deafness can be divided into conductive hearing loss where a cause will generally be found on examination and sensorineural hearing loss with a normal examination.

Sensorineural hearing loss can occur gradually, rapidly or suddenly and can affect both ears or only one, it can be associated with vertigo.

The pattern of sensorineural hearing loss can help suggest the diagnosis but there are few effective treatments so that causation is difficult to show. (1)

Sudden unilateral profound hearing loss.

The cause of this type of hearing loss is thought to be due to viral infection of the inner ear or autoimmune response or a fistula.

The treatment involves taking oral steroids as soon as possible after the onset although there is no good evidence that steroids are effective.

A case based upon the failure to prescribe steroids is likely to fail on causation until research proves that the treatment is effective.

An MRI of the internal auditory meatus is usually normal and as the patient still has one normally functioning ear no hearing aid is offered.

Many cases the patient has been prescribed ototoxic ear drops (Gentamicin or Neomycin) in the presence of a perforation of the ear drum which means that the drops can reach the inner ear.

There is a range of opinion with some experts of the opinion that ototoxic ear drops in the presence of a perforation of the ear drum can...

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