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Practice Guidelines

Hearing loss in adults, assessment and management: summary of NICE guidance

BMJ 2018; 361 doi: (Published 22 June 2018) Cite this as: BMJ 2018;361:k2219
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Hearing loss: triaged referral

A summary of new NICE guidelines

Rapid Response:

Re: Hearing loss in adults, assessment and management: summary of NICE guidance

As an older patient with SOME hearing loss, may I please make a few points?

1. We (Anand JK and Court I) conducted a survey of old peoples’ homes.
The exercise was funded by Marks and Spencer.
Readers might care to read the paper and see if our work merits duplication elsewhere.
Ref: BMJ 1989 May 27;298(6685):1429-30

2. It is quite possible that anosmia or hypoosmia might accompany mild hearing loss of the conduction type (personal experience as a patient). Of course an aged patient may also have a degree of sensori-neural variety.
I would plead that BEFORE fitting hearing aids, the audiologist/ audiometrician might do three things:
a) clear the external auditory canal of wax
b) ask an otorhinolaryngologist to examine the posterior nasal passage and nasopharynx for catarrh and look at the drum as well for signs of middle ear catarrh
c) treat pathology found

and THEN check the PATIENT’s ability to understand speech.

From personal experience as a patient, I would say that fluticasone proprionate suspension 1mg/ml might relieve the catarrh sufficiently to improve the conduction loss to obviate the need for a hearing aid! In SOME patients for SOME period at least.

Competing interests: No competing interests

25 June 2018
JK Anand
Retired doctor
Free spirit