ENT Clinic Note

Dr. Eleanor Vance, Consultant ENT Surgeon - ENT Clinic Note Patient: Mr. Arthur Jenkins Date: 01 November 2024 Mr. Jenkins presented with a 6-month history of progressive hearing loss in his left ear, accompanied by intermittent tinnitus described as a low-pitched hum. He reports that the hearing loss has been gradually worsening, significantly impacting his ability to participate in conversations, particularly in noisy environments. He denies any associated pain, discharge, or vertigo. He has tried over-the-counter ear drops without success. There is no family history of significant hearing loss. The symptoms are having a moderate impact on his social life and work productivity. Examination of the left ear revealed a healthy external auditory canal and a pearly grey, intact tympanic membrane with normal light reflex. Weber's test lateralised to the right ear. Rinne's test was positive bilaterally, suggesting sensorineural hearing loss in the left ear. The remainder of the head and neck examination, including cranial nerves, was unremarkable. Nasal endoscopy showed clear nasal passages and healthy turbinates. Oral cavity and pharynx appeared normal. Neck palpation revealed no cervical lymphadenopathy or masses. Treatment options discussed included further diagnostic imaging and audiometric testing to determine the extent and nature of the hearing loss. We specifically discussed a high-resolution CT scan of the temporal bones and a comprehensive audiogram. The benefits of these investigations include accurate diagnosis and guidance for treatment. Risks are minimal for the audiogram; for the CT scan, risks include radiation exposure, which is considered low. If sensorineural hearing loss is confirmed and significant, hearing aid options were briefly introduced as a potential intervention. Post-operative care instructions are not applicable at this stage. Recovery timeline involves awaiting investigation results. Scheduling for the audiogram and CT scan has been arranged for next week.