Acoustic Neuroma
You are asked to give the results of a recent MRI scan for asymmetrical hearing loss to Mr Smith. This demonstrates evidence of an acoustic neuroma.
Setting
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WIPER
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Ask if they are happy to see you
Perception
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Recap on past events – symptoms, investigations so far
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“Thank you for bringing me up to speed.”
Invitation
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“Results are back, can I give them to you now”
Knowledge
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Unfortunately it is not the news we were hoping for.
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The scan shows that you have a benign tumour called an acoustic neuroma. PAUSE
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Would you like me to explain the condition
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It is a non-cancerous tumour/growth of the brain. This means it does not spread
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In particular it grows on the nerve used for hearing and balance, which can cause problems such as hearing loss and unsteadiness.
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This is why you are getting the symptoms you have been describing
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Treatment options
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Conservative –these are slow growing so we can keep you monitored with annual scans to see if it is getting better
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For hearing – use hearing aids
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Tinnitus – mainly distraction techniques
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Surgery – remove tumour – risks associated with this including losing hearing
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Radiotherapy
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Refer to skull base surgeon and discuss at MDT to see which is best option
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Even with treatment, symptoms such as hearing loss and tinnitus can persist and affect your ability to work, communicate and/or drive. These problems may need additional treatment
Empathy
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I am sorry, I know this is not the news you were expecting
Strategy and summary
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Summarise findings
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Offer leaflet
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Answer any questions
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Offer hearing aid in mean time for safety
Round up and safety net
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If dizzy need to stop driving as per DVLA (DVLA guidelines for acoustic neuroma)
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Today we have talked about…. – Do you have any further questions?
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Once again my name is…
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Give secretary's number