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
  • WIPER

  • Ask if they are happy to see you

Perception
  • Recap on past events – symptoms, investigations so far

  • “Thank you for bringing me up to speed.”

 
Invitation 
  • “Results are back, can I give them to you now”
Knowledge
  • Unfortunately it is not the news we were hoping for.

  • The scan shows that you have a benign tumour called an acoustic neuroma. PAUSE

  • Would you like me to explain the condition

    • It is a non-cancerous tumour/growth of the brain. This means it does not spread

    • In particular it grows on the nerve used for hearing and balance, which can cause problems such as hearing loss and unsteadiness.

    • This is why you are getting the symptoms you have been describing

  • Treatment options

    • Conservative –these are slow growing so we can keep you monitored with annual scans to see if it is getting better

    • For hearing – use hearing aids

    • Tinnitus – mainly distraction techniques

    • Surgery – remove tumour – risks associated with this including losing hearing

    • Radiotherapy

  • Refer to skull base surgeon and discuss at MDT to see which is best option

  • 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
  • I am sorry, I know this is not the news you were expecting
Strategy and summary
  • Summarise findings

  • Offer leaflet

  • Answer any questions

  • Offer hearing aid in mean time for safety 

Round up and safety net
  • If dizzy need to stop driving as per DVLA (DVLA guidelines for acoustic neuroma)

  • Today we have talked about…. – Do you have any further questions?

  • Once again my name is…

  • Give secretary's number

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