From the Guidelines
I do not recommend providing a Motion 13 1 NX hearing aid for the patient's left ear at this time. The patient currently has a Motion 13 1 NX hearing aid in his right ear that was provided on January 13,2025. According to the clinical practice guideline on age-related hearing loss 1, clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. However, this guideline also emphasizes the importance of assessing communication goals and hearing-related quality of life (QOL) before proceeding with additional interventions.
For the patient's right groin pain complaint, I will order an ultrasound to evaluate the cause. I will schedule a follow-up appointment to discuss the ultrasound results and determine appropriate treatment for the groin pain. In the meantime, the patient should continue using his right hearing aid as prescribed. Before considering a hearing aid for the left ear, we should complete a comprehensive audiological evaluation to determine if a hearing aid is necessary and what type would be most beneficial. This approach is supported by the guideline's recommendation to assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing 1.
Key considerations in this patient's care include:
- Evaluating the patient's hearing loss and its impact on his communication, safety, function, cognition, and QOL 1
- Assessing the patient's sociodemographic factors and preferences that may influence access to and utilization of hearing health care 1
- Counseling the patient on communication strategies and assistive listening devices 1
- Monitoring the patient's hearing and adjusting the treatment plan as needed to ensure optimal outcomes and QOL.
From the Research
Patient Complaints and Requests
- The patient is complaining of hearing problems and is requesting a hearing aid for his left ear, in addition to the one he already has in his right ear.
- The patient is also experiencing pain in his right groin area.
Diagnostic Approach for Groin Pain
- According to 2, ultrasonography is often used to diagnose groin hernias, especially in women, and can be helpful in diagnosing recurrent hernias, surgical complications, or other causes of groin pain.
- The study 2 also mentions that magnetic resonance imaging (MRI) has higher sensitivity and specificity than ultrasonography and can be useful for diagnosing occult hernias.
Treatment Options for Groin Pain
- 3 discusses the use of ultrasound-guided peripheral nerve stimulation implant for managing intractable pain after inguinal herniorrhaphy, which may be a potential treatment option for the patient's groin pain.
- 4 highlights the advantages of ultrasonography in interventional procedures for chronic pain management, including improved visualization of anatomy and avoidance of ionizing radiation.
Rehabilitation and Physical Therapy
- 5 explores the use of physical therapy and rehabilitation in hernia care, including the development of a standardized rehabilitation protocol and the identification of barriers to its adoption.
- The study 5 found that physical therapy can improve function, return to activities of daily living, and promote overall recovery in patients with hernia disease.
Therapeutic Ultrasound for Chronic Pain
- 6 evaluates the effectiveness of therapeutic ultrasound in managing chronic knee, shoulder, and hip pain, and finds that it can be a useful adjunct to other treatments, although further trials are needed to define its true effect.