Nowadays this speciality (also known as otorhinolaryngology) often overlaps with plastic surgery, neurosurgery and maxillo-facial surgery.
In the past Clinical Negligence claims for facial nerve damage were common but are less so now with improvement in training, but issues surrounding the early diagnosis and treatment of acoustic neuromas can sometimes result in litigation. At JMW Solicitors compensation was obtained for a woman whose ENT doctor failed to diagnose her Acoustic neuroma for over 15 months. Damage to the facial nerve is a recognised complication of a mastoidectomy and is not negligent if it can be proved that the anatomy was abnormal. The same principles apply to recurrent laryngeal nerve injury (the nerve supplying the vocal chords), which can be damaged during thyroid surgery, radical neck dissection and laryngectomy. Damage to this nerve sometimes also occurs during anaesthetic induction when an endotracheal tube is passed between the vocal chords, but this type of injury almost always recovers spontaneously.
Since the introduction of endoscopic sinus surgery some years ago damage to the bones surrounding the eye (orbital injury) and to the skull during this procedure have become by far the commonest cause of medical negligence claims associated with ENT. A frequently occurring complication is a leak of cerebro-spinal fluid (CSF) from the brain. This often settles within a few days but if it does not a crainiotomy (opening of the skull) will be required to repair it resulting in a permanent loss of sense of smell. More seriously it can sometimes lead to meningitis or brain abscess and occasionally the optic nerve can be damaged resulting in blindness. Guidelines state that no endoscopic nasal procedure should be embarked on without a CT scan of the sinuses.
Most ENT department have a very high workload resulting in many patients being examined and operated on by relatively inexperienced doctors, and this inevitably sometimes results in sub standard care and medico-legal claims. However, 90% of ENT operations are straightforward with risks of 1% or less.
A large proportion of ENT operations are aimed at improving quality of life rather than directly related to health and this type of surgery sometimes result in litigation in a similar way to cosmetic surgery. Such operations are those to do with minor nasal obstruction, catarrhal symptoms, snoring, voice improvement and rhinoplasty.
JMW Medical Negligence Solicitors offer free initial advice on clinical and medical negligence claims, evaluating whether you have a case. We are able to deal with cases using public funding (formerly Legal Aid) or No Win No Fee in appropriate cases.
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