title: Inadvertent insertion of hearing aid impression material into the middle ear: Case report and implications for future community hearing services.
abstract: BACKGROUND
  The creation of ear moulds for hearing aids is generally considered a safe and routine procedure for trained professionals. In the literature there are reports of otological complications caused by hearing aid mould impression material in the middle ear cavity but such complications are considered rare.
  
  
  METHODS
  We present the case of a patient in whom impression material entered the middle ear through a perforation of the tympanic membrane during the process of making a hearing aid mould and review how this was managed.
  
  
  CONCLUSIONS
  We discuss how many aspects of the British Society of Audiology guidelines were not followed during this procedure and make recommendations as to how independent community practitioners need to be closely supervised with regular review to minimise the risks of such complications.
  
  
  CONCLUSIONS
  Our report demonstrates how a serious otological complication from the creation of a hearing aid impression in a community based private hearing clinic was managed. The reporting of such complications is rare but the incidence is likely to be much higher than the literature would suggest. We recommend and advise how these adverse incidents may be minimised and managed through competency reviews and formal referral links from community centres to hospital otolaryngology/audiology departments.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, United Kingdom. Electronic address: ashwin.algudkar@gmail.com.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Algudkar
authors.forename: Belma
authors.initials: B
authors.lastname: Maden
authors.forename: Arvind
authors.initials: A
authors.lastname: Singh
authors.forename: Taran
authors.initials: T
authors.lastname: Tatla
keywords: Audiology; Complications; Hearing aid; Otology