Chronic Hearing Loss Referral Access Criteria
Chronic Hearing Loss Referral Access Criteria
| Referrers should use this page when referring patients to public adult ENT outpatient services for chronic hearing loss. |
| Emergency referral |
 If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region. |
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| Immediate referral |
 Immediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):
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- Chronic hearing loss (more than 72 hours) with the following associated conditions:
- trauma
- foreign body
- dizziness or vertigo
- facial numbness or weakness
- ear pain
- ear discharge
To contact the relevant service, see Clinician Assist WA: Acute ENT assessment (external site)
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Long standing sensorineural hearing loss (more than 72 hours)
- asymmetrical sensorineural hearing loss
- rapidly deteriorating (weeks to months) sensorineural hearing loss (significant hearing loss or loss of speech discrimination)
- sensorineural hearing loss accompanied by at least two episodes of: vertigo; asymmetrical tinnitus; asymmetrical speech discrimination
- bilateral or unilateral sensorineural hearing loss which cannot be helped with hearing aids (may be an implant candidate)
- Conductive hearing loss:
- hearing loss indicated for implantable hearing devices
- benign bony growth, affecting hearing
- suspected otosclerosis affecting hearing
- greater than expected hearing loss for age
- associated with chronic middle ear disease (refer to section on chronic middle ear disease)
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| Mandatory information |
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Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).
This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
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| History |
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Relevant history, onset, duration of symptoms including:
- description of hearing loss i.e. one or both sides, severity, significant change in hearing
- Current medication list
- Details of previous treatment and outcome
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| Examination |
- Summary of neurological examination
- Tuning fork test (Rinne test and/or Weber test) (where available and providing it will not cause significant delay)
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| Investigations |
- Audiology and audiogram report must be included (where available and providing it will not cause significant delay)
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| Highly desirable |
| History |
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Information regarding any hearing aids or hearing devices and communication mode utilised by the patient e.g. Auslan
- Any previous audiology assessment results
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| Examination |
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| Investigations |
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- No defined category 1 criteria
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Category 2
Appointment within 90 days
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- Rapidly progressive severe unilateral or bilateral sensorineural hearing loss and/or severe vertigo
- Potential candidate for hearing implantation
- Greater than expected hearing loss for age
- Associated with chronic middle ear disease (refer to section on chronic middle ear disease)
- Asymmetrical SNHL suspicious for acoustic neuroma
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Category 3
Appointment within 365 days
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- Benign bony growth
- Otosclerosis
- Bilateral, symmetrical, moderate hearing loss
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| Exclusions |
- Hearing loss is an excluded condition for the following:
- Symmetrical age-related hearing loss of mild severity
- Patients with a normal audiogram
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Feedback
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Last reviewed: 02-10-2023