Hearing loss or concern - other (Audiology)

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Hearing loss with associated neurological signs
    • Sudden / Rapid onset unilateral or bilateral hearing loss

    Note: direct phone contact with the ENT registrar on call to discuss the case and arrange review as clinically appropriate

    • Refer to HealthPathways or local guidelines
    • Meningitis - there is a very high risk of ossification of cochlear structures (labyrinthitis ossificans) post bacterial meningitis (particularly Streptococcus pneumoniae), which can occur rapidly, and inhibit cochlear surgery. Any patient identified with significant hearing loss post-infection, should be referred to ENT urgently for radiological assessment and consideration of cochlear implantation. The association between viral meningitis and hearing loss is less clear.
    • In cases of sudden deterioration of hearing, do otoscopy to check for ear infections and use tuning fork tests (if available) to try to differentiate sensorineural (urgent) from conductive (non-urgent) hearing loss. See links to tuning fork tests (Weber & Rinne) below.
    • In cases of sudden sensorineural hearing loss, accessing treatment (e.g. Prednisone and/or hyperbaric oxygen) ASAP is essential to help optimise hearing outcomes.
    • For hearing aid wearers, refer to their local hearing aid provider to ensure optimal hearing aid fitting
    • High incidence in refugee community and patients with poor access to primary health care
    • High incidence of otitis media and associated hearing loss for Aboriginal and Torres Strait Islander people.
    • Over half the population aged between 60 and 70 has a hearing loss
    • People who have difficulty hearing and who want to use hearing aids are most likely to gain benefit from their use
    • Give the person and, if they wish, their family or carers, information about:
      • the causes of hearing loss, how hearing loss affects the ability to communicate and hear, and how it can be managed
      • organisations and support groups for people with hearing loss
      • communication strategies
      • ear health advice for outer/middle ear-related hearing concerns
    • Refer to Hearing Australia if:
      • younger than 26 years or
      • an Aboriginal and Torres Strait Islander who is over 50 years (also see other ATSI eligibility at OHS website).

    Clinical resources

    Patient resources

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Suspected hearing loss following bacterial meningitis (earliest possible appointment)
  • Following meningitis infection – for hearing assessment and monitoring
  • Ototoxic treatments requiring baseline or monitoring assessments
Category 2
(appointment within 90 calendar days)
  • Syndrome/ disorders/injury associated with permanent hearing loss
  • Chronic hearing loss – rapid or significant change in auditory functioning
  • Family history childhood hearing loss
  • Referred on hearing screen (Refugee, Detention Centre, Aboriginal and Torres Strait Islander Program or GP Clinic)
Category 3
(appointment within 365 calendar days)
  • All other not excluded
  • Significant conductive loss with intact drum

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Details of syndrome/disorder/injury/family history associated with permanent hearing loss, comorbidities
  • Audiology/audiometry including audiogram (where available and not cause significant delay)
  • Details of ototoxic treatments (if applicable)
  • Otologic history
  • Previous relevant surgery or treatment

3. Additional referral information Useful for processing the referral

  • Hearing and communication needs at home, work, education and social situations
  • Psychosocial difficulties related to hearing

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 15 January 2025

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