Hearing loss

Indications for urgent referral

Seek urgent audiometry with bone conduction if the patient has sudden onset hearing loss with less than a one week history in the absence of clear aetiology and/or associated with vertigo and tinnitus. Provide results prior to appointment if possible.

For urgent referrals, contact the ENT Register at the relevant hospital.

Criteria for routine specialist referral via CRS

Long standing asymmetrical sensorineural hearing loss (>five days):

  • include results from audiometry with bone conduction
  • if possible include MRI results/report if suspected acoustic neuroma.

Conductive hearing loss:

  • non-traumatic sudden-onset conductive hearing loss (usually unilateral)
  • traumatic sudden-onset conductive hearing loss (usually unilateral) if long standing
    • if acute event with dizziness = emergency referral
    • if acute event with ear discharge = urgent referral
  • hearing loss indicated for implantable hearing devices
  • benign bony growth, or benign polyps affecting hearing
  • suspected otosclerosis affecting hearing
  • greater than expected hearing loss for age.

Routine referral information required

All referrals must include comprehensive medical history, test results as per below, summary of treatment and response to date:

  • medication list
  • summary of neurological examination
  • assessment of risk factors for acoustic neuroma
  • tuning fork test outcomes (Rinne test and/or Weber test) or state reason why not undertaken
  • audiology report and audiogram results and report must be included (or state reason why not undertaken).

If dry mouth/eyes include:

  • ANA
  • RF
  • antiRO
  • antiLA.

For implantable hearing devices referral must indicate response to trial of optimised hearing aids.

Information about community management

Further information regarding primary care management of ENT conditions is available on the HealthPathways WA website. Please email the HealthPathways team to obtain the login details: healthpathways@wapha.org.au. HealthPathways are currently working on responding to the new criteria and will have all the ENT pathways adapted to WA as soon as possible.