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Chronic Hearing Loss

Chronic Hearing Loss

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Nil

Immediately contact on-call registrar or service to arrange an immediate ENT assessment (seen within 7 days) for:

  • 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, please see HealthPathways: Acute ENT Assessment

Presenting issues
  • 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 chronic middle ear disease RAC)
Mandatory referral information (referral will be returned if this information is not included)

History

  • Relevant history, onset, duration and severity of hearing loss 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

Examination

  • Summary of neurological examination
  • Tuning fork test (Rinne test and/or Weber test) (where available and providing it will not cause significant delay)

Investigations

  • Audiology and audiogram report (where available and providing it will not cause significant delay)

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)
Highly desirable referral information
  • Information regarding any hearing aids or hearing devices and communication mode utilised by the patient e.g. Auslan
  • Other previous audiology assessment results
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • No category 1 criteria
Category 2
Appointment within 90 days
  • 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 
Category 3
Appointment within 365 days
  • Benign bony growth
  • Otosclerosis
  • Bilateral, symmetrical, moderate hearing loss 
Excluded ENT services

Referral to public adult ENT outpatient services is not routinely accepted for the following conditions:

Condition Details
Hearing loss

Excluded condition for the following:
Hearing aid dispensing

Last reviewed: 24-05-2023

More information

Email: DOHSpecialistRAC@health.wa.gov.au

wa.gov.au