Ear drum perforation Referral Access Criteria

 Referrers should use this page when referring patients to public adult ENT outpatient services for ear drum perforation. 
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.
  • If acute event with dizziness, nausea and vomiting
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):
  • Nil
To contact the relevant service, see HealthPathways: Acute ENT assessment (external site)
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Ear drum perforation for more than 3 months
  • Attic perforation with possibility of cholesteatoma
  • Either of the above plus facial weakness
Mandatory information
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 due to financial reasons or geographical location).

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.

History
  • Nil
Examination
  • Nil
Investigations
  • Diagnostic audiology assessment (where available and providing it will not cause significant delay)
  • Ear swab results if discharge
Highly desirable
History
  • Nil
Examination
  • Results of health assessment for Aboriginal and/or Torres Strait Islander People
Investigations
  • Nil
Indicative triage category

Category 1

Appointment within 30 days

  • Ear drum perforation with facial weakness
  • Ear drum perforation with suspicion of perilymph fistula

Category 2

Appointment within 90 days

  • Possibility of cholesteatoma
  • Persistent / recurrent discharge despite treatment
  • Disabling pain
  • Hearing loss significantly limiting quality of life, education, work 

Category 3

Appointment within 365 days

  • Dry ear drum perforation with non-disabling hearing loss
Exclusions
  • Simple ear drum perforation as a part of acute otitis media is an excluded condition unless the following features apply:
    • If perforation does not resolve or if cholesteatoma is suspected patient needs to be referred
Useful information
  • Nil

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Last reviewed: 02-10-2023