Ear drum perforation

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:

  • If acute event with dizziness, nausea and vomiting

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

  • Nil

To contact the relevant service, please see HealthPathways: Acute ENT Assessment

Presenting issues
  • Ear drum perforation for more than 3 months
  • Attic perforation with possibility of cholesteatoma
  • Either of the above plus facial weakness
Mandatory referral information (referral will be returned if this information is not included)


  • Diagnostic audiology assessment (where available and providing it will not cause significant delay)
  • Ear swab results if discharge

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
  • Health assessment for Aboriginal and/or Torres Strait Islander people
Indicative triage category
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
Excluded ENT services

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

Condition Details
Simple ear drum perforation as part of otitis media
  • Ensure perforation resolves, otherwise needs to be referred

Last reviewed: 24-05-2023

More information

Email: DOHSpecialistRAC@health.wa.gov.au