Dysphonia/hoarseness Referral Access Criteria

Referrers should use this page when referring patients to public paediatric ENT outpatient services for dysphonia/hoarseness. This RAC is applicable to referrals for patients aged <16 years only. Please refer to the ENT (Adult) RAC for referrals for patients aged 16 years or more.

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.
  • Foreign body (button batteries – inhaled or ingested). if suspicion of button battery immediate emergency review
  • Acutely enlarging neck mass with any associated airway symptoms e.g., stridor, drooling, dysphagia etc
  • Airway compromise: severe stridor/drooling/ breathing difficulty/acute, sudden voice change/ severe odynophagia
  • Trauma
  • Abscess or haematoma (e.g., peritonsillar, parapharyngeal (quinsy), salivary, neck or retropharyngeal abscess)
  • Post-tonsillectomy haemorrhage
  • Hoarseness associated with neck trauma or surgery
  • If new onset hoarse voice and any airway obstructive symptoms             
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate paediatric ENT assessment (seen within 7 days):
  • Nil
To contact the relevant service, see HealthPathways: Acute Paediatric ENT assessment (external site)
Presenting issues
 If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Abnormal voice > 1 month – i.e.: hoarse, rough, raspy, strained, weak, breathy 
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
  •  Details of previous treatment and outcome
Examination
  • Nil
Investigations
  • Nil
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • Speech pathology assessment results 
Indicative triage category

Category 1

Appointment within 30 days           

  • No defined category 1 criteria 

Category 2

Appointment within 90 days

  • >1 month of moderate to severe hoarseness and voice loss
  • Suspicion of any of the following:
    • papilloma
    • thrush
    • vocal cord palsy

Category 3

Appointment within 365 days

  • Intermittent hoarseness
Exclusions
  • Nil
Useful information
  • Nil

Feedback

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Last reviewed: 27-05-2024