​​​Emergency

If complication of acute suppurative otitis media (ASOM) (mastoiditis (proptosis of pinna), meningitis, associated neurological signs (for example facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing)) is present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar.

When public outpatient services are not routinely provided

Middle ear effusion in one ear for < 6 months or both ears for < 3 months.

Criteria to access public outpatient services

CategoryCriteria

Category 2
Recommended to be seen within 90 calendar days.​​

  • Confirmed or suspected structural damage to the tympanic membrane (for example significant retraction, cholesteatoma).
  • Effusion and any of the following:
    • speech delay, educational handicap and/or Aboriginal Torres Strait Islander descent
    • structural or medical comorbidities (for example cleft palate, craniofacial abnormalities, diabetes, sensorineural hearing loss) and lasting > 3 months with audiometry showing significant bilateral or unilateral conductive hearing loss (≥ 30 dB in better ear).
  • Perforated tympanic membrane and any of the following:
    • ongoing pain
    • persistent drainage from the middle ear for > 6 weeks despite topical antibiotics
    • Significant hearing loss ≥ 45 dB in better ear.
  • ≥ 3 episodes of acute otitis media within 6 months.
  • ≥ 4 episodes of acute otitis media within 12 months and hearing loss.

Category 3
Recommended to be seen within 365 calendar days.

  • Chronic otitis media with effusion (glue ear) for 3 months with no significant hearing loss and no impact on speech and language development.
  • Perforation not healed in 6-12 months, and a hearing loss > 25 dB, or if other significant risk factors (for example speech delay or other disability) are present.
  • Dry perforation persists > 6 months in a child aged ≥ 8 years for consideration of tympanoplasty.
  • Middle ear dysfunction (including Eustachian tube dysfunction) affecting one or both ears for > 6 months with both of the following:
    • impact on speech and language development
    • pre-existing disability, or high risk of speech, language or learning disability.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • medical management to date
    • most recent diagnostic audiology assessment results (audiogram, tympanometry and/or otoscopic examination).

If available

  • Speech pathology assessment against normal developmental milestones.
  • Family history of hearing loss.
  • Previous audiology assessment results.
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ or among a vulnerable, disadvantaged or priority population.
  • If the patient is suitable for virtual care or telehealth.
  • If the patient has special needs or requires reasonable adjustments to be made.
  • If the patient requires an interpreter (if so, list preferred language).

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

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Current as at: Monday 17 June 2024
Contact page owner: System Purchasing