Mater Specialist Quick Find

Audiology Service - public patients

Purpose

This page contains information for general practitioners (GPs) on how to refer patients aged 16 years and over to Audiology Services at Mater Hospital Brisbane.

Specialist Outpatient Referrals

Required information and categorisation criteria

If referral for care is indicated please list all of the minimum referral requirements and reason for request:

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgment indicates a referral for specialist review is necessary

Service 

This service includes referrals for hearing loss and balance disorders, ear conditions, cochlear implants,

Please note:

Referrals to Audiology will not result in any patient being referred onto the ENT Department. 

Separate GP referrals are required for each department. When a patient has ear/hearing related concerns, a referral should be sent to Audiology in the first instance to obtain additional information.

If audiology identifies the need for an Ear Nose and Throat (ENT) consultation, a recommendation will be made in the audiology report to a patient's General Practitioner.

Please contact the Mater Cochlear Implant Clinic directly for details of the Adult Cochlear Implant anticipated waiting times and assessment process.

How to Refer

If referral for care is indicated please list all of the General Referral Information, reason for request, and essential information as indicated below.

Referrals can be sent by:

Smart Referrals

Digital referrals in your practice software that include templates linked with referral criteria for quality handover for any public hospital

SmartForms

Cloud solution in your practice software that eliminates the need for template management

Secure messaging

Medical Objects:   HM4101000R8

HealthLink EDI: materref     

Fax       

 07 3163 8548

For fax and secure messaging our latest Mater Adult Referral Form or Antenatal Form are available to  embed into most major Practice Management software systems.       

Emergency

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department of seek emergent medical advice if in a remote region:

Adult

  • Hearing loss with sudden loss or sudden deterioration of hearing (sudden = within 72 hours) (British Academy of Audiology, 2016)
  • Otitis media with any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis etc
  • Vertigo/Vestibular with recent sudden onset with neurological symptoms
  • Facial Nerve Palsy with sudden onset facial weakness

 

Scope of Service

Conditions out of scope:

The following conditions are not routinely provided at Mater Hospital Brisbane Audiology Department.

View list of conditions

  • Chronic bilateral tinnitus
    • Referral is not indicated unless tinnitus is disabling or associated with changes in hearing loss, aural fullness and/or discharge or vertigo
    • Please refer to private Audiology providers for tinnitus management options (eg. masking hearing aid, Neuromonics etc) for chronic bilateral tinnitus (that is not associated with other symptoms listed above).
  • Mild/brief orthostatic dizziness
  • Hearing aid dispensation
  • Uncomplicated/chronic symmetrical hearing loss in over 70 years old
  • Post-surgical BAHA management (refer to Audiology at RBWH if cannot be managed by local hearing aid clinic).
  • Facial nerve assessment or monitoring (refer to PAH if facial nerve assessment/monitoring is required via Audiology)

 

Conditions in scope:

Specialist Outpatient Referrals: Required information and categorisation criteria

If referral for care is indicated please list all of the minimum referral requirements and the conditions specific information below for:

Bone Conduction and Middle Ear Implants

Essential information (Referral will be declined without this)

  • History and aetiology of hearing loss
  • Previous ENT treatment
  • Hearing aid history if applicable
  • Previous audiogram(s)
  • Concurrent ENT referral is required for bone conduction and/or middle ear implant candidacy assessment

Additional referral information (useful for processing the referral)

  • History of skin conditions if applicable
  • Difficulties/limitations of hearing aid trials if applicable
  • Additional and relevant diagnosis, disabilities and medical issue
  • Any CT scans (temporal bones)

Other useful information for management (not an exhaustive list)

  • Refer to ENT Referral Guidelines and local health pathways for more information
  • Patient must meet candidacy criteria and be medically contraindicated to wearing air conduction aids bilaterally to meet eligibility criteria for bone conduction and/or middle ear implantation

Exclusion criteria – Middle Ear/ Bone Conduction Implant

  • Adults with single sided deafness that are referred for the purpose of the contralateral routing of signal to the normal hearing ear. Adults with single sided deafness should be referred for assessment via private Audiology / ENT services.

Clinical resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • No category 1 criteria

 

 

 

 

 

  • No category 2 criteria

 

  • Chronic mixed or conductive hearing loss
  • Unable for medical reasons to use a conventional Air Conduction (AC) hearing aid in the affected ear (e.g. conditions such microtia/ atresia, skin conditions, chronic supportive otitis media).

 

 

 

Cochlear Implants Adults - Concurrent ENT Referral Required

Essential information (Referral will be declined without this)

  • History and aetiology of hearing loss
  • Previous audiogram(s)
  • Concurrent ENT referral is required for cochlear implant (CI) candidacy assessment

Additional referral information (useful for processing the referral)

  • MRI (brain/ cranial nerves) or CT (Temporal Bones) results if previously performed
  • Difficulties/limitations of hearing aid trial
  • Results of aetiological investigations
  • Additional and relevant diagnosis, disabilities and medical issue

Other useful information for management (not an exhaustive list)

  • Cochlear Implant candidacy assessment services are available at the Mater Hospital, South Brisbane only. In many cases, long term (post-surgical) audiology CI management can be provided via tele-health in regional hospitals/health services.
  • Refer ENT CPC and health pathways for more information
    Please note that a referral to both Audiology and ENT are required for cochlear implant candidacy assessment (indefinite GP referral preferred to ENT).
  • Cochlear implantation will only be considered after an assessment by a multidisciplinary team. As part of the assessment adults should also have had a valid trial of an acoustic hearing aid for at least 3 months (NICE Guidelines, Cochlear implants for children and adults with severe to profound deafness, 2009). Current, optimally fitted hearing aids, in good working condition are required for cochlear implant candidacy assessment (unless contraindicated or inappropriate).
  • For adults, the QLD Public Health system is currently funded to provide unilateral cochlear implants to adults with bilateral severe/profound sensorineural hearing loss. Adults with single sided deafness should be referred for assessment via private Audiology / ENT services.

Clinical resources

Patient resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • Predominantly severe to profound sensorineural hearing loss that is:
    • recent sudden onset
    • associated with recent history of meningitis
  • Patient also has significant / deteriorating visual impairment

 

 

  • Predominantly severe to profound sensorineural hearing loss and:
    • limited or no benefit from wearing hearing aids
    • hearing loss may be acquired, progressive, congenital
  • No category 3 criteria

 

 

 

Hearing assessment

Essential information (Referral will be declined without this)

  • Reason why hearing test is being requested

Additional referral information (useful for processing the referral)

  • Details of current or previous treatments with ototoxic pharmaceutical agents:
    • Aminoglycoside and chemotherapeutic agents can cause permanent bilateral SNHL
    • Loop diuretics, salicylates, and antimalarial agents usually cause temporary bilateral SNHL that returns to normal soon after pharmacological therapy is stopped
  • Details of any change in hearing levels post commencement of pharmaceutical treatment if applicable
  • Details of any otologic symptoms or pre-existing hearing loss if applicable.
  • Any previous hearing assessments if applicable
  • ENT history if applicable
  • Neurology/neurosurgery history if applicable
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Details of any trauma
  • Any previous audiology assessment results
  • The person's hearing and communication needs at home, at work or in education, and in social situations
  • Psychosocial difficulties related to hearing

Other useful information for management (not an exhaustive list)

  • Ototoxic medications – impact long term codeine use
  • Mater Audiologists provide diagnostic hearing assessments which may result in a recommendation for hearing aids and/or an ENT opinion, but not the fitting of hearing aids.
  • Queensland public hospitals (including the Mater Hospital) do not dispense conventional or standard hearing aids. Aids for children, veterans, pensioners, ADF or NDIS participants with hearing needs are fitted by local audiologists via application to the Australian Government Hearing Services Program (Hearing service program). For non-eligible patients with a symmetrical mild, moderate or severe hearing loss, refer to a local private hearing aid provider.

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • Referral for baseline hearing assessment prior to treatment for patients undergoing ototoxic treatment
  • Re-assessment / monitoring of hearing for those who are currently being treated with ototoxic agents
  • Suspected ototoxicity related to long term and/or GP prescribed medication

 

 

 

 

  • Long term monitoring of for ototoxic treatment (CF, haematology) over a long period of time
  • Refugee hearing screen
  • Syndromes associated with hearing loss
  • Assessment following diagnosis of child with permanent hearing loss

 

  • Other medical concern indicating need for hearing test

 

Hearing loss

Essential information (Referral will be declined without this)

  • History including relevant symptoms, comorbidities, cognitive ability, physical mobility and dexterity (NICE Guidelines, 2018)
  • Description of:
    • hearing loss i.e. one or both sides
    • change in hearing loss (sudden, rapid or gradual)
    • failed screening results
    • describe symptoms that are persistent and/or troublesome to patient or family

Additional referral information (useful for processing the referral)

  • Family history of hearing loss
  • Any previous surgery or treatment
  • Information regarding any hearing aids or hearing devices and communication mode utilised by the patient e.g. Auslan
  • Speech discrimination testing
  • Any previous audiology assessment results
  • The person's hearing and communication needs at home, at work or in education, and in social situations
  • Psychosocial difficulties related to hearing

Other useful information for management (not an exhaustive list)

  • Refer to ENT Referral Guidelines, Health pathways or local guidelines
  • In cases of sudden deterioration of hearing, do otoscopy to check for ear infections and use tuning fork tests (if available) to try to differentiate sensorineural (urgent) from conductive (non-urgent) hearing loss. See links to tuning fork tests (Weber & Rinne) below.
  • In cases of sudden sensorineural hearing loss, accessing treatment (e.g. Prednisone and/or hyperbaric oxygen) ASAP is essential to help optimise hearing outcomes.
  • For hearing aid wearers, refer to their local hearing aid provider to ensure optimal hearing aid fitting
  • High incidence in refugee community and patients with poor access to primary health care
  • Over half the population aged between 60 and 70 has a hearing loss
  • People who have difficulty hearing and who want to use hearing aids are most likely to gain benefit from their use
  • Give the person and, if they wish, their family or carers, information about:
    • the causes of hearing loss, how hearing loss affects the ability to communicate and hear, and how it can be managed
    • organisations and support groups for people with hearing loss
  • Mater Audiologists provide diagnostic hearing assessments which may result in a recommendation for hearing aids and/or an ENT opinion, but not the fitting of hearing aids.
  • Queensland public hospitals (including the Mater Hospital) do not dispense conventional or standard hearing aids. Aids for children, veterans, pensioners, ADF or NDIS participants with hearing needs are fitted by local audiologists via application to the Australian Government Hearing Services Program (Hearing service program). For non-eligible patients with a symmetrical mild, moderate or severe hearing loss, refer to a local private hearing aid provider.

 

Clinical resources

Patient resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • Sudden (≤ 1 week) onset off loss of hearing, unilateral or bilateral and not associated with outer or middle ear disease
  • Sudden onset deterioration
  • Post head trauma - hearing loss
  • Fluctuating hearing loss other than associated with colds

 

 

 

 

  • Hearing loss associated with ear disease e.g. perforation, discharging ear
  • Syndrome or disorders associated with hearing loss (i.e Paget’s disease, neurodegenerative disease, osteosclerosis)
  • Chronic hearing loss - change in symptoms or clinical findings
  • Adults with hearing loss which is affecting communication and treatable conditions have been excluded
  • Failed screen
  • Family history of hearing loss

 

  • Gradual onset of hearing difficulties, e.g. presbyacusis

NB Hearing Aid dispensing (Hearing service program)

 

 

 

 

Otitis media

Essential information (Referral will be declined without this)

Description of:

  • Onset, duration, frequency, severity
  • Previous ENT history
  • Social modifiers ie. effect on work

Additional referral information (useful for processing the referral)

  • Family history of hearing loss in patient’s parents or siblings
  • Other medical conditions or syndromes known to be related to hearing loss including Down syndrome
  • Results of Health Assessment for Aboriginal and/or Torres Strait Islander People

Other useful information for management (not an exhaustive list)

  • Refer to Adult ENT Hearing Loss Referral Guideline, Health pathways or local guidelines
  • Exclude sudden sensorineural hearing loss (urgent), see Hearing loss Referral Guideline
  • If adult wears a hearing aid, consider impact of the condition on the ability to wear the device
  • Management of environmental factors
  • Consider referral to ENT service

Clinical resources

Clinical resources

Patient resources

 

 

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • No category 1 criteria

 

 

 

  • Suspicion of complicated otitis media e.g. cholesteatoma
  • Painful discharging ears despite topical antibiotic (first line) and/or PO antibiotic therapy (second line) for 5 days
  • Middle ear conditions without previous audiology
  • ASOM with ear drum perforation
  • Chronic middle ear conditions that have previous audiology

 

 

 

Tinnitis

Essential information (Referral will be declined without this)

Description of:

  • advise unilateral / bilateral
  • type (pulsatile/non-pulsatile), intensity, onset etc.
  • functional impact of tinnitus
  • any associated hearing/balance symptoms
  • ENT/Otological history (history of middle ear disease/surgery etc.)

Additional referral information (useful for processing the referral)

  • Mechanism of injury (barotrauma)
  • Psychological history
  • Documented social modifiers on quality of life
  • Documented TMJ or recent dental work (dental/Physiotherapist as necessary)
  • Any intervention and its effect

Other useful information for management (not an exhaustive list)

  • Refer to ENT Referral Guidelines, Health pathways or local guidelines
  • Concurrent referral to ENT is Recommend
  • Patient education/tinnitus management advice
  • Chronic tinnitus consider:
    • private audiology for tinnitus retraining therapy, masking hearing aid or for hearing aid if hearing loss present
    • referral to psychologist due to possible links with stress, anxiety and depression
    • referral to hearing practitioner as management of associated hearing loss can sometimes help with tinnitus.
    • public/private audiology for patient education/tinnitus management advice
  • Unilateral tinnitus may require investigation for retro cochlear lesion; consider Imaging for investigation of retro cochlear lesion (Health Monash, 2014)
  • Consider referral to a Dentist &/or Physiotherapist if associated TMJ problems are suspected

Clinical resources

Patient resources

 

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • Unilateral tinnitus and any of the following:
    • vertigo
    • hearing loss
    • otalgia
    • otorrhoea
  • Pulsatile tinnitus or disabling tinnitus with any of the following
    • vertigo
    • hearing loss
    • balance disturbance
  • Follow up of recent barotrauma event (air flight, diving or blast injury)

 

  • Unilateral, pulsatile or disabling tinnitus without any associated symptoms

 

  • Bilateral tinnitus

 

Vertigo/Vestibular

Essential information (Referral will be declined without this)

Description of:

  • Dizziness/balance symptoms (vertigo, disequilibrium, light-headed etc)
  • onset, duration, frequency and positional
  • functional impact of dizziness (e.g. if unable to work due to these symptoms etc.)
  • any associated otological/neurological symptoms (e.g. changes to hearing/tinnitus, onset of headache)
  • any previous diagnosis of dizziness (attach correspondence)
  • any treatments (medication/other) previously tried, duration of trial and effect
  • any previous investigations/imaging results
  • past history of middle ear disease/surgery

Additional referral information (useful for processing the referral)

  • History of any of the following:
    • cardiovascular problems [e.g. stroke, TIA, vertebro-basilar artery insufficiency]
    • neck problems [cervical degeneration, Chiari malformation etc.]
    • neurological conditions [epilepsy/seizures, MS, Parkinson’s etc.]
    • auto immune conditions/diabetes
    • eye problems [blindness, history of retinal detachments, eye muscle weakness/lazy eye etc.]
    • migraine history
    • previous head injury
  • Current medication list
  • Investigations and/or other conditions eliminated as a causative factor for vestibular problems.
  • Results of any diagnostic investigations to date to determine cause of vestibular symptoms
  • Previous treatment with vestibulo-toxic / ototoxic medications (Gentamycin, Cisplatin etc.)
  • History of drug and alcohol abuse
  • Psychological history [anxiety and/or claustrophobia etc.]

 

Other useful information for management (not an exhaustive list)

  • Refer to ENT Referral Guidelines, Health pathways or local guidelines particularly if has associated otological symptoms/conditions
  • Refer to Neurologist if has associated neurological symptoms (non-acute) or suspected vestibular migraine (send to Emergency if acute with neurological symptoms).
  • Perform Dix-Hallpike Manoeuvre, Head Impulse Test (HIT) and/or HINTS tests to determine likely cause of vertigo.
  • If BPPV is likely based on symptoms and a positive Dix-Hallpike (patient reports subjective vertigo & torsional nystagmus observed), then treat with canalith repositioning manoeuvre (e.g. Epley manoeuvre) and consider referral to a vestibular physiotherapist
  • If HIT unilaterally positive with acute vertigo, consider vestibular neuritis
  • Consider referral to Vestibular Physiotherapist for vertigo with no associated neurological / central signs.
  • Occupational therapy home assessment for falls prevention
  • Consider advice regarding safe driving/licencing
  • Consider MedsCheck with Pharmacist if polypharmacy possible (≥ 5 daily medications)
  • Check ear canals (otoscopy) before referring to Audiology for vestibular function testing – canals must be completely clear of all wax / debris to enable complete / reliable vestibular function testing (refer to ENT for wax removal if unable to be managed in GP clinic).

Clinical resources

Patient resources

 

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • No category 1 criteria

NB: recent, sudden onset dizziness / vertigo with associated neurological symptoms should be referred to Emergency ASAP.

 

  • Recent sudden onset with no neurological symptoms
  • Symptoms are preventing ability to work / maintain employment

 

 

  • Suspected benign paroxysmal positional vertigo (BPPV) not responding to repeated canalith repositioning manoeuvres (> 3 treatments)
  • Co-morbid vestibular or otological conditions
  • Symptoms not resolved after seeing vestibular physiotherapist
  • Chronic dizziness

 

 

Bulk Billed Clinics

Mater Health offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed clinic, please provide a referral to the Mater Audiology Department

Contact us

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200.

 

Current waiting time for appointments

We provide up to date data on how long patients are waiting for their first appointment by specialty here.

 

Referral Guideline Development

These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria  project. 

 

 

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