Mater Specialist Quick Find

ENT – public patients

Purpose

This page contains information for general practitioners on how to refer patients aged 16 years and over to ENT services at Mater Hospital Brisbane

Service 

This service includes referrals  for hearing loss and balance disorders, ear conditions and ear surgery, cochlear implants, nasal and sinus conditions, tonsil, laryngeal and thyroid surgery and assessment of suspected head and neck cancer

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 and reason for request, and essential information as indicated below.

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

 

Referrals can be sent by:

Secure messaging  Medical Objects:   HM4101000R8
  HealthLink EDI:    materref   
Fax    07 3163 8548

 

 

                                                                                            

Emergency

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

View list of conditions:

Ear

  • ENT conditions with associated neurological signs
  • Sudden onset hearing loss in absence of clear aetiology and/or associated with vertigo and tinnitus
  • Sudden onset debilitating constant vertigo where the patient is very imbalanced (vestibular neuritis/stroke)
  • Sudden onset facial weakness
  • Barotrauma with sudden onset vertigo 
  • Foreign body
  • Complicated mastoiditis/cholesteatoma or sinusitis (periorbital cellulitis, frontal sinusitis with persistent frontal headache)
  • Ear canal oedema/unable to clear discharge
  • Trauma

Nose

  • Acute bacterial rhinosinusitis - visual disturbance/signs, neurological signs/frontal swelling/severe unilateral or bilateral headache
  • Acute nasal fracture with septal haematoma
  • Severe or persistent epistaxis

Throat

  • Airway compromise- stridor/drooling breathing difficulty/acute or sudden voice change/severe odynophagia
  • Ludwig’s angina
  • Acute tonsillitis with airway obstruction and/or unable to tolerate oral intake and/or uncontrolled fever
  • Tonsillar haemorrhage
  • Acute hoarseness associated with neck trauma or surgery
  • Laryngeal obstruction and/or fracture
  • Pharyngeal/laryngeal foreign body
  • Accidental dislodgement or obstruction of permanent tracheostomy
  • New onset of bleeding or shrinkage of laryngectomy stoma
  • Abscess or haematoma, (e.g. peritonsillar abscess/quinsy, salivary abscess, septal or auricular haematoma, paranasal sinus pyocele) with or without associated cellulitis

 

Scope of Service

Conditions out of scope

The following conditions are not routinely provided at Mater Hospital Brisbane:

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
  • Mild/brief orthostatic dizziness
  • Hearing aid dispensation
  • Uncomplicated/chronic symmetrical hearing loss in over 70 years old
  • Mild acute rhinosinusitis
  • Aesthetic surgery

 

Conditions in scope

Allergic Rhinitis / Nasal Congestion / Obstruction

Essential information (Referral will be declined without this)

  • General referral information
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment

Additional referral information (useful for processing the referral)

  • CT scan paranasal sinuses results
  • Skin prick/RAST/IgE results (Allergic rhinitis)

Other useful information for management (not an exhaustive list)

MEDICAL MANAGEMENT

  • 2 month course of:
  • Intra nasal mometasone BD for 2 weeks, then nocte thereafter
  • 5 days only of BD nasal decongestant spray e.g. oxymetazoline at the start of the course
  • BD-TDS saline rinse/irrigation
  • Manage any co-existing allergies
  • Patient education
  • CONSIDER THE FOLLOWING
  • CT scan paranasal sinuses
  • Short course of oral corticosteroid therapy
  • Skin prick testing/RAST/IgE (Allergic rhinitis)

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

Nasal obstruction (polyps) and any of the following:

  • Unilateral
  • offensive or bloody discharge

 

 

 

 

 

No category 2 criteria

Nasal obstruction (polyps) and any of the following:

  • Bilateral
  • Persisting polyps despite preliminary course of oral steroids with at least 8 weeks of inhaled corticosteroid

Allergic Rhinitis

  • Failed/not responding to maximal medical management

Nasal obstruction and any of the following:

  • Post trauma
  • deviated nasal septum 

concha bullosa where surgical management is indicated

 

Chronic Ear Disease

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Ear swab M/C/S results
  • Results of Health Assessment for Aboriginal and/or Torres Strait Islander People
  • Fine cut/slice CT scan of temporal bone

Other useful information for management (not an exhaustive list)

  • If ear discharge is present, swab for M/C/S
  • No irrigation of the ear
  • Antibiotic ear drops TDS for 1 week
  • Tragal pump technique
  • Topical ear medication
  • Keep ear dry
  • Analgesia
  • Review after 3 months by GP
  • Arrange diagnostic audiological assessment
  • Consider fine cut/slice CT scan of temporal bone to rule out extensive cholesteatoma

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

Discharging ear for longer than 3 months failing to settle with topical medication and new onset otalgia, headaches, vertigo (i.e. suspicious for cholesteatoma) and/or radiological confirmation of cholesteatoma (i.e. bony erosion reported)

 

Discharging ear for longer than 3 months failing to settle with topical medication

Imaging suggestive of possible cholesteatoma (i.e. no bony erosion reported)

No category 3 criteria

 

Dizziness / Vertigo

Essential information (Referral will be declined without this)

  • General referral information
  • Description of:
  • onset, duration, frequency and quality
  • functional impact of vertigo
  • any associated otological/neurological symptoms
  • any previous diagnosis of vertigo (attach correspondence)
  • any treatments (medication/other) previously tried, duration of trial and effect
  • any previous investigations/imaging results
  • hearing/balance symptoms
  • past history of middle ear disease/surgery
  • Diagnostic audiology assessment  (Highly desirable where available and not cause significant delay)

Additional referral information (useful for processing the referral)

  • History of any of the following:
  • cardiovascular problems
  • neck problems
  • neurological
  • auto immune conditions
  • eye problems
  • previous head injury

Other useful information for management (not an exhaustive list)

  • Exclude central cause of vertigo (cardiac/respiratory)
  • Perform Hallpike test and Head Impulse Test (HIT) to determine likely cause of vertigo
  • If BPPV likely based on symptoms and a positive Hallpike, then treat with canalith repositioning manoeuvre (Epleys or BBQ roll) and consider referral to a physiotherapist/vestibular physiotherapist
  • If HIT positive with acute vertigo, consider vestibular neuritis
  • Consider migraine associated vertigo and if appropriate consider trial of
  • Pizotifen 0.5mg to 1mg orally, at night, up to 3mg daily or
  • Propranalol 40mg orally, 2-3 times daily, up to 320mg or
  • Verapamil (sustained release) 160 or 180mg orally, once daily, up to 320 or 360mg daily
  • Arrange diagnostic audiological assessment and/or vestibular testing
  • Review of current medications
  • Occupational therapy home assessment for falls prevention
  • Consider advice regarding safe driving/licencing

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

Benign Paroxysmal Positional Vertigo (BPPV) refractory to repeated canalith repositioning manoeuvres (> 3 treatments)

Co-morbid vestibular or otological conditions 

Patients where particle repositioning is not advised due to limited range of movement in the neck, or due to general mobility issues that cannot be managed by a physiotherapist/ vestibular physiotherapist

Symptoms not resolved after seeing vestibular physiotherapist

 

Dysphagia

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Barium swallow or Modified Barium Swallow results
  • CT thorax results
  • CXR results
  • TSH results

Other useful information for management (not an exhaustive list)

  • CXR
  • TSH
  • speech pathology referral for swallowing assessment if concerned about dysphagic symptoms

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

Suspicion of oropharyngeal lesion - dysphagia and any of the following:

  • hoarseness
  • unilateral otalgia
  • progressive weight loss
  • smoking history
  • excessive alcohol intake

Significant stenotic/dysphagic symptoms and any of the following:

  • gagging, choking, and/or coughing when swallowing
  • food or liquids coming back up to throat, mouth, and/or nose after swallowing
  • feel like foods or liquids are stuck in throat or chest or problems getting food or liquids to go down on the first attempt
  • oropharyngeal pain or referred pain to ear when swallowing
  • pain or pressure in chest or heartburn
  • weight loss/loss of appetite/food avoidance
  • shortness of breath post eating (in absence of other cause)

Recurrent chest infections (aspiration pneumonia)

 

 

 

 

 

No category 2 criteria

No category 3 criteria

 

Dysphonia

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Speech pathology assessment results

Other useful information for management (not an exhaustive list)

  • Diabetes, gastroesophageal reflux, hypothyroidism, oropharyngeal tumours, lung lesion, recurrent laryngeal nerve damage or chronic rhinosinusitis if indicated
  • CXR
  • Speech pathology assessment if concern about voice quality

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

Persistent hoarseness or change in voice quality which fails to resolve in 4 weeks and any of the following:

  • history of smoking
  • excessive alcohol intake
  • recent intubation
  • recent cardiac or thyroid surgery

Recurrent episodes of hoarseness, altered voice in patient with no other risk factors for malignancy

No category 3 criteria

 

Ear Drum Perforation

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Ear swab M/C/S result
  • Results of health assessments for Aboriginal and/or Torres Strait Islander people

Other useful information for management (not an exhaustive list)

  • If ear discharge is present, swab for M/C/S
  • Topic ear medication
  • Antibiotics (eardrops or tablets)
  • Analgesia
  • Keep ear dry
  • Review after 3 months by GP
  • Arrange diagnostic audiological assessment

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

 

 

 

 

 

Persistent discharge despite treatment and disabling pain and/or hearing loss significantly limiting quality of life, education, work

Recurrent episodes of discharging ear

Deteriorating hearing

No category 3 criteria

 

Epistaxsis (Recurrent)

Essential information (Referral will be declined without this)

  • General referral information
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Current medication list including any NSAIDS, aspirin or warfarin and anti-hypertensive medication
  • Coagulopathy/platelet disorder screening results

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Investigations of coagulopathy, platelet disorder and/or hypertension
  • Hypertension management
  • Pressure on the nostrils (> 5mins)
  • If bleed is visible in Little’s area consider cautery with silver nitrate (after applying topical anaesthesia)
  • Intranasal packing coated with antibiotic ointment

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

Recurrent epistaxis with no obvious cause

Associated change in sense of smell

Epiphora

Diplopia

No category 2 criteria

Recurrent epistaxis on a background of nasal trauma

 

Facial Nerve Palsy

Essential information (Referral will be declined without this)

  • General referral information
  • Neurology/neurosurgery history
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Diagnostic audiology assessment (Highly desirable where available and not cause significant delay)

Additional referral information (useful for processing the referral)

  • Fine cut/slice CT scan of temporal bone results

Other useful information for management (not an exhaustive list)

Medical management

  • Oral steroids 1mg daily for 5 days
  • Consider oral anti virals if indicative of Ramsay Hunt syndrome
  • Eye protection from corneal abrasion e.g. lacrilube and tape eye shut nocte
  •  
  • Consider speech pathology assessment if speech and/or swallowing affected
  • Arrange diagnostic audiological assessment
  • If facial palsy with otalgia and/or otorrhoea, consider fine cut/slice CT scan of temporal bone to rule out cholesteatoma

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

Lower motor neuron palsy and any of the following:

  • hearing loss
  • suspected other cranial nerve involvement

Lower motor neuron palsy and otalgia and/or otorrhoea

Vesicles in tympanic membrane and otalgia and/or otorrhoea

Perineural spread from cutaneous SCC with or without sensory changes e.g. tingling, numbness, formiculation

 

No category 2 criteria

No category 3 criteria

 

Head and Neck Mass

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • CT chest +/- FNA results

Other useful information for management (not an exhaustive list)

Consider  the following:

  • CT or USS of neck, CT chest +/- FNA

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

Confirmed head and neck malignancy

Suspicious solid mass and / or cystic neck lumps > 6 weeks and any of the following:

  • history of smoking
  • history of excessive alcohol intake
  • previous head/neck malignancy

No category 2 criteria

No category 3 criteria

 

Hearing Loss

Essential information (Referral will be declined without this)

  • General referral information
  • Description of:
  • hearing loss i.e. one or both sides
  • change in hearing loss
  • Diagnostic audiology assessment (Highly desirable where available and not cause significant delay)

Additional referral information (useful for processing the referral)

  • 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

Other useful information for management (not an exhaustive list)

  • Cerumen dissolving drops and possible suction or irrigation
  • Oral decongestant, Valsalva manoeuvres and re-evaluate after 3 weeks
  • Arrange diagnostic audiological assessment
  • For hearing aid wearers, refer to their local hearing aid provider to ensure optimal hearing aid fitting

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

Rapid progressive severe unilateral or bilateral sensorineural hearing loss and/or vertigo

 

 

 

 

 

No category 2 criteria

Bilateral severe to profound hearing loss and any of the following:

  • poor speech discrimination
  • does not receive adequate benefit from hearing aids

Chronic hearing loss - change in symptoms or clinical findings

 

Nasal Fracture (Acute)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Exclude septal haematoma
  • Cool compress to reduce swelling
  • Analgesia
  • Re-evaluate at 3-4 days to ensure nose looks normal and breathing is normal

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

Acute nasal fracture requiring surgical intervention i.e. external bone displacement (best results for acute nasal fracture are achieved within 2 weeks from time of injury)

 

NB: Referrer contact needs to be made promptly by either emergency department referral or direct contact with the ENT service

No category 2 criteria

No category 3 criteria

 

Obstructive Sleep Apnoea

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Recent polysomnography (PSG) results

Other useful information for management (not an exhaustive list)

  • Long-term intranasal steroids (mometasone) if no contraindications
  • Manage allergies
  • If BMI > 30 manage weight loss
  • Epworth Sleepiness Scale
  • Consider Sleep Studies for evaluation, PSG and consideration/trial of CPAP
  • If patient has an under bite, refer to a dentist for a mandibular advancement splint

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

Upper airway obstruction due to tonsillar hypertrophy

Moderate to severe symptoms (e.g. Epworth Sleepiness Scale > 15) and a positive sleep study

Failure of CPAP therapy due to patient anatomical factors e.g. nasal obstruction/deviated septum, tongue size/upper airway anatomy, mandibular anatomy

 

Oropharyngeal Lesion

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • History of smoking/chewing tobacco/chewing beetle nut/alcohol/any sharp chipped teeth
  • FBC results

Other useful information for management (not an exhaustive list)

  • Please do not perform biopsy or FNA
  • If bleeding significant, check FBC

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

Suspicious oropharyngeal (lip, tongue, hard/soft palate, uvula, floor of mouth) lesion or mass with any of the following:

  • leukoplakia
  • ulceration
  • pain
  • bleeding
  • discharge

Non healing oropharynx ulcer for > 2/52

No category 2 criteria

No category 3 criteria

 

Primary Parathyroid Adenoma

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Sestamibi parathyroid scintigraphy results

Other useful information for management (not an exhaustive list)

  • NB If imaging results are not suggestive of a primary parathyroid adenoma, refer to endocrinology

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

Primary parathyroid adenoma identified on imaging with raised serum calcium and/or raised PTH

No category 2 criteria

No category 3 criteria

 

Rhinosinusitis (Acute)

Essential information (Referral will be declined without this)

  • General referral information
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Treat any acute bacterial infection appropriately (10 day course of Augmentin duo forte)
  • 5 days only of BD nasal decongestant spray e.g. oxymetazoline at the start of the course
  • 3 months of:
  • oral roxithromycin 300mg daily
  • intra nasal steroid spray e.g. mometasone BD for 2 weeks, then nocte thereafter
  • intra nasal saline rinse/irrigation (not spray) BD-TDS
  • If rhinorrhoea is the predominant symptom add either atrovent spray or second generation antihistamine
  • Consider short course of oral corticosteroid therapy
  • If symptoms persist at close of treatment, consider CT para nasal sinuses
  • Analgesia
  • Manage environmental factors:
  • co-existing allergies
  • discuss contribution of smoking
  • Discuss role of environmental and household pollutants (wood/coal smoke, incense, perfumes, chlorine) Failed antibiotic treatment/not responding to maximal medical management 

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

Failed antibiotic treatment/not responding to maximal medical management 

 

No category 2 criteria

No category 3 criteria

NB: referral is not indicated for mild acute rhinosinusitis

 

Rhinosinusitis (Chronic / Recurrent)

Essential information (Referral will be declined without this)

  • General referral information
  • Frequency of episodes
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • CT para nasal sinuses post full course of medical management

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Treat any acute bacterial infection appropriately (10 day course of Augmentin duo forte)
  • 5 days only of BD nasal decongestant spray e.g. oxymetazoline at the start of the course
  • 3 months of:
  • oral roxithromycin 300mg daily
  • intra nasal steroid spray e.g. mometasone BD for 2 weeks, then nocte thereafter
  • intra nasal saline rinse/irrigation (not spray) BD-TDS
  • If rhinorrhoea is the predominant symptom add either atrovent spray or second generation antihistamine
  • Consider short course of oral corticosteroid therapy
  • If symptoms persist at close of treatment, consider CT para nasal sinuses
  • Analgesia
  • Manage environmental factors:
  • co-existing allergies
  • discuss contribution of smoking
  • Discuss role of environmental and household pollutants (wood/coal smoke, incense, perfumes, chlorine)

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 and recurrent: persistent symptoms > 8 weeks, and/or > 3 episodes per year or

Failed/not responding to maximal medical management

Complicated sinus disease (extra sinus extension, suggestive of fungal disease)

 

Salivary Tumour

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • FNA results

Other useful information for management (not an exhaustive list)

  • Consider the following
    • USS +/- CT
    • FNA

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

Confirmed or suspected tumour or hard mass in the salivary glands

 

No category 2 criteria

No category 3 criteria

 

Sialolithiasis (Salivary Stones)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • M/C/S results

Other useful information for management (not an exhaustive list)

  • Non-invasive management of small stones:
  • Hydration, moist heat therapy, NSAIDs, have the patient take citrus fruits to promote salivation/ spontaneous expulsion of stone
  • Consider XR or USS
  • Consider M/C/S

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

Acute salivary gland inflammation which fails to respond to oral antibiotics within 1 week

 

No category 2 criteria

Symptomatic salivary stones and/or recurrent symptoms that fail to respond to non-invasive treatment

 

Thyroid Mass

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • USS +/- FNA
  • TSH and T4
  • Speech pathology referral for swallowing assessment if concerned about dysphagic or dysphonic symptoms

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

Cytology confirmed malignancy or suspicious FNA or dominant nodule > 4cm on USS

Compressive symptoms e.g. dyspnoea, hoarseness or dysphagia

Generalised thyroid enlargement without compressive symptoms or

Recurrent thyroid cysts

Surveillance of known benign thyroid lumps > 40mm in diameter

 

Tinnitus

Essential information (Referral will be declined without this)

  • General referral information
  • Description of:
    • onset, duration frequency and quality
    • functional impact of tinnitus
    • any associated hearing/balance symptoms
    • any intervention and its effect
    • past history of middle ear disease/surgery
  • Diagnostic audiology assessment

Additional referral information (useful for processing the referral)

  • Private MRI to exclude acoustic neuroma in unilateral tinnitus
  • Mechanism of injury (barotrauma)

Other useful information for management (not an exhaustive list)

  • Patients with acute barotrauma should be sent to emergency
  • If cerumen present, use dissolving drops and irrigation or suction if available
  • Arrange diagnostic audiological assessment/tinnitus assessment
  • Patient education/tinnitus management advice
  • Consider private MRI to exclude acoustic neuroma in unilateral tinnitus
  • Chronic tinnitus - as above, and:
  • private audiology for masking hearing aid
  • consider cognitive behavioural therapy
  • private audiology for hearing aid if hearing loss present
  • public/private audiology for patient education/tinnitus management advice

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

Recent onset unilateral tinnitus and any of the following:

  • vertigo
  • hearing loss
  • otalgia
  • otorrhoea

Recent onset unilateral or bilateral pulsatile tinnitus or disabling tinnitus i.e.

  • vertigo
  • hearing loss
  • balance disturbance

Follow up of recent barotrauma event (air flight, diving or blast injury)

At the recommendation of local audiologist (highlighting the clinical concerns along with previous audiological report/results)

 

No category 2 criteria

Chronic bilateral

NB: Referral is not indicated unless tinnitus is disabling or associated with hearing loss, aural fullness and/or discharge or vertigo

 

Tonsillitis (Recurrent)

Essential information (Referral will be declined without this)

  • General referral information
  • The number and timeframe of previous episodes
  • The degree of systemic upset
  • Previous antibiotic prescriptions
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Please advise if taking any anticoagulant medication, including aspirin and fish oil, and any family history of coagulation disorder in referral

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Manage acute episodes
  • Analgesia
  • Antibiotics
  • Fluids
  • Throat gargle
  • Rest
  • Consider monospot test for glandular fever

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 or recurrent infection with fever/malaise and decreased PO intake:

  • 4 or more episodes in the last 12 months or
  • 6 or more episodes in the last 24 months and/or
  • sleep apnoea due to tonsillar hypertrophy and/or
  • tonsillar concretions with halitosis and/or
  • absent from work/university/college for 4 weeks in a year

 

Other Ear Nose and Throat Condition

Essential information (Referral will be declined without this)

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

 

Our Specialists 

 

Dr Christopher Que Hee

Director of ENT

Dr Jonathon Askew

ENT Specialist

Dr James Bowman

ENT Specialist

Dr Andrew Chang

ENT Specialist

Dr Scott Coman

ENT Specialist

Dr Anthony Parker

ENT Specialist

Dr Nicola Slee

ENT Specialist

 

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 named referral to one of the specialists listed above.

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. 

 

Content last reviewed: 14 February 2018

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