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Hearing Loss - Cochlear Implants

Useful management information

Cochlear Implantationand/or programming services are not available at all locations

Refer to Healthpathways for more information

Meningitis - there is a very high risk of ossification of cochlear structures (labyrinthitis ossificans) post bacterial meningitis (particularly Streptococcus pneumoniae), which can occur rapidly, and inhibit cochlear surgery. Any patient identified with significant hearing loss post-infection, should be referred to ENT urgently for radiological assessment and consideration of cochlear implantation. The association between viral meningitis and hearing loss is less clear

  • Please note that a referral to both Audiology and ENT are required for cochlear implant candidacy assessment (indefinite GP referral to ENT preferred)
  • Logan Hospital Audiology will provide patients (aged 2-25 years who are eligible for hearing services through Hearing Australia) with programming of their cochlear implant.Logan Hospital does not provide any ENT medical management of cochlear implants. 
  • 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 (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

Health Direct : Cochlear Implants information

Minimum referral criteria (Does your patient meet the minimum criteria?)

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

  • Cochlear implant candidate following meningitis
  • Cochlear implant candidate with significant visual impairment
Category 2
(appointment within 90 calendar days)
  • Bilateral severe to profound hearing loss and any of the following
    • Poor speech discrimination
    • does not receive adequate benefit from hearing aids
    • for consideration of cochlear  implants

Category 3
(appointment within 365 calendar days)

  • No category 3 criteria

If your patient does not meet the minimum referral criteria

  • Assessment and management information can be found on a range of conditions at Brisbane South HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

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 judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

 

Essential referral information for Hearing Loss - Cochlear Implants referrals (Referral will be returned without this)

  • History and aetiology of hearing loss
  • Details of vision impairment (if applicable)
  • Hearing aid
  • Previous audiogram(s)

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional referral information for Hearing Loss - Cochlear Implants referrals

  • MRI (brain/ cranial nerves) or CT (Temporal Bones) if performed
  • Results of investigations
  • Relevant comorbidities, and disabilities 
  • History of skin conditions if applicable

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries.  Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 16 February 2024