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Ear, Nose and Throat (ENT)

Find assessment and management information on Ear, Nose and Throat (ENT) conditions at:

Emergency Immediate transfer to the Emergency Department

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

Adult
EAR

  • Trauma
  • Mastoiditis/cholesteatoma, acute and complicated
  • ENT conditions with associated neurological signs
  • Ear canal oedema/unable to clear discharge
  • Vertigo, sudden onset, debilitating, constant (vestibular neuritis/stroke)
  • Barotrauma with sudden onset vertigo
  • Hearing loss with associated neurological signs
  • Sudden / Rapid onset unilateral or bilateral hearing loss (>30dBHL at 3 or more frequencies that developed over less than a 72-hour period)           (direct phone contact with the ENT registrar on call to discuss the case and arrange review as clinically appropriate)
  • Facial weakness, sudden onset
  • Foreign body
  • Auricular haematoma

NOSE

  • Acute bacterial rhinosinusitis - visual disturbance/signs, neurological signs/frontal swelling/severe unilateral or bilateral headache
  • Acute nasal fracture with septal haematoma
  • Unilateral facial swelling with or without dental sepsis
  • 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
  • Abscess or haematoma, (e.g. peritonsillar abscess/quinsy, salivary abscess) with or without associated cellulitis
  • 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
  • Profound dysphagia (i.e. inability to manage secretions)
  • Supraglottitis

Paediatric

EAR

  • Foreign body(suspected button battery should have uregent referral)
  • Trauma
  • New onset facial nerve palsy
  • ENT conditions with associated neurological signs e.g. facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
  • Acute and/or complicated mastoiditis
  • Otitis externa with uncontrolled pain and/or cellulitis extending beyond the ear canal and/or ear canal is swollen shut
  • Auricular haematoma
  • Any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis etc
  • Suspicion of sudden sensorineural hearing loss
  • Confirmed cholesteatoma with facial nerve palsy or increasing otalgia

NOSE

  • Foreign body (suspected button battery should have urgent referral)
  • Trauma with other associated injuries i.e. other facial fractures e.g. orbit
  • Periorbital cellulitis with or without swelling with or without sinusitis
  • Severe or persistent epistaxis
  • Septal haematoma

THROAT

  • Foreign body (button batteries – inhaled or ingested should have urgent referral)
  • 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  

SLEEP DISORDERED BREATHING/OBSTRUCTIVE SLEEP APNOEA

  • Clinical concern regarding prolonged apnoeas, cyanosis, altered level of consciousness or significant and escalating parental concerns should prompt direct phone contact with the ENT registrar on call to discuss the case and arrange review as clinically appropriate

Are you referring to the right service?

  • General Practitioners are able to directly refer patients to a Queensland Health (QH) Audiologist.
  • QH Audiologists are able to offer diagnostic hearing assessments which can result in a recommendation of hearing aids or an ENT opinion; however they do not fit hearing aids.
  • Queensland public hospitals do not dispense conventional or standard hearing aids.
  • Patients with mild, moderate or severe hearing loss, which is symmetrical, should be referred to a local hearing aid provider.
  • Hearing aids are provided for children, veterans and pensioners through the Office of Hearing Services, a division of the Federal Department of Health, and are dispensed by local audiologists.
  • Hearing Aid Bank is for crisis intervention only to assist people to access hearing aids urgently Hearing Aid Bank | Metro South Health

Urgent referrals Arranging urgent review

To arrange a very urgent outpatient appointment, please phone the relevant hospital’s switchboard and ask to speak to the Registrar of the relevant specialty.

Out of scope services

The following are not routinely provided in a public ENT service:

  • Simple wax removal
  • Chronic bilateral tinnitus unless disabling associated with other symptoms
  • Mild/brief orthostatic dizziness
  • Simple ear drum perforation as part of acute otitis media

Excluded Services

  • Aesthetic surgery
  • Diving assessments
  • Central auditory processing assessments
  • Requests for hearing assessment following failed automated hearing screen (eg – pharmacy; online)
  • Provision of hearing aids (except for adults eligible for the Princess Alexandra Hospital crisis care hearing aid bank)

Notes

  • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
  • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

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 3 June 2024