Hearing Loss - Cochlear Implants (Audiology/ENT) (PAED)

PAEDIATRIC

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • No emergency indicators identified; routine prioritisation applies
    • Please refer to HealthPathways for information about the closest Hearing Implant service.
    • Cochlear Implant services are not available at all locations
      Some services may offer post-surgery cochlear implant services only
    • Some services may not be funded for all referral types.  For example, cochlear implantation for single sided deafness is currently only available at the Queensland Children’s Hospital to children who meet eligibility criteria
    • Meningitis – there is a very high risk of cochlea ossification following bacterial meningitis, which can occur rapidly, and inhibit cochlear surgery. Urgent referral to audiology should be made for any child who has not yet had a hearing assessment following meningitis.   Any patient identified with significant hearing loss post-meningitis infection, should be referred to ENT urgently for radiological assessment and consideration of cochlear implantation.
    • For children born deaf or with severe hearing loss, having a cochlear implant fitted before the age of 18 months can be vital for developing age-appropriate speech and language skills
    • Clinical urgency is the dominant consideration in the prioritisation of a referral for a child currently in out of home care (OOHC), or at risk of entering or leaving OOHC.
    • Queensland public hospitals do not dispense conventional or standard hearing aids # Except for adults who meet criteria for Princess Alexandra’s crisis care hearing aid bank
    • Queensland Health 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.
    • Hearing aids for children and young adults (<26 years) are provided through Hearing Australia (Hearing Australia (Children and Young Adults)
    • Early Intervention is essential for children with permanent hearing loss.  Options for Early Intervention can be found in the Hearing Australia Choices e-book.

    Clinical resources

    Patient resources

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Referrals for Cochlear implant candidacy following meningitis (earliest available appointment)
  • Newly diagnosed severe to profound bilateral SNHL in children with congenital deafness (< 4 years old)
  • Children with significant vision impairment/Usher Syndrome whose SNHL has deteriorated to severe to profound.
  • Current cochlear impatient patient with otitis media, confirmed device movement or failure, pain, implant site skin breakdown/infection, or following trauma
  • A child currently in out of home care (OOHC) or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service
Category 2
(appointment within 90 calendar days)
  • Limited or no benefit from wearing hearing aids as recommended by Hearing Australia audiologist or early intervention / speech pathologist
  • Single sided deafness
  • Severe to profound bilateral SNHL (acquired, progressive, or congenital deafness)
  • Current cochlear implant patient experiencing issues e.g. deterioration in hearing and performance
  • Aboriginal and/or Torres Strait Islander
Category 3
(appointment within 365 calendar days)
  • Stable cochlear implantees transferring from other program

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • 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

2. Essential referral information Referral will be returned without this

  • Audiology reports and/or current audiograms (except when will unduly delay referral E.g. Meningitis)
  • Otological / ENT history
  • MRI (brain/cranial nerves) and CT (temporal bones) results if available
  • Confirmation of OOHC (where relevant)
  • Indigenous Status

3. Additional referral information Useful for processing the referral

  • Social modifiers i.e., effect on home schooling, out of home residence
  • Relevant diagnoses, co-morbidities, disabilities, and medical issues
  • Results of aetiological investigations including genetics (provide reports if available)
  • Involvement from other health professionals
  • Results of aetiological investigations (include reports/proof, including genetic results as necessary)
  • Additional and relevant diagnosis, co-morbidities, disabilities, and medical issues
  • MRI (Brain/ cranial nerves) and CT (Temporal Bone) results if applicable

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    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
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    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

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    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.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • 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.

Last updated: 16 January 2025

© State of Queensland (Queensland Health) 2023

Except as permitted under the Copyright Act 1968, no part of this work may be reproduced, communicated or adapted without permission from Queensland Health. To request permission email ip_officer@health.qld.gov.au1.