Ears and Otoscopy - Adult (>16 years) - PDF Document

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  1. Ears and Otoscopy - Adult (>16 years) Assessment Unilateral Symptoms Bilateral Symptoms Hearing loss Otitis media/externa Cerumen (wax) impaction Perforated tympanic membrane Eustachian tube dysfunction Osteomata Cholesteatoma Foreign body Hearing loss Otitis media/externa Cerumen (wax) impaction Osteomata Otosclerosis Diabetes Red Flags  Sudden unilateral hearing loss  Unilateral tinnitus requires investigation to exclude acoustic neuroma or an arteriovenous malformation Contact Rapid Access Medical Service (RAMS) for further advice on (07) 5470 6600 Warning: Do not treat with topical antibiotics if tympanic perforation cannot be excluded Tinnitus Acoustic neuroma Arteriovenous malformation Tinnitus Ménière’s disease ↓ Examination and Investigations Examination Investigations Audiometry Tympanometry 50% of people over 80 years have hearing loss amenable to aids Otoscopy Weber test Rinne’s test CT Scan (contrast and/or non-contrast) See list of service providers ↓ Treatment: Primary/Secondary Procedural Referral Wax softeners should be used for 7 days prior to syringing/microsuction Aural syringe and/or aural microsuction Hearing services for hearing aids or tinnitus programs See list of GP service locations for access to this procedure See list of service providers Treat otitis media and externa as per Therapeutic Guidelines – Antibiotic, Version 15 (2014) ↓ Treatment: Tertiary Referral to ENT Specialist/Service Referral eligibility: Referral must include: • Consultation notes • Hearing service report (if appropriate) • Imaging report (if appropriate) • Pathology report (if appropriate) • All treatments have been undertaken and symptoms persist • Investigations have been performed and are abnormal NB: Incomplete referrals to SCHHS, under this Pathway, will be automatically returned for completion and resubmission If you feel any patient needs clinical review or falls outside of these guidelines please contact the registrar on call for advice on (07) 5370 3630.