All Adult patients with unilateral or bilateral hearing loss – with or without tinnitus – but no other red flags (see below) should be referred to Audiology NOT ENT. Audiology is able to offer otoscopy and pure tone audiometry (PTA).
If there is unilateral tinnitus or presumed inner ear / sensorineural hearing loss, please mark this clearly on the referral so the patient will be seen by an audiologist qualified to send the patient directly for an MRI scan if required. If the audiologist is concerned, they can refer on to ENT.
Sudden sensorineural hearing loss is an ENT emergency.
if the patient presents within 6 weeks of onset urgent treatment could improve the likelihood of their hearing recovering. Please see the Sudden Sensorineural Hearing Loss page for further detail on referring these patients urgently through the ENT on call team at SJH.
For conductive hearing loss, hearing aids are often recommended prior to considering surgery.
People who already have an NHS hearing aid, can contact the Audiology Department directly without a referral. See Hearing aid for more details
C.M. & L.McM 25-03-25
Who to refer:
Please refer to ENT anyone with hearing loss and the following red flags:
- Sudden hearing loss
- Persistent pain
- Recurrent discharge from the ear
- Abnormal appearance of the drum
- Vertigo / unsteadiness not consistent with age or existing pathologies
- Evidence of persistent conductive hearing loss – Rinne’s test Bone Conduction better than Air Conduction
- Pulsatile tinnitus that persists for 6 weeks or more where there is no other cause found – please see tinnitus referral information guidance.
Who not to refer:
- Anyone with hearing loss and no red flags, whether or not tinnitus is present (please refer to Audiology instead)
- Those with NHS hearing aids who require help with those please see Hearing aid for detail
How to refer
Via SCI Gateway to ENT Lauriston / St John’s, Livingston / East Lothian Community Hospital Hearing Loss pathway.
