Signs and Symptoms

• Speech delay suspected to be secondary to hearing loss – refer to audiology
• Hearing loss up to 4 weeks may follow upper respiratory tract infections or acute suppurative otitis media. In the absence of red flags watchful waiting is appropriate in these cases.
  • The majority of these patients with hearing loss more than 4 weeks will have glue ear and are appropriate for the paediatric audiology pathway.
• Children with hearing loss associated with other features such as:
  • Abnormality of ear drum or canals
  • Discharging ears
    • These patients should be referred routinely to ENT if they cannot be managed safely in primary care

Emergency

Patients with sudden onset hearing loss (unilateral or bilateral), in the absence of an obvious cause e.g. URTI, should be referred to ENT the same day as an emergency

Referral criteria

Refer to paediatric audiology

Children with:

• Speech delay suspected to be secondary to hearing loss
• Hearing loss for more than 4 weeks with normal appearance of canals and tympanic membranes.

Refer to ENT

Children with hearing loss associated with other features such as:

• Abnormality of ear drum or canals
• Discharging ears

Referral Instructions

Audiology referrals should be sent via e- Referrals:

• Speciality: Children's & Adolescent Services
• Clinic Type: Audiology
• Service: DRSS-Northern-Child & Adolescent Services-Devon ICB - 15N

Referrals to ENT should be sent via e-Referrals:

• Speciality: Children's & Adolescent Services
• Clinic Type: ENT
• Service: DRSS-Eastern/Northern-Child & Adolescent Services-Devon ICB - 15N

Referral form

DRSS Referral Form 

Evidence

This guideline has been developed by Royal Devon and Exeter Healthcare Foundation Trust based on local guidelines.

NICE surgical management of otitis media with effusion in children CG60

Pathway Group

This guideline has been signed off on behalf of NHS Devon.

Publication date: December 2016

Updated: September 2021

Reviewed: April 2024