REFERRALS TO GPs
- Signs of acoustic neuroma: asymmetric audiometry and/or speech discrimination, constant unilateral tinnitus, vertigo.
- Conductive hearing loss: middle ear effusion, otosclerosis, cholesteatoma, TM perforation.
- Cognitive assessment.
- Medicare structure dictates that all outbound ENT referrals must go via GP.
ALTERNATIVES TO CONVENTIONAL HEARING AIDS
- Unilateral hearing loss: if the loss is too severe for aiding, a CROS aid relays sound from the ‘bad’ ear to the ‘good’ ear without amplification. If there is aid able hearing loss in the ‘good’ ear, a BICROS aid adds corrective amplification.
- When residual hearing is insufficient for hearing aids to work effectively, cochlear implants have a higher success rate. There is no age barriers to implantation provided the patient is fit for surgery. We routinely refer to the RVEEH.
- Mild hearing loss: TV headphones and other assistive listening devices, which may be fully subsided for pensioners.
Tinnitus: permanent wear hearing aids that provide 24/7 tinnitus relief.
HEARING LOSS CLINICAL IMPLICATIONS – RESEARCH
- When the 3FA (average 500Hz, 1kHz, 2kHz) hearing loss is greater than 35dB, the risk of auditory deprivation becomes significant: decay within the auditory cortex results distorts speech discrimination. If left unattended, this limits the potential with aiding.
- Every 10dB of hearing loss increases the risk of dementia by 16% (Ageing Research Review meta-analysis, July 2024)
- For those at higher risk of developing dementia (e.g. family history), treatment of hearing loss slows the rate of cognitive decline by an average of 48% over 3yrs (Lancet, 2023)
- Aided patients have a 19% lower risk of developing dementia than unaided patients with hearing loss (JAMA Neurology, Feb 2023)
- Every 10dB of hearing loss increases the risk of clinical depression by 28% (American Journal of Geriatric Psychiatry, May 2020)
- Aiding adults over 60yo with bilateral hearing loss reduces the risk of falls by 50% on average (Journal of American Geriatric Society, Oct 2024)
