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HomeHospitals and ServicesEar nose throat (ENT) clinic - Royal North Shore Hospital

Ear nose throat (ENT) clinic - Royal North Shore Hospital

Level 3 - Ambulatory Care Centre (outpatient clinics)

Acute Services Building (main entry level)

Royal North Shore

Reserve Rd

St Leonards

2065

Map view

Ear nose throat (ENT) clinic - Royal North Shore Hospital

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Contact us

 

General enquiries: (02) 9463 1400

[email protected]

 

Referrals

Phone: (02) 9463 1400

We accept ereferrals from GPs via HealthLink - For more information go to - Electronic Referrals for Outpatient Clinics​ - Northern Sydney Local Health District (nsw.gov.au) 

Opening hours

 

Monday: 13:00 - 16:30
Tuesday: 08:00 - 12:00
Wednesday: 13:00 - 16:30
Friday: 13:00 - 16:30

 

As each clinic focuses on a different area of ENT surgery you will be booked into the most appropriate clinic for your condition. 

 What we do

We provide treatment for: 

  • Cancers of the ear, nose and throat 
  • Voice clinic for voice concerns 
  • Nasal problems including anterior skull base tumours, pituitary pathology 
  • Ear problems including minimally invasive endoscopic ear surgery, complex ear surgery, lateral skull base surgery and cochlear implantation for severe deafness 
  • General Paediatric clinic including grommets, tonsils and adenoids 

 What to bring

  • Relevant images/scans/blood test results (including CT or MRI scan of affected area) 
  • Relevant test results (including hearing tests, allergy tests, microbiology) 
  • List of current medications and drug allergies 
  • Your referral letter from your GP/Specialist 

 When to visit us

Your GP or non-GP specialist is always your first step in seeking treatment for any condition. You will be referred to our service if your treating doctor feels that your treatment requires the input of an ENT surgeon. Once we receive the referral it will be reviewed by a doctor and you will be notified of the outcome and next steps. Please allow at least 4 weeks for this process to be undertaken. We see patients either face to face or via telehealth - your specialist will let you know what the best option is for you.   

 

Please note that phone calls from the hospital will appear as a blocked number.   

 

If you have a scheduled appointment you will receive a reminder text message.   

 

Please allow a full morning or afternoon for your appointment. Some patients require a longer review and delays can occur. 

 How to visit us

Exit off Pacific Highway and the M1 will take you to the hospital on Reserve Road in St Leonards

Bus Route 114 stops directly at the hospital

The hospital is close to St Leonards train station

The hospital is a 5 minute walk from St Leonards Station

Street and multi storey car parking are available on the Royal North Shore hospital campus. Fees apply, so please check signage. Concession parking rates are available for patients and carers. Click here for more details.

The ENT Clinic is located at Check in D. 

 

When you enter the hospital walk past the yellow lifts. The Ambulatory Care Centre will be on your right hand side between the orange and green lifts. Check in D can be found by turning left after you pass the enquiries desk. 

 Referral information

Diagnosis 

Referral accepted when 

Recurrent Acute Otitis Media 

  • More than 3 Recurrent ear infections with resulting social/developmental concerns within 12 months 
  • Recurrent ear infections with associated otorrhoea 
  • Speech development delay 
  • Child with craniofacial abnormality à Refer directly to Sydney Children’s Hospital Network 

Middle ear effusion (glue ear) 

  • Persistent audiological evidence of effusion longer than 3 months  
  • Audiological evidence of bilateral effusion with history suggestive of developmental delay in infant  
  • Audiological evidence of effusion with history suggestive of social/classroom impairment in school aged children 
  • Child diagnosed with a syndrome à Refer directly to Sydney Children’s Hospital Network 

Ear drum perforation 

  • Traumatic perforation not healing after 3 months
  • Recurrent episodes of discharging ear 
  • Persistent discharge despite treatment  
  • Deteriorating hearing 
  • When vertigo exists with acute perforation 
  • Any suspicion of cholesteatoma 

Chronic Ear Disease 

  • Discharging ear for longer than 3 months 
  • Failure to settle with topical medication 
  •  Otalgia, headaches, vertigo  
  • Complications i.e. meningitis, facial palsy, vertigo 

Tinnitus – UNILATERAL or pulsatile 

  • Unilateral tinnitus with abnormal MRI 
  • Unilateral sensorineural deafness 

Tinnitus - bilateral 

  • Referral not required or accepted 

Vertigo 

  • Structural abnormality within the vestibular system on CT/MRI 
  • Otherwise refer to Neurology 

Acute, Chronic, Recurrent Rhinosinusitis 

  • Failed adequate medical management with CT evidence of sinus disease beyond the maxillary sinuses (e.g. involving sphenoid, ethmoid or frontal sinus) 
  • Complicated sinus disease (extrasinus extension, suggestion of fungal disease).  
  • Unilateral sinus opacification because of risk of malignancy 
  • Any unilateral pathology 
  • Presence of RED FLAGS:  
  • Unilateral epiphora 
  • Unilateral epistaxis or unilateral obstruction 
  • Visual disturbance 
  • Loss of smell 
  • Facial numbness 

Epistaxis 

  • Once failed adequate medical management 
  • Persisting unilateral epistaxis, particularly in teenage males 

Nasal Obstruction 

  • Once failed adequate medical management  
  • Post traumatic where the patient has decided they want surgical management 

Tonsillitis 

  • When the frequency of attacks are causing significant educational / social constraints AND that all involved want to consider surgery  
  • 7 episodes in past year, 5 per year over 2 years, or 3 per year for over 3 years  
  • 2 prior episodes of quinsy in someone with no history of recurrent tonsillitis OR 1 quinsy if there is history 

Adult OSA 

  • ONLY after respiratory assessment with Polysomnography (PSG) and consideration/trial of CPAP  
  • If BMI greater than 30 – NEEDS to have adequately attempted weight loss programme (including review with bariatric surgeon) and been intolerant of maximal medical management  
  • If respiratory assessment finds predominant problem is nasal obstruction (irrespective of BMI) 

Paediatric OSA 

  • >2 years old 
  • Snoring with obvious obstructive features (apnoea/choking) and large tonsils on examination 
  • Co-existing craniofacial abnormality à Refer directly to Sydney Children’s Hospital Network 

Dysphonia 

  • Persistent hoarseness or change in voice which fails to improve with conservative measures after 3 weeks needs laryngoscopy à call ENT registrar and mark referral as URGENT 

Facial palsy 

  • Call ENT registrar to discuss all facial palsies – early treatment can change outcomes 
  • Associated hearing loss or other suspected cranial nerve involvement. 
  • Failure of improvement in facial weakness after 3 weeks of medical management 

Salivary stones 

  • Call ENT registrar to arrange review to judge on retrievability – in the acute setting, advice re medical management may be enough with plan to follow once settled 
  • Failure of medical management 
  • Recurrent swelling or sialadenitis 

Salivary masses 

  • Contact ENT registrar if ongoing concern after imaging 
  • Offer to r/v any referred lump ( salivary or other neck lump ) after initial imaging (often be U/S +/- FNA) 
  • If FNA result / size of mass needs surgical management 

Suspected/ confirmed head & neck malignancies 

  • For all suspected malignancies (including any neck lumps persisting for >3 weeks) contact ENT registrar and mark referrals as URGENT 
  • Any airway compromise please refer to the emergency department  

Head & neck skin malignancies 

Refer if concerned re: 

  • Positive margin  
  • Complex lesion requiring reconstruction  
  • Cosmetically sensitive area  
  • Recurrent lesion  
  • Deep structures or perineural involvement 

Unilateral sudden onset hearing loss 

  • Sudden onset sensorineural hearing loss à contact ENT registrar and refer urgently 

Lesions in oral cavity persisting >3 weeks 

  • Contact ENT registrar and refer urgently if lesion present for >3 weeks 

 

Indications for urgent referral to local Emergency Department 

  • Airway compromise 
  • Severe or persistent epistaxis 
  • Tonsillar haemorrhage 
  • Hoarseness associated with neck trauma or surgery 
  • Stridor 
  • Laryngeal obstruction and/or fracture 
  • Acute nasal fracture with septal haematoma. 
  • Complicated mastoiditis, cholesteatoma, or sinusitis (periorbital cellulitis, frontal sinusitis with persistent frontal headache) 
  • Pharyngeal or laryngeal foreign body 
  • Abscess or haematoma, e.g., peritonsillar abscess, septal or auricular haematoma, paranasal sinus pyocele 
  • Nasal foreign body – battery 
  • Barotrauma with sudden onset vertigo 
  • Any other conditions of immediate concern 

 

Exclusion criteria 

  • Dysphagia and laryngeal hypersensitivity à Refer for Speech Pathology assessment 
  • Bilateral tinnitus 
  • Headaches without nasal symptoms or CT confirmed sinusitis 

  

Out of NSLHD 

  • Reason must be stated explicitly  
  • Resident of other LHD that does not provide the clinical service 
  • Continuing care of existing condition already managed by NSLHD 
  • Demonstrated complexity requiring services of NSLHD 
  • Compassionate circumstances, e.g. family, proximity, staff 

  

The following information must be included for referral to be accepted: 

  • ENT assessment 
  • History of symptoms, including duration, progression and response to any treatments tried 
  • Relevant pathology and imaging 
  • Audiology results, if relevant to presenting complaint 

 

Providing more information will aid the triage process and make it more likely that your patient will be seen in the most timely manner possible 

Please submit referrals using the eReferral system through HealthLink, which can be accessed through most clinical software systems 

 
If unsure which ENT specialist you would like to see based on the presenting issue, address letters to Dr Martin Forer or alternatively, address letters to one of the doctors listed in the ‘Other information’ section”
Fax (02) 94631065 
Email: [email protected] 

  

Referrals will be triaged and your patient will be notified of the outcome as soon as possible. This process may take between 1-4 weeks. You will be contacted if more information is needed.  

Telehealth services are available, please indicate on the referral if you feel this would be suitable for your patient’s appointment. 

 Other information

Our Team 
 

Dr Martin Forer – Head of Department, ENT surgeon (General and Rhinology) 

Dr Nicholas Jufus – ENT surgeon (General and Otology) 

Dr Justin Kong – ENT surgeon (General and Rhinology) 

Dr Leo Pang – ENT surgeon (General and Head & Neck surgery) 

Prof Nirmal Patel – ENT surgeon (General and Otology) 

Dr David Veivers – ENT surgeon (General and Head & Neck surgery) 

Dr Andrew Wignall – ENT surgeon (General and Head & Neck surgery) 

Dr Danielle Stone (PhD) – Speech pathologist 

Mr Hans Satyan – Audiologist 

 Related links