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Referral Criteria

Regrettably, due to the insufficient number of pediatric otolaryngologists at CHEO, as of May 1, 2007, we will be accepting ONLY tertiary level referrals. Consults will be triaged, and if felt to not be appropriate under our new guidelines, they will be faxed back to the referring physician. A list of accepting Otolaryngologists and their areas of interest are included with this notice. We regret the inconvenience this creates, but unfortunately our wait times have become unacceptably long. As a result, patient care has been significantly compromised and ongoing care of current patients is suffering as well.

Referral Criteria


Referral Criteria con'td

Tertiary level referrals only

 The following constitute appropriate bases for referral:

1. Underlying medical conditions, requiring ongoing care at CHEO, eg.

  • Complex cardiac condition
  • Oncology clinic patients 
  • Diabetes, metabolic, renal issues

2. Underlying genetic syndromes, e.g.

  • Trisomy 21
  • CHARGE Syndrome 
  • Digeorge Syndrome 
  • Velocardiofacial Syndrome 

3. Sensorineural hearing loss

  • Failed infant hearing screening

4. Cranofacial abnormalities, e.g.

  • Cleft lip and palate
  • Craniosynostotis

5. Airway concerns, e.g.

  • Stridor
  • Recurrent croup
  • Vocal cord paralysis 
  • Aspiration 
  • Suspected choanal atresia or significant nasal obstruction


6. Voice issues

  • Hoarseness, seen in voice clinic when over 4-5 years of age

7. Drooling

  • Saliva Management clinic accepts patients ­less than or equal to 5 years of age.

8. Hypernasality

  • the consult is triaged and a nasality test is arranged by our triage team, with the help of our Cleft Palate Co-ordinator. Please include any speech therapy consultations.

9. Head and neck masses

10. Nasal fractures

  • Fax the consult stating the DATE OF INJURY, not just the date of your assessment, and we will call the patient for an appointment 5-7 days AFTER the injury.

11. Severe complications of otitis media, e.g. (not isolated, acute perforation due to acute otitis media)

  • Mastoiditis 
  • Otitis media in a neonate 
  • Persistent perforation once acute otitis media is resolved

12. Aural atresia

13. Suspected Cholesteotoma

14.Traumatic perforation:we will see at the 6 week mark, preferably with an audiogram. Please use Ciprodex otic drops x1 week and instruct patients to keep the ear/ears dry.

15. Significant suspected obstructive sleep apnea (OSA)

16. Sibling of current ENT patient (please state the treating ENT surgeon)

Referral Form (34 Kb .doc)


In contrast, the wait for audiology services has recently reduced. Audiology is happy to perform the audiology needs in children, for suspected hearing loss, especially in children 4 and under.

Sensorineural Hearing Loss 

Referrals for suspected hearing loss will be screened through audiological assessment, only those patients who are found to have significant hearing loss will be followed by ENT at CHEO.

Appropriate Consults to CHEO part-time Otolaryngologists

  1. Recurrent otitis media
  2. Persistent fluid
  3. Suspected hearing loss 
  4. Nasal obstruction
  5. Snoring, mild obstructive sleep apnea

  6. Tonsilitis
  7. Sinusitis/rhinitis
  8. Epistaxis
  9. Tongue Tie

Contact Information

Sandra Dube R.P.N.

Clinic C-B ENT Nurse
Department of Otolaryngology for:

  • Dr. J. MacCormick
  • Dr. J.P. Vaccani
  • Dr. M. Bromwich

Tel: 737-7600 x2587

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