Reviewed on : 19 Jul 2018

Reviewed by : GP Gateway Editor

Expires : 19 Jul 2020

All community-based ENT issues can appropriately be referred to this service. We do not see any patients with suspected cancer or pre-cancer. All referrals are made via the NHS eReferral Service where the clinic is called ENT Community Clinic. The service is available to patients registered with a Coventry GP.

The Community ENT service is based at:
First floor of City of Coventry Health Centre
2 Stoney Stanton Road,
Coventry
CV1 4FS

The service is provided by a team of ENT consultants Mr. Peter Dekker, Mr. Piyush Patel Mr. Stephen Rejali and Mr. Hamid ElSawy Specialist Registrar.

Clinics are run on a Monday afternoon and a Tuesday evening.

Conditions seen in Community ENT

Chronic Ear infections      Epistaxis

Glue ear                           Grommets (see additional notes)

Hearing loss                    Tonsillectomy & Adenoids

Post nasal drip                Rhinoplasty

Septal defect                    Sinusitis

Snoring                            Sore throat

Tinnitus

Hoarseness (longstanding, if recent within 3 weeks refer via 2 week wait )

Low Priority Procedures

Grommets for glue ear are considered a Low Priority Procedure

See link for Grommets & Myringotomy page

Referral to Audiology (see below) for hearing tests is advisable if persistent hearing loss is suspected before referral for consideration of grommets

Referrals for grommets may be accepted where there is significant audiological evidence of hearing loss associated with glue ear or middle ear effusion see below (see full low priority grommet referral form for complete details)

Persistent bilateral otitis media with hearing loss

Persistent bilateral otitis media documented over a period of 3 months AND a hearing level in the better ear of 25-30 dBHL

or

Worse ear averaged at 0.5, 1,2 and 4 kHz (or equivalent dBA where dNHL not available)

Conductive hearing loss

Persistent hearing loss for more than a year with deficit estimated to be more than 25 decibels

OR

Recurrent infection

My patient has experienced more than 6 episodes of acute otitis media in previous 12 months

OR

Developmental or educational effects

Developmental impairment (e.g. speech/ language/ cognitive/ behavioural) likely to be due to, or exacerbated by, clinically suspected hearing loss

OR

Has poor progress at school directly attributable to this condition, the child has proven hearing loss, plus a second disability such as Down’s Syndrome or cleft palate

Procedures performed within the consultant led clinic include:

• Cauterization to nasal canal (for the treatment of epistaxis)
• Hearing Tests (pure tone audiometry and tympanometry)
• Micro suction of the ear canal
• Nasendoscopy
• Clinical assessment for surgery
• Assessment for CT scan/MRI
• Assessment for Sleep studies

Hearing Aids (do not refer to this clinic)

Assessment for hearing aids is no longer carried out in the Community ENT clinic; patients should be advised to access- an approved Hearing Care Centre.

Hearing Tests

On a Tuesday evening clinic we have an audiologist who can measure pure tone audiometry and tympanometry.

However if the hearing test is for a child under 4 it is more suitable to refer them to children’s services.

Nasendoscopy

The nasendoscope is routinely used as part of the ENT assessment to examine the nasal cavities, pharynx and larynx. It is used to:

• identify normal and abnormal pathology
• identify Nose–nasal polyps, vascular defects, inflammation; upper pharynx–ulcers, lymphoid hyperplasia, cysts; lower pharynx–lymphoid hyperplasia, cysts, vocal cord trauma
• to gain information that allows a diagnosis to be reached.

Within ENT community clinics we carry out a 3 Step cleanse of the nasendoscope to minimise the risk of infections like Creutzfeldt–Jakob disease (CJD)

Please indicate on your patient referral if a PATIENT HAS EVER BEEN NOTIFIED THAT THEY ARE AT RISK OF CJD OR vCJD FOR PUBLIC HEALTH SERVICES.

Micro suction

Micro suction is performed within the clinic setting and is an option if syringing isn’t successful. If referring for this it may be an option to use an ear wax softener a few weeks prior to the appointment.