This surgeon is participating in the
Otolaryngology Central Access and Intake - Facilitated Access to Specialized Treatment (FAST) program. Reference FAST profile.
The following clinical problems will only be accepted if the appropriate criteria are met, due to overwhelming clincial demand.
Sleep-disordered breathing:
- Nightly snoring with witnessed apneas that has lasted longer than 6 months AND;
- Daytime symptoms of excessive fatigue or hyperactivity/irritability AND;
- Minimum three month trial of medical therapy including nasal steroid, anti-histamine (when appropriate), allergy work-up (when appropriate) AND;
- Evidence of attention to sleep hygiene measures and workup of other causes including iron deficiency
OR
- Documented evidence of medical sequelae of obstructive sleep apnea (failure to thrive, hypertension, cor pulmonalae)
Recurrent tonsillitis:
- Recurrent bacterial tonsillitis requiring antibiotic therapy of appropriate frequency (seven episodes in one year, five episodes per year for two years, three episodes per year for three years); AND
- Every episode confirmed with at least one of: positive swab for group A strep, positive bacterial culture, fever with tonsillar exudate and lymphadenopathy; AND
- Significant quality of life impact such as prolonged school/work absenteeism OR recurrent peritonsillar abscess OR antibiotic resistance
Recurrent or chronic otitis media:
- Three or more documented episodes of acute otitis media in a six month period or four in twelve months; AND
- Persistent middle ear effusion (over 6 weeks) after resolution of acute infection
OR
- Documented evidence of persistent middle ear effusion with hearing loss for longer than three months
Recurrent epistaxis:
- Recurrent episodes of prolonged or frequent epistaxis (three or more times per week); AND
- Documented evidence of minimum three month trial of nasal hygiene (humidification, nasal lubricants, avoidance of triggers) AND
- Proper education on first aid measures including avoidance of home based packing
OR
Recurrent epistaxis with documented significant anemia or documented bleeding diathesis
Chronic rhinitis:
- Chronic nasal obstruction/congestion/rhinorrhea for greater than 6 months; AND
- Adequate trial of medical therapy for at least three months without improvement, including the use of intranasal steroid with proper technique, oral/topical anti-histamine and/or anti-leukotriene as appropriate; AND
- Management of allergies including allergy testing and/or allergist referral (when appropriate), avoidance of allergic triggers and adequate medical therapy
Ankyloglossia:
- Documented feeding difficulties (infants) after appropriate referral and management by a breastfeeding specialist and/or speech-language pathologist; OR
- Documented articulation difficulties (older children) after appropriate management and therapy by a speech-language pathologist
We will not accept referrals for tonsil stones, halitosis, throat clearing, subjective hearing impairment, subjective speech impairment, lip ties, or cerumen impaction other than in special circumstances.
We advise that suggestions to refer for matters related to tonsils and adenoid size by Dental and Orthodontic community colleagues be assessed first by the Family Physician and/or Pediatrician.
We are also unable to accept any non-urgent referrals for patients 16 years of age and up- these should be referred to an adult otolaryngology provider, as they will not be seen and treated by Pediatric Otolaryngology prior to turning 18.
This surgeon is participating in the
Otolaryngology Central Access and Intake - Facilitated Access to Specialized Treatment (FAST) program. Reference FAST profile.
The following clinical problems will only be accepted if the appropriate criteria are met, due to overwhelming clincial demand.
Sleep-disordered breathing:
- Nightly snoring with witnessed apneas that has lasted longer than 6 months AND;
- Daytime symptoms of excessive fatigue or hyperactivity/irritability AND;
- Minimum three month trial of medical therapy including nasal steroid, anti-histamine (when appropriate), allergy work-up (when appropriate) AND;
- Evidence of attention to sleep hygiene measures and workup of other causes including iron deficiency
OR
- Documented evidence of medical sequelae of obstructive sleep apnea (failure to thrive, hypertension, cor pulmonalae)
Recurrent tonsillitis:
- Recurrent bacterial tonsillitis requiring antibiotic therapy of appropriate frequency (seven episodes in one year, five episodes per year for two years, three episodes per year for three years); AND
- Every episode confirmed with at least one of: positive swab for group A strep, positive bacterial culture, fever with tonsillar exudate and lymphadenopathy; AND
- Significant quality of life impact such as prolonged school/work absenteeism OR recurrent peritonsillar abscess OR antibiotic resistance
Recurrent or chronic otitis media:
- Three or more documented episodes of acute otitis media in a six month period or four in twelve months; AND
- Persistent middle ear effusion (over 6 weeks) after resolution of acute infection
OR
- Documented evidence of persistent middle ear effusion with hearing loss for longer than three months
Recurrent epistaxis:
- Recurrent episodes of prolonged or frequent epistaxis (three or more times per week); AND
- Documented evidence of minimum three month trial of nasal hygiene (humidification, nasal lubricants, avoidance of triggers) AND
- Proper education on first aid measures including avoidance of home based packing
OR
Recurrent epistaxis with documented significant anemia or documented bleeding diathesis
Chronic rhinitis:
- Chronic nasal obstruction/congestion/rhinorrhea for greater than 6 months; AND
- Adequate trial of medical therapy for at least three months without improvement, including the use of intranasal steroid with proper technique, oral/topical anti-histamine and/or anti-leukotriene as appropriate; AND
- Management of allergies including allergy testing and/or allergist referral (when appropriate), avoidance of allergic triggers and adequate medical therapy
Ankyloglossia:
- Documented feeding difficulties (infants) after appropriate referral and management by a breastfeeding specialist and/or speech-language pathologist; OR
- Documented articulation difficulties (older children) after appropriate management and therapy by a speech-language pathologist
We will not accept referrals for tonsil stones, halitosis, throat clearing, subjective hearing impairment, subjective speech impairment, lip ties, or cerumen impaction other than in special circumstances.
We advise that suggestions to refer for matters related to tonsils and adenoid size by Dental and Orthodontic community colleagues be assessed first by the Family Physician and/or Pediatrician.
We are also unable to accept any non-urgent referrals for patients 16 years of age and up- these should be referred to an adult otolaryngology provider, as they will not be seen and treated by Pediatric Otolaryngology prior to turning 18.
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