Royal Australasian College of Surgeons

Recommendations from the Royal Australasian College of Surgeons on hernias, blood transfusion, reflux in gastric band patients & appendicitis. RACS is the leading advocate for surgical standards, professionalism and surgical education in Australia and New Zealand. The College is a not-for-profit organisation that represents more than 7000 surgeons and 1300 surgical trainees and International Medical Graduates.

Don’t order computed tomography (CT) scan of the head/brain for sudden hearing loss.

Date reviewed: 17 March 2017

Computed tomography scanning is expensive, exposes the patient to radiation and offers no useful information that would improve initial management. CT scanning may be appropriate in patients with focal neurologic findings, a history of trauma or chronic ear disease.

Sudden hearing loss is distinct from progressive loss and chronic ear disease. Sudden sensorineural hearing loss (SSHL) can be described as at least 30dB sensorineural hearing loss (SNHL) in at least three consecutive frequencies within a three-day period

Supporting evidence
  • Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical practice guideline: Sudden hearing loss. Otolaryngol Head Neck Surg 2012;146(IS):S1-35.
  • Tarshish Y, Leschinski A, Kenna M. Pediatric sudden sensorineural hearing loss: Diagnosed causes and response to intervention. International Journal of Pediatric Otorhinolaryngology 2013;77(4):553–9.
How this list was made How this list was made

RACS collaborated with General Surgeons Australia (GSA) and the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) respectively on the development of lists for Choosing Wisely Australia. Each organisation worked closely with key members including the Sustainability in Healthcare Committee and Professional Development and Standards Board (RACS), and the Boards of Directors (GSA and ASOHNS) to develop the lists of tests/treatments/procedures for general surgery, and head and neck surgery.

Download RACS Recommendations