44 45The primary criteria for the referral of a patientfor a medical or other specialist opinion and /or treatment are as follows:• Visible congenital or traumatic deformityof the ear;• History of active drainage from the ear inthe previous 90 days;• History of sudden or rapidly progressivehearing loss in one or both ears withinthe previous 90 days;• Acute or chronic dizziness;• Audiometric air-bone gap equal to orgreater than 15 dB at 500 Hz, 1000 Hzand 2000 Hz;• Visible evidence of significant cerumenaccumulation or a foreign body in the earcanal;• Pain or discomfort in the ear;• Abnormal appearance of the eardrumand ear canal such as:- Inflammation of the external auditorycanal,• Presence of hearing loss• Uni- or bilateral• Conductive, sensorineural or mixed• Mild to profound• Presence of a chronic tinnitus (onlyapplicable for devices which provide theTinnitus feature).ContraindicationsGeneral clinical contraindications for the use ofhearing aids and Tinnitus software are:• Hearing loss is not in the fitting rangeof the hearing aid (i.e. gain, frequencyresponse)• Acute tinnitus• Deformity of the ear (i.e. closed ear canal;absence of the auricle)• Neural hearing loss (retro-cochlearpathologies such as absent/non-viableauditory nerve)