![]() ![]() ![]() AQP providers may reject referrals where an assessment for tinnitus is requested so please bear this in mind when making a referral. (*Please note that audiology AQP providers can only accept referrals for assessment of patients (aged 18 and over) who have suspected hearing loss, and will not accept referrals for patients requiring assessment or treatment of tinnitus itself. This service can may onward referrals to ENT clinic if this is required.Įars must not be occluded by wax and referrals that do not state this clearly will be returned. This can be requested by referring to audiology (non- AQP) via e-RS*. Where a patient with persistent bilateral tinnitus reports hearing difficulties, it is recommended that they should undergo a hearing assessment initially. Tinnitus is frequently associated with underlying hearing loss. Please see Management in Primary care section below further details.įor patients with persistent or troublesome bilateral tinnitus: In the absence of red flags, then many cases of tinnitus will be short lived and self limiting. See Red Flag section below for indications for immediate or urgent (HOT clinic) referrral. Wax occlusion should be treated with drops, as per local guidelines.Ĭonsider screening for features of anaemia, thyroid disease, hyperlipidaemia, and diabetes.If the tinnitus is pulsatile, then auscultate for heart murmurs and carotid/mastoid bruits. ![]() Tuning fork hearing test should be performed.Otoscopy - the ear canal and tympanic membranes should be examined by otoscopy.how it is affecting their daily life / mental health.associated with otalgia, otorrhoea, dizziness or hearing loss.See CKS guidelines for advice on How to assess someone with tinnitusĪll patients suffering from tinnitus should be asked whether the tinnitus is: This may originate from an identifiable source that produces sound near to, or within, the ear (for example a vascular abnormality producing a pulsatile sound near to the ear, or muscle related noise). Objective tinnitus (affecting 1% of people with tinnitus) if the sound can be heard by the affected individual and the examiner.This is caused by a change in the way sound is perceived by the central nervous system. Subjective tinnitus (more common) if the perceived sound can only be heard by the affected individual.Tinnitus can be constant or intermittent, unilateral or bilateral, pulsatile or non-pulsatile. It may be highly variable and often described as a ringing, hissing, buzzing, whooshing, whistling, or humming. It is defined as the perception of sound in the absence of an external source. Tinnitus is a common symptom, affecting around 10% of UK adults. The guide below has been developed from national guidelines with advice on local referral pathways from the ENT and audiology department at St Michaels Hospital, Bristol. Do not submit another eRS referral in this situation as these requests will be returned.Ĭurrent waits for outpatient clinics in ENT are as follows (August 2022): Only submit written requests to expedite if there is clinical deterioration or concern. The ENT service kindly requests that if patients approach referrers requesting an appointment to be expedited not to ask them to ring the hospital as they will not be able to help. When referring, please also warn patients of long waits for outpatient appointments. Please consider using primary care management pathways where possible and only refer patients if these options have been exhausted. ENT Clinics are currently under extreme pressure as a result of COVID recovery and increased demand for appointments.
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