This guideline covers the diagnosis and management of tinnitus in adult patients.

Virtually all adults will experience tinnitus at some point in their life, this is usually self-limiting. Bilateral tinnitus is almost never associated with significant pathology.


History and Examination

  • Tinnitus persisting for more than 6 weeks
  • Conduct ear and neurological examination
  • If pulse synchronous tinnitus - listen to neck for carotid bruit

Red Flags

The symptom of tinnitus in isolation has no specific Red Flags. Tinnitus can sometimes be associated with other symptoms that meet the Head and Neck 2ww Guidance.

Persistent unilateral tinnitus with or without vertigo, hearing loss or other symptoms may sometimes represent an acoustic neuroma. These patients are now also assessed by the audiology team and should be referred routinely.


Bilateral tinnitus with hearing loss

Please see Hearing problems in adults guideline

Bilateral tinnitus without hearing loss

Self-management – see link below

  • Review 6 weeks by GP if no better consider referral to audiology
  • Address co-morbidities e.g. depression, stress and anxiety

Further information at:

Self-help for tinnitus - BTA website


Referral Criteria

Routine referral to Audiology:
  • Troublesome or intrusive bilateral tinnitus for more than 6 weeks with significant impact on quality of life despite adequate self-treatment
  • Pulse synchronous tinnitus in absence of cardiovascular cause or anaemia
  • Persistent unilateral tinnitus

Referral Instructions

Referrals to audiology


Audiology referrals should be sent to Chime Audiology as paper referrals as this service is not provided on e-Referral Service:

Audiology Department, RD&E Hospital Wonford Tel: 01392 402 223/6


Audiology referrals should be sent via e-Referrals

  • Speciality: Diagnostic Physiological Measurement
  • Clinic type: Audiology – Hearing Asses/ Reassess
  • Service: DRSS Northern/Western/South Devon and Torbay- Audiology- Devon CCG- 15N
Referrals to ENT

e-Referral Service Selection

  • Specialty: Ear, Nose & Throat
  • Clinic Type: Tinnitus
  • Service: DRSS Eastern – Ear Nose and Throat- Devon CCG- 15N

Referral Forms

DRSS referral form

Supporting information

Patient Information

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group.

Publication date: April 2019

Date Updated: September 2021

Last updated: 23-09-2021


Home > Referral > Eastern locality > ENT & Audiology > Tinnitus


  • First line
  • Second line
  • Specialist
  • Hospital