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Referral
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Tinnitus
Scope
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
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:
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
Northern/Western/SD&T
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
Eastern
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
Referrals to ENT
e-Referral Service Selection
- Specialty: Ear, Nose & Throat
- Clinic Type: Tinnitus
- Service: DRSS Northern – Ear Nose and Throat- Devon ICB- 15N
Referral Form
Patient Information
- What is Tinnitus? - British Tinnitus Association website
- Save your Ears - BTA
- Noise and the Ear - BTA
- Self Help for Tinnitus - BTA website
Pathway Group
This guideline has been signed off on behalf of NHS Devon.
Publication date: April 2019
Date Updated: September 2021
