Tinnitus Referral Access Criteria
Tinnitus Referral Access Criteria
Referrers should use this page when referring patients to public adult ENT outpatient services for tinnitus.
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| Emergency referral |
 If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region. |
- Tinnitus with sudden onset hearing loss in absence of clear aetiology and/or associated with vertigo
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| Immediate referral |
 Immediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):
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To contact the relevant service, see Clinician Assist WA: Acute ENT assessment (external site)
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Disabling tinnitus associated with hearing loss, aural fullness and/or discharge or vertigo
- Pulsatile tinnitus
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| Mandatory information |
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Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).
This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
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| History |
- Relevant history, onset, duration, frequency, and quality of symptoms including:
- Associated hearing and/or balance symptoms
- Details of previous treatment and outcome including antibiotic or irrigation prescriptions
- Relevant past medical history including past middle ear disease/surgery
- Degree of functional impairment (e.g. quality of life)
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| Examination |
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Appearance of the ear canal effusion or cerumen history/presence
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| Investigations |
- Audiology and audiogram results (where available and providing it will not cause significant delay)
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| Highly desirable |
| History |
- Mechanism of injury (barotrauma)
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| Examination |
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| Investigations |
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- No defined category 1 criteria
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Category 2
Appointment within 90 days
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Pulsatile tinnitus
- Severe communication difficulties due to hearing loss (bilateral downward sloping OR severe) despite hearing aids
- Sudden onset or chronic unilateral or bilateral pulsatile tinnitus or disabling tinnitus and any of the following:
- vertigo / dizziness
- hearing loss
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Category 3
Appointment within 365 days
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- No defined category 3 criteria
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Last reviewed: 02-10-2023