What are the current guidelines for referring patients with suspected acoustic neuroma to secondary care?

Referral guidelines for suspected acoustic neuroma:

Adults presenting with unilateral or asymmetric hearing loss, persistent unilateral tinnitus, or vertigo that has not fully resolved or is recurrent should be considered for referral to an ear, nose and throat (ENT), audiovestibular medicine, or specialist audiology service for diagnostic investigation using local referral pathways.

Specifically, referral is indicated if hearing loss is not explained by acute external or middle ear causes and includes symptoms such as unilateral or asymmetric hearing loss, persistent tinnitus that is unilateral or has significantly changed in nature, and vertigo that is recurrent or unresolved.

Additionally, if there is a middle ear effusion not associated with an upper respiratory tract infection, especially in adults of Chinese or south-east Asian family origin, referral via a suspected cancer pathway should be considered.

Urgent referral is warranted if there are additional neurological signs such as altered sensation or facial weakness on the same side as the hearing loss, or if sudden onset or rapid worsening of hearing loss occurs.

These referrals should be made to secondary care services such as ENT or audiovestibular medicine for further assessment, including imaging to exclude acoustic neuroma.