When should a patient with labyrinthitis be referred to an ENT specialist for further evaluation?

Referral to an ENT specialist for a patient with labyrinthitis should be considered if:

• Vertigo symptoms have not fully resolved or are recurrent, indicating the need for further diagnostic evaluation and management.
• There are atypical symptoms or signs such as hearing loss, tinnitus, or other neurological symptoms that may suggest alternative or additional diagnoses beyond labyrinthitis.
• The patient experiences severe or persistent symptoms that do not improve with initial management in primary care.
• There is suspicion of complications or differential diagnoses that require specialist assessment, including imaging or audiological investigations.

In summary, patients with labyrinthitis should be referred to ENT if vertigo persists or recurs, if there are associated auditory or neurological symptoms, or if initial treatment fails to resolve symptoms, to exclude other diagnoses and provide specialist care.

References: NICE NG98, NICE NG127