When should I consider referring a patient with Ménière's disease to an ENT specialist?

When considering referring a patient with Ménière's disease to an Ear, Nose, and Throat (ENT) specialist, you should primarily consider referral for diagnostic investigation if they present with specific characteristics of their symptoms ¹.

• Hearing Loss: Consider referral if the patient experiences hearing loss that fluctuates and is not associated with an upper respiratory tract infection ¹. Also, consider referral for unilateral or asymmetric hearing loss as a primary concern ¹. If there is sudden onset or rapid worsening of hearing loss, referral timelines vary: immediate referral (within 24 hours) for sudden onset (3 days or less) within the past 30 days, or urgent referral (within 2 weeks) if sudden onset was more than 30 days ago or if the hearing loss worsened rapidly (over 4 to 90 days) ¹,³.
• Vertigo: Referral should be considered if the vertigo has not fully resolved or is recurrent ¹.
• Tinnitus: Consider referral if the patient has persistent tinnitus that is unilateral, pulsatile, has significantly changed in nature, or is causing distress ¹,³. Referral is also appropriate if tinnitus is associated with unilateral or asymmetric hearing loss ³.

These criteria help determine when further specialist assessment is needed for patients with symptoms consistent with or diagnosed as Ménière's disease ¹.