Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
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 NICE NG98.
- Hearing Loss: Consider referral if the patient experiences hearing loss that fluctuates and is not associated with an upper respiratory tract infection NICE NG98. Also, consider referral for unilateral or asymmetric hearing loss as a primary concern NICE NG98. 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) NICE NG98,NICE NG155.
- Vertigo: Referral should be considered if the vertigo has not fully resolved or is recurrent NICE NG98.
- Tinnitus: Consider referral if the patient has persistent tinnitus that is unilateral, pulsatile, has significantly changed in nature, or is causing distress NICE NG98,NICE NG155. Referral is also appropriate if tinnitus is associated with unilateral or asymmetric hearing loss NICE NG155.
These criteria help determine when further specialist assessment is needed for patients with symptoms consistent with or diagnosed as Ménière's disease NICE NG98.