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This table summarizes the guidelines from NICE on when and how to refer individuals suffering from various manifestations and severities of tinnitus.
| Situation | Action | Details |
|---|---|---|
| Tinnitus with a high risk of suicide | Immediate referral | To a crisis mental health management team. Provide a safe place if waiting for assessment. |
| Tinnitus with neurological symptoms | Immediate referral | If associated with sudden significant neurological symptoms/signs (e.g., facial weakness) OR acute uncontrolled vestibular symptoms (e.g., vertigo), OR suspected stroke. |
| Tinnitus and sudden hearing loss | Refer within 24 hours | If tinnitus is associated with hearing loss that developed suddenly ( over a period of 3 days or less ) within the past 30 days. |
| Post-immediate referral | Ongoing assessment & management | Even after an immediate referral, tinnitus assessment and management should continue. |
| Tinnitus with distress or hearing loss | Refer within 2 weeks | If tinnitus causes distress affecting mental well-being or is associated with sudden hearing loss more than 30 days ago or rapidly worsening hearing loss (4 to 90 days). |
| Specific tinnitus symptoms | Standard referral | If tinnitus persists despite initial support, or if there's persistent objective tinnitus, or if associated with unilateral/asymmetric hearing loss. |
| Specific tinnitus types | Consider referral | For persistent pulsatile tinnitus or persistent unilateral... |
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