Tinnitus – Information for GPs
Exclude red flag symptoms
- Persistent (>3 months) unilateral tinnitus
- Associated deafness or tympanic membrane abnormality
- Pulsatile tinnitus unless associated with an acute inflammatory ear condition
- Persistent intrusive tinnitus
Patients with bilateral tinnitus without hearing loss will often benefit from a description of the natural history of tinnitus (it usually becomes less intrusive or disappears) and simple recommendations for distraction with external noise. It is usually harmless.
Refer patients with red flags above. We are trying to pick up acoustic neuromas or vascular lesions (glomus tumours etc.). These are largely slowly progressing phenomenon.
Expert opinion varies but an open discussion with patients particularly those whose fitness or life expectancy would make the patient themselves decide to rule out any form of operative intervention might be better to observe their symptoms (referring if hearing loss develops) or consider a GP requested MRI IAMs to exclude acoustic neuroma for reassurance.
Patient information leaflets
Information to include in referral letter
- Nature of tinnitus, ear/ears affected, hearing loss
- Relevant past medical/surgical history
- Current regular medication
- Smoking status