When should I refer a patient with tinnitus to an audiology specialist?

Refer a patient with tinnitus to an audiology specialist if they have persistent tinnitus that is causing distress, especially if it is unilateral or pulsatile, or has significantly changed in nature ².

Refer immediately if tinnitus is associated with sudden onset of neurological symptoms, significant neurological signs, or suspected stroke ².

Consider referral for tinnitus assessment and management in line with local pathways if the patient has persistent tinnitus despite initial support, or if tinnitus is unilateral, pulsatile, or significantly distressing ².

Additionally, refer if tinnitus is associated with objective tinnitus or unilateral/asymmetric hearing loss ².