Head and neck mass (ENT)

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Neck mass causing severe upper airway complications or compromise
  • Post-operative neck or upper airway complications e.g. bleeding, haematoma or voice changes

Immediately contact on-call registrar or service to arrange an immediate ENT assessment (seen within 7 days) for:

  • Confirmed head and neck malignancy

To contact the relevant service, please see HealthPathways: Acute ENT Assessment

Presenting issues
  • Confirmed head and neck malignancy
  • Suspicious solid mass, or cystic neck lumps, present for more than four weeks
  • New suspicious solid mass, or cystic neck lumps, in patients with a previous head/neck malignancy
  • Sialadenitis 
Mandatory referral information (referral will be returned if this information is not included)

If patient is eligible for the Fiona Stanley Hospital Rapid Access Neck Lump Clinic:

  • No additional investigations required before referral

All other patients:

History

  • Smoking and alcohol history
  • Current medication list including whether patient is currently taking antiplatelet or anticoagulant medication

Investigations

  • USS +/- CT neck results
  • FBC
  • U&Es

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)

Highly desirable referral information
  • CT chest +/- FNA results (provider and date)
  • Coagulation studies 
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • Suspicious solid mass and/or cystic neck lumps > 6 weeks and any of the following:
    • history of smoking
    • history of excessive alcohol intake
    • previous head/neck malignancy 
Category 2
Appointment within 90 days
  • No defined category 2 criteria
Category 3
Appointment within 365 days
  • No defined category 3 criteria
Last reviewed: 02-10-2023