Head and neck mass (ENT) Referral Access Criteria

Referrers should use this page when referring patients to public adult ENT outpatient services for head and neck masses. 
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department 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
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):

  • Confirmed head and neck malignancy
To contact the relevant service, see HealthPathways: Acute ENT assessment (external site)
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • 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 information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

History

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

  • No additional investigations required before referral

All other patients:

  • Smoking and alcohol history
  • Current medication list including whether patient is currently taking antiplatelet or anticoagulant medication
Examination
  • Nil
Investigations
  • USS +/- CT neck results
  • FBC
  • U&Es
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • CT chest +/- FNA results (provider and date)
  • Coagulation studies
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
Exclusions
  • Nil
Useful information
  • Nil
Last reviewed: 02-10-2023