Our Otolaryngology, Head and Neck Surgery service specialises in the treatment of Head and Neck Oncology, Otoneurological disorders and Skull Base surgery. The service is also known as Ear, Nose and Throat (ENT).
The service forms an integral part of the Head and Neck Oncology Unit and works closely with the Oral and Maxillofacial Surgery and Plastic and Reconstructive Surgery services.
We hold a weekly Specialist Consultant clinic and a weekly Registrar clinic. Head and Neck Oncology patients are seen in a weekly Multidisciplinary Specialist clinic.
We accept GP and specialist referrals for this service.
Referrals are triaged depending on priority. Emergency cases can present to the Emergency & Trauma Service at any time.
To refer a patient, complete and send your referral to Outpatients by fax to (03) 9342 4234.
You can use the following form or a template from your own system:
Referrals should include:
- relevant clinical history for the patient
- the reason for referral
- patient details including address, date of birth and contact phone numbers
- your details and provider number
- the name of the consultant (for Medicare clinics)
- if your patient requires ongoing management, please identify the referral as being "indefinite"
Special referral instructions
Urgent referrals for the Head and Neck Tumour Stream can be faxed to the service.
All other Outpatient clinic referrals are triaged. Currently, due to resource constraints, the Royal Melbourne ENT department is focusing our efforts on treating Head and Neck Cancer and Neurotology / Skull Base problems in a timely fashion.
OCP Guidelines for referral
Below step outlines the process for establishing a diagnosis and appropriate referral. The types of investigation undertaken by the general or primary practitioner depend on many factors, including access to diagnostic tests and medical specialists and patient preferences.
What signs and symptoms to look for:
The following symptoms should be investigated if they persist for more than three weeks, especially if there is more than one symptom:
- difficulty swallowing
- persistent sore throat (particularly together with earache)
- unexplained neck or parotid lump
- mouth ulcer or mass
- leukoplakia (white or red patches) of oral mucosa
- unexplained tooth mobility and/or non-healing dental extraction site
- altered speech
- spitting or coughing up blood (coughing up blood from the chest requires a respiratory physician referral)
- unilateral blockage of the nose or ear
Most of these problems have non-malignant causes but require further assessment. The presence of multiple signs and symptoms, particularly in combination with other underlying risk factors, can indicate an increased risk of head and neck cancer.
What assessments needs to be done by the general or primary medical practitioner or dental practitioner
Investigations prior to referral:
- If there is suspicion of malignancy or a neck lump persists or grows (including thyroid, salivary gland or lymph node), ultrasound-guided fine-needle aspiration cytology (USgFNAC) of a node.
- Non-fine-needle aspiration (FNA) biopsies should not be carried out in a non-specialist setting
How to do the correct referral?
All patients with a suspected head and neck cancer should be referred to a head and neck specialist with expertise in these cancers who is affiliated with a multidisciplinary team.
Referral should be to an ear, nose and throat (ENT)/head and neck surgeon for investigation of suspected larynx or pharynx cancer, or to an ENT/head and neck surgeon or oral and maxillofacial surgeon for investigation of suspected oral cancer.
The symptoms listed before warrant prompt referral to a specialist, highlighting the concern that there may be a cancer.
Referral for suspected head and neck cancers should incorporate appropriate documentation sent with the patient including:
- a letter that includes important psychosocial history and relevant past history, family history, current medications and allergies
- results of current clinical investigations (imaging and pathology reports)
- results of all prior relevant investigations
- any prior imaging, particularly a hard copy or CD of previous chest x-rays and computed tomography (CT) scans where online access is not available (lack of a hard copy should not delay referral)
- notification if an interpreter service is required