1. 2 week wait referral criteria
ENT
2 week wait referral criteria

2. Aims To learn the ENT 2 week wait criteria.
Please get into groups for my fun quiz!

3. 1. True or False Is this one of the 2ww referral criteria?
An unexplained lump in the neck, of recent onset, or previously undiagnosed lump that has changed over a period of 3 to 6 weeks.

4. 2. True or False Is this one of the 2ww referral criteria?
Chronic halitosis for greater than 3 months with unknown cause.

5. 3. True or False Is this one of the 2ww referral criteria?
Unilateral unexplained pain in the head/neck area for more than 3 weeks, associated with otalgia but normal otoscopy.

6. 4. True or False Is this one of the 2ww referral criteria?
An unexplained persistent sore or painful throat.

7. 5. True or False Is this one of the 2ww referral criteria?
Unexplained painless red or white patches of the oral mucosa.

8. 6. True or False Is this one of the 2ww referral criteria?
Unexplained tooth mobility persisting for more than 3 weeks.

9. 7. True or False Is this one of the 2ww referral criteria?
Unilateral anosmia persisting for more than 3 weeks.

10. 8. Question
Hoarseness persisting for more than 3 weeks should be referred via the 2 week wait.
What else should you do?

11. 9. True or False Is this one of the 2ww referral criteria?
Unilateral tinnitus associated with deafness.

12. Answers
1. An unexplained lump in the neck, of recent onset, or previously undiagnosed lump that has changed over a period of 3 to 6 weeks.
True

13. Answers
2. Chronic halitosis for greater than 3 months with unknown cause.
False
Chronic halitosis associated with tonsillitis should be referred to ENT but not as a 2ww.

14. Answers
3. Unilateral unexplained pain in the head/neck area for more than 3 weeks, associated with otalgia but normal otoscopy.
False
Becomes a 2ww referral if they have had pain for more than 4 weeks.

15. True Answers 4. An unexplained persistent sore or painful throat.
What is meant by persistent?
Not stated in the 2ww guidelines but says one month in Oxford handbook of general practice.

16. Answers
5. Unexplained painless red or white patches of the oral mucosa.
False
2ww referral if the patches are painful, swollen or bleeding, otherwise refer non-urgently.

17. Answers
6. Unexplained tooth mobility persisting for more than 3 weeks.
True
Refer urgently to a dentist.

18. False Answers 7. Unilateral anosmia persisting for more than 3 weeks.
I made this up. Can be caused by a head injury or frontal lobe lesion.

19. Answers
8. Hoarseness persisting for more than 3 weeks should be referred via 2 week wait. What else should you do?
Chest x-ray
If there is a positive finding on chest x-ray referral should be made to a team specialising in the management of lung cancer; the hoarseness could be caused by pancoast’s tumour.

20. False Answers 9. Unilateral tinnitus associated with deafness.
This is an urgent referral to ENT to look for acoustic neuroma. It is not in the 2 week wait criteria because acoustic neuroma is a slow growing tumour.

21. Head and neck cancer 2 week wait guidelines:
An unexplained lump in the neck, of recent onset, or previously undiagnosed lump that has changed over a period of 3 to 6 weeks.
An unexplained persistent swelling in the parotid or submandibular gland.
An unexplained persistent sore or painful throat.
Unilateral unexplained pain in the head and neck area for more than 4 weeks, associated with otalgia but a normal otoscopy.

22. Head and neck cancer 2 week wait guidelines:
Unexplained ulceration of the oral mucosa or mass persisting for more than 3 weeks.
Unexplained red and white patches of the oral mucosa that are painful, swollen or bleeding.
Hoarseness persisting for more than 3 weeks. These patients should be referred urgently for a chest x-ray.
Refer urgently to a dentist if unexplained tooth mobility persisting for more than 3 weeks.