Nose and Sinus referral principles:
- E-advice via SCI Gateway – please use!
- Patients can be referred on SCI gateway to Lauriston, St John’s or East Lothian Community Hospital
- Maximise medical therapy first –chronic rhinosinusitis is a long-term inflammatory condition which requires optimised, prolonged treatment prior to referral:
- oral steroids can be used judiciously – please see the Lothian Joint Formulary
- the ENT specialist view is that topical nasal fluticasone can be used for longer than 12 weeks without necessarily referring;
- Referrals for rhinosinusitis for red flag symptoms are accepted where urgent diagnosis is required;
- Septal issues causing significant obstruction – please refer, as there are no alternative treatments – but advise a very long wait (might be 2 years);
- Nasal and sinus tumours are exceptionally rare;
- Anosmia can persist after Covid infection and patient education and self-management are key.
Nose Emergencies:
- Patients presenting within two weeks of a nose fracture who have not attended A&E and have a SIGNIFICANT deformity – please discuss with on-call ENT at St Johns.
- For severe, prolonged nose bleeds not responding to first aid and needing specialist input – please refer to A&E – see epistaxis for further detail.
Service Information – please see the ENT welcome page.
C.M. & G.MacD 20-02-23
