Head and Neck: Guidelines for Urgent Referral

• Hoarseness persisting for > 6 weeks.

• Ulceration of oral mucosa persisting for > 3 weeks.

• Oral swellings persisting for > 3 weeks.

• All red or red and white patches of the oral mucosa.

• Dysphagia persisting for 3 weeks.

• Unilateral nasal obstruction particularly when associated with purulent discharge.

• Unexplained tooth mobility not associated with periodontal disease.

• Unresolving neck masses for > 3 weeks.

• Cranial neuropathies.

• Orbital masses.

The level of suspicion is further increased if the patient is a heavy smoker or heavy alcohol drinker and is aged over 45 years and male. Other forms of tobacco use (chewing Betel, Gutkha, Pan) should also arouse suspicion.