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Radiological diagnosis of mastoiditis in patients screened for acoustic neuroma

Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have acoustic neuroma. Various abnormalities are picked up through this investigation, one of which, not uncommonly reported, is mastoiditis. This requires referral to otolaryngology and further evaluation. In...

Clinical histopathology of 250 parotidectomy patients

Clinical histopathology of 250 parotidectomy patients This is a retrospective study of 250 consecutive parotidectomy patients at units in Belgium and the Netherlands. The sensitivity and specificity of FNAC was 64% and 99% respectively, the sensitivity being slightly lower than...

To scan or not to scan?

This comprehensive review article seeks to establish how useful is MRI in the evaluation of patients with a history of smell loss or distortion. Interestingly, while some studies found the imaging unhelpful, one paper described found a 25% rate of...

What to do with incidental findings on FDG PET/CT?

18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) is commonly used in head and neck cancer staging. This investigation frequently identifies incidental findings unrelated to the index head and neck cancer. To assess the nature of these incidental findings, notes of...

High definition tractography to identify cranial nerves

It has always been challenging to visualise cranial nerves on traditional imaging as the cranial nerves have a fine structure and complex anatomy. This is especially true regarding the cochlear nerve. In congenitally hearing impaired children, the visualisation of the...

Should we be doing earlier MRIs in sudden sensorineural hearing loss?

There is recognised variation between ENT departments in exact imaging protocols for the workup of idiopathic sudden sensorineural hearing loss (ISSNHL) but a routine MRI to exclude retrocochlear pathology is standard, usually following immediate treatment with oral +/- intratympanic steroids....

Do we need contrast MRI when screening for vestibular schwannoma?

Gadolinium contrast enhanced T1-weighted (gT1w) MRI images of the internal acoustic meati have long been considered the gold standard in the diagnosis of vestibular schwannoma (VS). However, the addition of contrast to the MRI examination increases the cost and time...

Diagnostic criteria for superior semicircular canal dehiscence syndrome

The latest Bárány Society’s consensus document on diagnostic criteria for vestibular disorders is one for superior semicircular canal dehiscence syndrome (SCDS). There are three major categories: (A) Symptoms consistent with a third mobile labyrinthine window; (B) Physiologic tests – clinical...

Innovation in medical product technologies

There is a point in all innovation projects where the clinician has exhausted their knowledge and needs expert help to create a prototype. Mark Prince, Design Engineer, discusses this phase of the project and how engineers’ analytical thinking brings a...

A funny thing happened on the way to a conference – and other stories

This series of stories is dedicated to those of you with whom some of these moments were shared (or endured) and, above all, to my amazing and long-suffering husband, David Howard. Most of you know him as an exceptional head...

Cochlear implants: recipient stories

The most powerful evidence for the remarkable achievements made with cochlear implants over 40 years comes from the life-changing, personal stories of those who have benefited from the technology. James Rylance I first noticed a problem with hearing when I...

Using tele-audiology in Zambia’s ear and hearing care desert

Addressing the medical desert with tele-audiology and tele-education. If a ‘medical desert’ is defined as a community that lives more than 60 miles away from the nearest acute care hospital, then try to imagine an appropriate term for a situation...