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Useful algorithm to manage adults with branchial cysts

Managing a solitary cystic lateral neck mass, specifically differentiating between a simple second branchial cyst and a metastatic cyst poses a challenge. Often the diagnosis only becomes apparent on the final histology. This paper analysed 28 adults that presented to...

Thyroid nodules in children

Whilst 5% of nodules in adults may harbour malignancy it is reported in this review that about a quarter of nodules may do so in children. Malignancies in this group are almost always well-differentiated subtypes of papillary, follicular and medullary...

Thyroid nodule update

This excellent article summarises the current diagnostic difficulties with an endocrine gland that frequently produces nodules, some of which may harbour malignancy. At 50 years of age and over there is about a 50% chance of having a nodule; at...

Factors influencing transformation of laryngeal dysplasia to malignancy in a 10-year review

Laryngeal dysplasia has a propensity to change into malignancy, the generally reported rate of this being about 14%. In this retrospective study of 125 patients, the authors have assessed the severity of dysplasia in relation to the incidence and time...

Non-surgical and surgical management of arytenoids granuloma

Arytenoid granulomas are often a sequelae of laryngopharyngeal reflux (LPR). Unless there is suspicion of malignancy, they require a very balanced approach between conservative management and surgical intervention. The authors present a series of 62 patients with whom the primary...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...

New MRI technique assesses treatment response in skull base osteomyelitis

This paper describes another useful imaging technique to monitor Necrotising Otitis Externa (NOE). Echoplanar diffusion weighted magnetic resonance (DW MR) shows high signal on the ‘ADC map’ with active disease and this reduces in signal intensity as symptoms improve. This...

The challenges in the risk stratification of thyroid nodules and cancers: the role of molecular testing

Around the world, molecular testing is becoming more widely used to personalise the management of thyroid nodules. Thyroid nodules are relatively common. They are palpable in ~5% of the population, while high-resolution ultrasound (US) incidentally finds them in 19–68% of...

What does functional neuroimaging tell us about tinnitus?

One of the most common causes of tinnitus is noise exposure, be that either cumulative day-to-day exposure over a lifetime or experience of acute noise trauma such as a loud concert or shooting incident. Observational data indicate that up to...

Are vascular loops at the CPA of any clinical significance?

Neurotologists have grappled with this question for many years. The aim of the study was to determine the clinical relationship of vertigo symptoms with vascular loop compression syndrome using 3D T2WI turbo spin echo high-resolution MRI. The study included 417...

MRI and the endolymphatic space

This is an interesting study which was performed to evaluate the endolymphatic space in patients with endolymphatic hydrops (EH), using MR imaging. Seven patients aged between 21–77 years; five female, two male with unilateral or bilateral symptoms of EH were...

Head and neck radiation and the brain

An increasing number of patients with head and neck squamous cell carcinoma and other lesions are treated with high dose radiotherapy. An increase in survival rates is being reported along with a younger patient demographic. The long-term effects of treatment...