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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...
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...Nature or nurture in surgical training
It’s Thursday in the UK, so that means time for another root and branch reform of medical training. If you’re not keen on the Greenaway Report (Shape of Training review) [1], don’t fret there’ll be another one along well before...Making sense of modern wireless hearing aid technologies
Before diving into the topic of the technology behind wireless hearing aids, it is important to define two key concepts. The first is wireless frequency. This is the frequency at which a wireless signal is transmitted. In the context of...
A cost reducing protocol for magnetic resonance imaging in patients suspected to have acoustic neuroma
Magnetic resonance imaging is the ‘gold standard’ for screening patients suspected to have an acoustic neuroma. However, inappropriate referrals for imaging are not helpful, especially with the growing need to reduce costs. In this study the authors compared two audit...
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...
