The role of radiology in active middle ear implantation.

Active middle ear implants (AMEIs) have been available for a number of years and yet most radiologists have never heard of them. Some bear a striking resemblance to cochlear implants whereas others are more similar to conventional hearing aids. The aims of this review are to provide an introduction as to the types of implants available, how they work and when they are indicated. Also, to highlight important pre-operative imaging features that can influence surgery and to consider the role of imaging in the post-operative setting. As patient choice increases, it becomes more likely that radiologists will encounter these devices in daily practice and knowledge of them may prove useful.

Improving paranasal sinus computed tomography reporting prior to functional endoscopic sinus surgery - an ENT-UK panel perspective.

BACKGROUND: Functional endoscopic sinus surgery is recognised to have a significant complication profile (e.g. blindness, cerebrospinal fluid leak and intracranial sepsis). Pre-operative computed tomography imaging is considered mandatory for surgical planning to reduce intra-operative risk. A radiological report is the 'gold standard' in image interpretation; however, because of a lack of otolaryngological or radiological guidance, its contents may be variable. By surveying practising otolaryngologists, this study aimed to provide some guidance which may be used by radiologists to produce more surgically relevant radiological reports. METHOD: A prospective questionnaire was distributed to the ENT-UK panel. RESULTS: A total of 117 consultant members of the panel completed the survey. Twenty-nine per cent indicated that they were uncomfortable interpreting all areas of the computed tomography scan. Greatest importance was given to areas including the ethmoid roof (dehiscence, asymmetry and angle), lamina papyracea (dehiscence) and sphenoid sinus (carotid canal dehiscence and optic nerve relationships). CONCLUSION: Functional endoscopic sinus surgery is commonly performed by non-subspecialist rhinologists. The information obtained from this study can be used by radiologists to improve report relevance, particularly for the generalist ENT surgeon. This contributes to improving patient safety and helps avoid medicolegal litigation when complications arise.

Duplication of internal jugular veins: case report.

OBJECTIVES: We report a rare case of internal jugular vein duplications, in order to raise the level of awareness of this anomaly amongst ENT surgeons, radiologists and intensive care practitioners. We briefly review and discuss the related literature. CASE REPORT: Duplicated internal jugular veins are a rare anatomical finding. They may be subclinical, or may present with neck swellings that may be mistaken for laryngocoeles or branchial cysts. We present a case of bilateral internal jugular vein duplication in a young adult. The referral was made on the basis of intermittent neck swelling, dyspnoea and dysphagia. Conservative treatment was instigated, and symptoms improved without surgical intervention. CONCLUSIONS: Only a handful of cases of duplicated internal jugular veins have been reported. The current case is unique, as no previously reported cases have presented with dyspnoea and dysphagia. We suggest a conservative approach, as there is currently no evidence that duplicated internal jugular veins cause any adverse health outcomes.

Renovascular hypertension. Radiographic methods.

In recent years the choice of radiographic methods available in the investigation of renovascular hypertension has increased significantly. It can be difficult for the clinician to decide which patients will benefit from screening and which modality to choose. This article seeks to address some of these issues. The role of the plain radiograph and intravenous urogram are briefly mentioned. Doppler ultrasound, MR, CT and conventional arteriography are discussed in detail. Their advantages and pitfalls are reviewed. In our institution ultrasound to document renal size and gadolinium-enhanced 3-D MRA are our recommended first-line investigations unless MRA is contraindicated. Digital subtraction arteriography is reserved for the small subgroup in which MRA fails to obtain an answer, for whatever reason.