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Detection rate of incidental findings and vestibular schwannomas on magnetic resonance imaging scans investigating unilateral audiovestibular symptoms
James Andrew Douglas1, Matthew James Lee2, Osama Al Hamarneh3, Christopher Coulson4
1MRCS DO-HNS, Core Surgical Trainee, Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
2MRCS, Core Surgical Trainee, Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
3FRCS ORL-HNS, Senior Registrar, Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
4PhD FRCS ORL-HNS, Consultant in Otolaryngology and lateral skull base Surgeon, Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.

Article ID: 100001JDO042014
doi:10.5348/0x4-2014-1-OA-1

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How to cite this article
Douglas JA, Lee MJ, Al Hamarneh O, Coulson C. Detection rate of incidental findings and vestibular schwannomas on magnetic resonance imaging scans investigating unilateral audiovestibular symptoms. Edorium J Otolaryngol 2014;1(1):1–6.


Abstract
Aims: Establishing the rate of detection of vestibular schwannomas and incidental findings on magnetic resonance imaging scans of the internal auditory meatus for investigating asymmetrical sensorineural symptoms, and see if there is a difference between types of center investigating these symptoms.
Methods: Retrospective review in two trusts, one district general hospital and one tertiary hospital over a two-year period. All primary scans were reviewed.
Results: The number of identified scans was 2174. Vestibular schwannomas were diagnosed in 1.7% (n=11) at district general hospital and 1.4% (n=21) at tertiary hospital. Incidental findings more common in tertiary hospital (39.9% vs 24.5% in district general hospital, p=<0.0001), most frequently ischemia (15.8%) and sinus disease (5.2%). Serious incidental findings were detected in 2.4% of scans. No abnormality detected in 1407 scans.
Conclusion: The pickup rate was not significantly different between district general hospital and tertiary hospital. High rate of incidental findings was seen, however, most did not require follow-up. Higher rate of abnormalities was detected in tertiary hospital associated with availability of neuroradiologists. The availability of neuroradiologist was useful when counseling patients prior to investigation.

Keywords: Acoustic, Vestibular schwannoma, Audiovestibular symptoms

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Author Contributions:
James Andrew Douglas – Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Matthew James Lee – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Osama Al Hamarneh – Conception and design, Acquisition of data, Critical revision of the article, Final approval of the version to be published
Christopher Coulson – Conception and design, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
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Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2014 James Andrew Douglas et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.