Non-echoplanar diffusion weighted imaging in the detection of post-operative middle ear cholesteatoma: navigating beyond the pitfalls to find the pearl.

Unlabelled: Non-echoplanar diffusion weighted magnetic resonance imaging (DWI) has established itself as the modality of choice in detecting and localising post-operative middle ear cleft cholesteatoma. Despite its good diagnostic performance, there are recognised pitfalls in its radiological interpretation which both the radiologist and otologist should be aware of. Our article highlights the various pitfalls and provides guidance for improving radiological interpretation and navigating beyond many of the pitfalls.

The Agreement between Protocols for the Investigation of Asymmetrical Audiovestibular Symptoms.

Objective: There are a number of published criteria for the investigation of asymmetrical audiovestibular symptoms. Our aim was to determine the agreement between these protocols when determining whether to investigate a group of patients treated at our institution.

Materials And Methods: Retrospective audit of the indications for arranging 854 consecutive magnetic resonance imaging scans of the internal auditory meatus.

Ossicular malposition in Larsen syndrome: a case report.

Larsen syndrome is a rare condition that causes multiple large joint dislocations and characteristic flattened facies. We present a case of a patient with Larsen syndrome with a conductive hearing loss due to ossicular malposition/dislocation. We discuss the aetiopathogenesis of hearing loss in Larsen syndrome.

Tuberculosis with secondary vasculitis presenting as a nasal septal perforation.

A 45 years old man with tuberculosis (TB) and secondary vasculitis presented with perforation of the nasal septum, involving skin and cranial nerves. Vasculitis is a recognized, tough rare complication of tuberculosis and has not been previously described in the literature as a cause of nasal septal perforation. It presents a diagnostic dilemma.

Call-fleming syndrome: an extraordinary complication of tonsillectomy.

A 36 years old woman underwent tonsillectomy for recurrent tonsillitis. At about one week in the postoperative period, she developed sudden onset severe ("thunderclap"), recurrent headaches and focal neurological signs including visual disturbances, ataxia and myoclonic jerks. Serial imaging with MRI, MRA and CT angiography revealed reversible white matter focal edema and segmental cerebral vasoconstriction.

Reconstruction of pharyngolaryngectomy defects using the jejunal free flap: a 10-year experience from a single reconstructive center.

Background: Reconstruction following pharyngolaryngectomy presents a complex reconstructive challenge, and a single-stage, reliable reconstruction allowing prompt discharge from the hospital and return of swallowing and speech function is required. The authors present their 10-year experience of 43 jejunal free flaps for pharyngolaryngectomy reconstruction by a single team and outline their operative algorithm to minimize postoperative morbidity.

Methods: The data for patients who underwent jejunal free flap reconstruction of circumferential pharyngoesophageal defects between March of 2000 and September of 2009 were reviewed retrospectively.

Intracranial polyps in patients with Samter's triad.

Background: We describe three patients with Samter's triad (nasal polyps, aspirin intolerance, and asthma) with skull base dehiscence in whom the polyps extended into the extradural space and also resulted in hypertelorism and widening of the nasal bridge.

Methods: One patient died in a road traffic accident while awaiting surgery. The other two patients underwent endoscopic resection of the polyps with a combined osteoplastic flap.