Isolated Schneiderian papilloma of the middle ear cleft.

A 60-year-old woman presented with pulsatile tinnitus in the left ear. MRI and CT imaging suggested a soft-tissue mass in the middle ear. Exploratory tympanotomy and biopsy confirmed Schneiderian (inverted) papilloma.

Rapid access rather than open access leads to improved effectiveness of an ENT emergency clinic.

An Ear, Nose and Throat (ENT) emergency clinic provides important access to specialist care for patients referred by General Practitioners (GPs), Emergency Departments and doctors on non-ENT hospital wards. The aim is to enable the prompt diagnosis and management of acute conditions, within an optimum environment containing appropriate clinical and staff resources. Amid concerns that an open access ENT casualty service had become overburdened we performed a four week audit of all attendances.