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Incidental mastoiditis on magnetic resonance imaging scans: clinical relevance and cost implications

Published online by Cambridge University Press:  05 November 2018

Y Abbas ,
H S Yuen ,
A Trinidade  and
G Watters
Y Abbas
Affiliation:
Otolaryngology Department, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
H S Yuen
Affiliation:
Otolaryngology Department, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
A Trinidade*
Affiliation:
Otolaryngology Department, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
G Watters
Affiliation:
Otolaryngology Department, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
*
Author for correspondence: Mr Aaron Trinidade, Otolaryngology Department, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY, UK E-mail: aaron.trinidade@southend.nhs.uk Fax: +44 (01)702 385 145
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Abstract

Objectives

To determine: (1) the incidence of incidental ‘mastoiditis’ reported on magnetic resonance imaging scans performed in patients with asymmetrical sensorineural hearing loss and/or unilateral tinnitus; (2) how many of those patients have actual otological pathology and/or require treatment; and (3) the financial implications of such a reporting practice.

Method

Retrospective case series.

Results

Between October 2015 and November 2016, 500 patients underwent magnetic resonance imaging of the internal auditory meatus to rule out cerebellopontine angle lesions. There was an incidental finding of increased mastoid signalling in 5.8 per cent (n = 29), of which 20.7 per cent (6 of 29) were reported as bilateral cases. The diagnosis of ‘mastoiditis’ was found in 39.7 per cent (29 of 73). None of these patients had any pathology identified clinically. Other significant pathology was identified in a further 8.8 per cent (n = 44).

Conclusion

The diagnosis of mastoiditis is primarily clinical. An incidental finding of high signalling in the mastoid region on magnetic resonance imaging is highly unlikely to represent actual clinical disease. In patients who are scanned for other reasons and who do not complain of otological symptoms, such findings are unlikely to require otolaryngology input.

Keywords

MastoiditisIncidental FindingsMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 11 , November 2018 , pp. 1010 - 1012
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Mr A Trinidade takes responsibility for the integrity of the content of the paper

References

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