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Magnetic resonance imaging of the internal auditory meatus for vestibular schwannoma in ENT practice: a retrospective analysis with literature and guidelines review

Part of: JLO Editors' Choice Papers 2022

Published online by Cambridge University Press:  20 October 2021

M B Perera ,
N Janjua ,
R Swaminathan ,
C Apthorp  and
H B Al-Deerawi
M B Perera*
Affiliation:
Department of ENT, Warwick Hospital, South Warwickshire NHS FoundationTrust, Warwick, UK
N Janjua
Affiliation:
Department of ENT, Warwick Hospital, South Warwickshire NHS FoundationTrust, Warwick, UK
R Swaminathan
Affiliation:
Department of ENT, Warwick Hospital, South Warwickshire NHS FoundationTrust, Warwick, UK
C Apthorp
Affiliation:
Department of Surgery, North Manchester General Hospital, Manchester, UK
H B Al-Deerawi
Affiliation:
Department of ENT, Warwick Hospital, South Warwickshire NHS FoundationTrust, Warwick, UK
*
Author for correspondence: Dr. M B Perera, Warwick Hospital, South Warwickshire NHS Foundation Trust, Lakin Road, WarwickCV34 5BW, UK E-mail: mukun82@yahoo.co.uk
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Abstract

Objectives

Magnetic resonance imaging scans of the internal acoustic meatus are commonly requested in the investigation of audio-vestibular symptoms for potential vestibular schwannoma. There have been multiple studies into protocols for requesting magnetic resonance imaging for vestibular schwannoma, but none have been reported based on UK National Institute for Health and Care Excellence guidelines for investigating audio-vestibular symptoms. This study intended to identify the local magnetic resonance imaging detection rates and patterns of vestibular schwannoma, and to audit the conformity of scan requests with the National Institute for Health and Care Excellence guidelines, with a review of relevant literature.

Method

A retrospective analysis of 1300 magnetic resonance imaging scans of the internal acoustic meatus, compared against National Institute for Health and Care Excellence guidelines, was conducted over two years.

Results and conclusion

Sixteen scans were positive for vestibular schwannoma, with a detection rate of 1.23 per cent. All positive cases fit the guidelines; three of these could have been missed using other criteria. A total of 281 requests did not meet the guideline criteria but revealed no positive results, supporting the use of National Institute for Health and Care Excellence guidelines in planning magnetic resonance imaging scans for audio-vestibular symptoms.

Keywords

Magnetic Resonance ImagingVestibular SchwannomaHearing LossTinnitusVertigo
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 10 , October 2022 , pp. 888 - 891
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr. M B Perera takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Academic Conference of Otolaryngology (BACO) International Virtual meeting, 10–12 January 2021 (Online), Birmingham, UK

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