Abstract
Magnetic resonance imaging (MRI) is accepted as the 'gold standard' in diagnosing acoustic neuromas. Limited availability and perceived high costs have prevented clinicians from using it as a first-line investigation. A prospective study was set up in a specially designated screening session to audit the cost effectiveness and accuracy of audiovestibular investigations compared to MRI. Ninety-nine patients with asymmetrical audiovestibular symptoms or signs were investigated. Of these 54 evoked response audiometry tests, and 39 calorics were either not performed or were inconclusive. One patient refused to enter the MRI machine. All others received an unequivocal report after MRI and four tumours (three intracanalicular) were detected. The total cost of the audiovestibular protocol was 12,545 pounds compared to 12,900 pounds for the MRI protocol, which is a diagnostic and well-tolerated procedure. This study shows that MRI can be cost effective, as well as accurate, when used as a single screening procedure for acoustic neuromas.
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Selected References
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- Moffat D. A., Hardy D. G., Baguley D. M. Strategy and benefits of acoustic neuroma searching. J Laryngol Otol. 1989 Jan;103(1):51–59. doi: 10.1017/s0022215100108023. [DOI] [PubMed] [Google Scholar]
- Moffat D. A., Hardy D. G. Early diagnosis and surgical management of acoustic neuroma: is it cost effective? J R Soc Med. 1989 Jun;82(6):329–332. doi: 10.1177/014107688908200606. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pfleiderer A. G., Evans K. L., Grace A. R., Lloyd G. A. A screening protocol used for the detection of acoustic neuromas: a clinical evaluation. Clin Otolaryngol Allied Sci. 1988 Apr;13(2):145–151. doi: 10.1111/j.1365-2273.1988.tb00755.x. [DOI] [PubMed] [Google Scholar]
- Phelps P. D. Current role of magnetic resonance imaging and gadolinium enhancement in current British ENT practice. Clin Otolaryngol Allied Sci. 1991 Oct;16(5):431–432. [PubMed] [Google Scholar]
- Smith I. M., Turnbull L. W., Sellar R. J., Murray J. A., Best J. J. A modified screening protocol for the diagnosis of acoustic neuromas. Clin Otolaryngol Allied Sci. 1990 Apr;15(2):167–171. doi: 10.1111/j.1365-2273.1990.tb00451.x. [DOI] [PubMed] [Google Scholar]
- Stack J. P., Ramsden R. T., Antoun N. M., Lye R. H., Isherwood I., Jenkins J. P. Magnetic resonance imaging of acoustic neuromas: the role of gadolinium-DTPA. Br J Radiol. 1988 Sep;61(729):800–805. doi: 10.1259/0007-1285-61-729-800. [DOI] [PubMed] [Google Scholar]
- Swan I. R. Diagnostic vetting of individuals with asymmetric sensorineural hearing impairments. J Laryngol Otol. 1989 Sep;103(9):823–826. doi: 10.1017/s0022215100110217. [DOI] [PubMed] [Google Scholar]