Purpose Endoscopic biopsy is recommended for diagnosis of nasopharyngeal carcinoma (NPC). A proportion of lesions are hidden from endoscopic view but detected with magnetic resonance imaging (MRI). This systematic review and meta-analysis investigated the diagnostic performance of MRI for detection of NPC. Methods An electronic search of twelve databases and registries was performed. Studies were included if they compared the diagnostic accuracy of MRI to a reference standard (histopathology) in patients suspected of having NPC. The primary outcome was accuracy for detection of NPC. Random-effects models were used to pool outcomes for sensitivity, specificity, and positive and negative likelihood ratio (LR). Bias and applicability were assessed using the modified QUADAS-2 tool. Results Nine studies were included involving 1736 patients of whom 337 were diagnosed with NPC. MRI demonstrated a pooled sensitivity of 98.1% (95% CI 95.2–99.3%), specificity of 91.7% (95% CI 88.3–94.2%), negative LR of 0.02 (95% CI 0.01–0.05), and positive LR of 11.9 (95% CI 8.35–16.81) for detection of NPC. Most studies were performed in regions where NPC is endemic, and there was a risk of selection bias due to inclusion of retrospective studies and one case–control study. There was limited reporting of study randomization strategy. Conclusion This study demonstrates that MRI has a high pooled sensitivity, specificity, and negative predictive value for detection of NPC. MRI may be useful for lesion detection prior to endoscopic biopsy and aid the decision to avoid biopsy in patients with a low post-test probability of disease.

Odontogenic maxillary sinusitis (OMS) is an inflammatory condition affecting the paranasal sinuses and is commonly encountered by both Otorhinolaryngologists and Dentists. However, there is an ongoing debate regarding the best sequence of management. Clinicians are faced with the dilemma of first addressing either the affected tooth or the affected sinus. This paper provides a review of the current literature on the aetiology, presentation, and management of OMS, as well as our experience in managing this condition. Overall, the causative pathology of the patient’s OMS, their symptoms, and the risk of surgery should drive decision making with regards to sequence of management.

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transfusion were most commonly younger trauma patients. Following adjustment for confounding variables, massive transfusion was significantly associated with an increased risk in 30-day (OR = 1.41; CI 1.03, 1.92; p-value = .03) and 90-day mortality (OR = 1.36; CI 1.06, 1.73; p-value = .01) but not 1 year mortality (OR = 1.17; CI 0.97, 1.41; p-value = .11). There was no significant difference in length of stay or hospital free days with respect to donor transfusion. Conclusion: Massive donor blood transfusion (> 10 units) increases early mortality after lung transplantation. Conversely, sub-massive donor transfusion does not increase donor risk. The mechanism of increased early mortality in massively transfused donors is unclear but is consistent with increased mortality risk seen with primary graft dysfunction.