Our results suggest that early tonsillectomy in patients with recurrent throat infection may result in improved patient satisfaction, better health, and improved utilization of medical resources.

We measured quality of life issues f or both children and their parents on the premise that parental quality of life should be an aspect of cost-effectiveness in otitis media treatment. The patients were less than 18years ofage and had had myringotomy with tube insertion at the head and neck surgery department of a large health maintenance organization. Quality of life for patients, parents , and caregivers was evaluated by telephone survey ofparents or caregivers and by retrospective chart review of the number ofpre-and p ostoperative healthcare visits and antibiotic usage. Chart review showed a significant postoperati ve reduction in the number ofclinic visits and in use of antibiotic drugs after insertion of tympanostomy tubes. Improved postoperative hearing was noted, and tympanostomy tube insertion was shown to be safe. The chart-review cost analysis showed that tympanostomy tube insertion is a cost-effective treatment fo r otitis media in children, and the telephone survey results showed that it improves quality oflife for children and their parents or other caregivers .

Objective: To determine the frequency of incidental findings found on magnetic resonance imaging scans of the internal auditory meatus performed to investigate audiovestibular symptoms, and to determine how to best manage these when found.Method: A retrospective review was conducted of internal auditory meatus magnetic resonance imaging scans during a three-month period in the radiology department at a UK district general hospital.Results: A total of 109 scans were reviewed. Of these, 92.7 per cent showed no retrocochlear pathology, 0.9 per cent showed vestibular schwannoma, 6.4 per cent revealed vascular loops, and 2.8 per cent showed incidental findings that warranted further action and investigation. Of the scans, 40.4 per cent showed other incidental pathologies such as age-related ischaemic changes, and sinus disease that required no further intervention. Of the magnetic resonance imaging scans reviewed, 49.5 per cent were entirely normal.Conclusion: Almost half of the scans investigating audiovestibular symptoms showed incidental findings. Otolaryngologists should have an understanding of the significance of the most commonly encountered incidental findings, and should counsel patients appropriately and refer them onward when necessary.

No abstract

To determine whether the specimen from fine-needle aspiration (FNA) biopsy of head and neck masses has greater diagnostic accuracy when using multihole needles than when using conventional, single-hole needles, we did a prospective, randomized, single-blinded study comparing diagnoses obtained using both types of needles in FNA biopsies of head and neck masses. Eighty-eight patients served as their own controls and had 91 FNA biopsies with both multihole and single-hole, 22-gauge needles. Order of biopsy was randomized and was unknown to the cytopathologist. No statistically significant differences were noted in quantity of specimen material obtained, quality of fixation, or diagnostic value between the multihole and conventional needle. We found no advantage in using the more costly multihole needle in FNA biopsy of head and neck masses.