ABSTRACT
Idiopathic sudden sensorineural hearing loss is a condition, in which an idiopathic rapid unilateral decline in hearing thresholds is seen. In this review, the latest research is summarised. In Denmark, the traditional treatment is systemic steroids (SST), but new research reveals, that the use of SST lacks evidence. There is significant evidence for the use of intratympanic steroid injections (ITSI) as salvage treatment. The use of ITSI as first-line treatment, as well as combined with SST, is found to be of equal effect as SST alone. A national Danish clinical guideline is needed.
Subject(s)
Hearing Loss, Sensorineural , Hearing Loss, Sudden , Denmark , Dexamethasone/therapeutic use , Glucocorticoids/therapeutic use , Hearing Loss, Sensorineural/therapy , Hearing Loss, Sudden/therapy , Humans , Injection, Intratympanic , Treatment Outcome , Tympanic MembraneABSTRACT
A patient suspected for metastatic breast cancer went through an 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT). Along with metastatic lymph nodes in the neck it showed high 18F-FDG uptake in a polypoidal structure in the sinus sphenoidalis. When asked she had no related symptoms due to the sphenoid polyp and the CT-scan showed no bone destruction. To rule out malignancy a biopsy was made showing benign sinonasal papilloma of oncocytic origin. High 18F-FDG PET uptake can be seen in benign structures and should therefore not be the only predictor for malignancy.
Subject(s)
Papilloma/diagnostic imaging , Paranasal Sinus Neoplasms/diagnostic imaging , Paranasal Sinus Neoplasms/secondary , Sphenoid Sinus/diagnostic imaging , Sphenoid Sinus/pathology , Aged , Breast Neoplasms/pathology , Female , Fluorodeoxyglucose F18 , Humans , Positron Emission Tomography Computed Tomography , RadiopharmaceuticalsABSTRACT
Spontaneous intracranial hypotension (SIH) is an uncommon condition associated with postural headache, nausea and dizziness. It is believed to be secondary to a dural tear with resultant cerebrospinal fluid (CSF) leak. This is a case report of a pregnant woman (gestational age 31 weeks) who contacted an obstetric department because of severe headache. Pre-eclamp-sia was suspected, but not found. An MRI showed a CSF leak at C1-C2 level and intracranial signs of SIH. The woman was treated with an autologous blood patch and recovered quickly. Focus on subjective symptoms and MRI findings seem to be important in the diagnostic procedure of SIH.
