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Detection Rate of Incidental Findings and Vestibular Schwannomas on Magnetic Resonance Imaging Scans Investigating Unilateral Audiovestibular Symptoms

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Aims: Establishing the rate of detection of vestibular schwannomas and incidental findings on magnetic resonance imaging scans of the internal auditory meatus for investigating asymmetrical sensorineural symptoms, and see if there is a difference between types of center investigating these symptoms. Methods: Retrospective review in two trusts, one district general hospital and one tertiary hospital over a two-year period. All primary scans were reviewed. Results: The number of identified scans was 2174. Vestibular schwannomas were diagnosed in 1.7% (n=11) at district general hospital and 1.4% (n=21) at tertiary hospital. Incidental findings more common in tertiary hospital (39.9% vs 24.5% in district general hospital, p=<0.0001), most frequently ischemia (15.8%) and sinus disease (5.2%). Serious incidental findings were detected in 2.4% of scans. No abnormality detected in 1407 scans. Conclusion: The pickup rate was not significantly different between district general hospital and tertiary hospital. High rate of incidental findings was seen, however, most did not require follow-up. Higher rate of abnormalities was detected in tertiary hospital associated with availability of neuroradiologists. The availability of neuroradiologist was useful when counseling patients prior to investigation.

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