Methods: A prospective study compared staging and tissue sampling accuracy with flexible endoscopy to EUA in 54 patients. Duration, tolerance and cost implications were also assessed.Results: Flexible endoscopic biopsy had a 77.1% sensitivity, 100% specificity and 82.2% diagnostic accuracy. Liquid-based cytology had 97.3% sensitivity, 100% specificity and 97.9% diagnostic accuracy in differentiating high-grade lesions from low-grade lesions. Local staging agreement occurred in 88.6% (n = 31/35) of malignant cases. The mean duration was 15 ± 7 min; 86% of patients perceived the procedure as tolerable. Flexible endoscopy as a primary diagnostic tool would have avoided EUA in 68.6% (n = 24/35) of squamous cell carcinoma cases, with a R128 232 cost savings. Conclusion:Office-based endoscopy is an accurate, well-tolerated, time-and cost-effective primary diagnostic tool of laryngopharyngeal lesions. It reduces the number of patients requiring EUA. Further evaluation is empirical when the histopathology does not confirm the clinical suspicion of malignancy.

New endoscopic and endovascular therapies have revolutionised the management of complex traumatic visceral aneurysms. A pseudoaneurysm of the gastroduodenal artery following penetrating abdominal trauma was successfully managed by selective angiographic embolisation.

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Bilateral acute hearing loss is rare, and the aetiology is poorly defined. Less common treatable pathologies such as otosyphilis must be part of the differential diagnosis and should be actively excluded. We present a case of a 23-year-old woman who developed acute bilateral hearing loss due to otosyphilis, confirmed on audiometry and laboratory tests. In this article, the CT, MRI and clinical findings are presented and discussed.