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Predicting CSF leaks pre FESS: Gera classification - a new tool?

An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...

Is clinical HIT as good as vHIT in the emergency room?

Establishing the cause of acute vestibular syndrome (AVS) is critical in the first few hours of presentation in the emergency department. The first question to ask is, “is it due to a peripheral vestibular pathology or a stroke?” This is...

IV dexamethasone versus LA infiltration during paediatric tonsillectomy

Postoperative nausea and vomiting following tonsillectomy is important to control for improved oral intake and satisfaction following surgery. Optimal management is still debated. This team from Beirut conducted a randomised double blind clinical trial comparing the effect of intravenous dexamethasone...

Acute peripheral vestibulopathy: is it really neuritis?

The pathophysiology of acute vestibular dysfunction has been debated for decades. By seeking to clarify the underlying aetiology, this study muddies the waters further by advocating systemic and intratympanic steroids as first line treatment if the aetiology is uncertain. The...

Octreotide in the medical management of chyle fistula post neck dissection

Chyle leak, although rare (1% and 2.5%), is a well-documented complication following surgical dissection of the neck. Although the left side of the neck is the most common site, chyle fistulas have been reported in the right side of the...