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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...
What to do with incidental findings on FDG PET/CT?
18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) is commonly used in head and neck cancer staging. This investigation frequently identifies incidental findings unrelated to the index head and neck cancer. To assess the nature of these incidental findings, notes of...
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...
Be sober to stay on your feet
Readers would either have had a personal experience or observed the inelegant gait of the inebriated. Re-aligning the body during postural perturbations involves changes in head position, shoulders, and hip, knee and ankle joints. The main hypothesis of this study...
Prognostic value of neutrophil-to-lymphocyte ratio in HPV-positive oropharyngeal cancer
The authors propose that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor disease-free survival (DFS) in patients with human papillomavirus positive (HPV+) oropharyngeal cancer (OPC). This is a retrospective study that compared the outcomes of 43 patients treated for HPV+...
Occlusal splint, injections or arthrocentesis in myofascial pain
Facial pain is a fairly common complaint and may present in a myriad of symptoms. These patients present to both dentists and general practitioners and could end up referred to a number of specialists. Temporomandibular disorders may originate from either...
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...
Standardising videofluoroscopy assessment for bottle-fed babies
Swallowing problems in babies may occur for many reasons including complex medical problems, premature birth, and low birth-weight. Dysphagia causes several further morbidities such as poor nutrition and compromised respiration, often raising distress for both infants and their caregivers. Early...
A single blinded RCT comparing triamcinolone with 5-FU treatment for keloid scars
This single blinded RCT compared 43 patients with 50 symptomatic keloids that were randomised to two matched groups of 25 scars, receiving either 5-fluorouracil (5-FU) or current first line treatment, triamcinolone (TAC). The surgeon administering the injectable treatments was unblinded,...
Validating a new international cholesteatoma classification – a necessary but challenging task
A European and Japanese joint consensus statement was published in 2017 which proposed a new cholesteatoma staging classification (EJS), with four stages. This follow-up publication aims to assess the internal and external validity of the staging system using existing prospectively...
Nasal physiology and septal perforations
This interesting article from North Carolina and New York aims to assess the impact of anterior septal perforations on nasal physiology, using computational fluid dynamics and computer simulation. A computerised 3D model was constructed of a normal patient aged 37,...
