The prevalence of malnutrition among patients with head and neck cancer is high. Assessment of nutritional status and appropriate management must be part of the initial work-up of these patients.

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Unilateral clear retrotympanic effusion in an adult subject should, apart from serous otitis media, suggest possible cerebrospinal fistula. In the absence of otologic or traumatic history, arachnoid granulation is one possible etiology, inducing spontaneous cerebrospinal fluid leakage when facing the temporal bone. Diagnosis is suggested by bone defects in the tegmen tympani or posterior wall of the temporal bone on CT, with the adjacent mastoid cavities filled with fluid. Pneumococcal vaccination and early surgical repair of the fistula should be performed to avoid neuromeningeal infection.

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