A breast surgery-specific ERAS protocol employing opioid-sparing techniques successfully eliminated postoperative narcotic prescription without sacrificing perioperative pain control or increasing postoperative complications. By promoting the adoption of similar protocols, surgeons can continue to improve patient outcomes while decreasing the quantity of narcotics available for diversion within our patients' communities.

Benign paroxysmal positional vertigo (BPPV) is a self-limiting condition characterized by vertigo and nystagmus induced by certain head positions. The most common causes of BPPV are post-traumatic following head injury and post-viral labyrinthitis. We present an interesting case of BPPV following an otherwise uneventful neurosurgical removal of a parietal osteoma using hammer and chisel. Caution should be exercised during such procedures as disabling vertigo can result for a considerable period of time.

Metastatic tumour of the sphenoid sinus from distant primary sites are rare. If sphenoid involvement from adjacent structures is excluded there have been 26 reported cases of metastatic sphenoid sinus tumours. Seminoma metastatizing to other paranasal sinuses has been reported but a careful literature search did not reveal this occurring previously in the sphenoid sinus.

No abstract

An in vitro study was performed to compare the relative efficacy of a number of aqueous- and organic-based wax-dispersing preparations. Water, which was originally intended to be a control, surprisingly proved to be the most effective, whilst olive oil appeared to be almost totally ineffective as a wax dispersant. In view of the relatively high cost of commercially available preparations, these results have significant clinical potential.