Objectives:To investigate the role of a 7-day course of oral prednisolone on recovery from tonsillectomy. Study Design: Double-blind, randomized, placebo-controlled trial of 50 consecutive patients, aged 5 years and older, who had no previous or known contraindications to steroid therapy. Method: The patients were randomized at the time of surgery to either a 7-day course of daily placebo or prednisolone (dosage: 10 mg per day in patients aged 5-11 y, 0.5 mg/kg in those aged 12 and older). Age, sex, weight, diagnosis, tonsil size (in cm 2 ), additional adenoidectomy, performing surgeon, method of dissection, length of procedure, total blood loss, intraoperative fluid requirement, and length of hospitalization were documented for each patient. During the first postoperative day, morning pain score, paracetamol use, oral fluid intake, temperature, presence of nausea and vomiting, level of activity (low, moderate, or normal), and type of diet (liquid, soft, or normal) were recorded. Results: The steroid group consisted of a greater number of diathermy dissection cases and had significantly less intraoperative blood loss (P value ‫؍‬ .022 and .017, respectively). On postoperative days 4 to 7, the steroid group experienced less nausea and vomiting (P value ‫؍‬ .01, .04, .04, and .04, respectively). Paracetamol use was less in the steroid group on days 2, 7, and 8 (P value ‫؍‬ .03, .02, and .02, respectively). There was no difference between the two groups for the other data measured. Conclusion: A 7-day course of corticosteroids may play a limited role in patients' recovery from tonsillectomy.

We sought to investigate the utility of new non-invasive tests of semicircular-canal and otolith function that are usable in the neuro-otology office practice in patients with vestibular schwannoma. Fifty patients with vestibular schwannoma were assessed using a 5-item battery consisting of air-conducted cervical- and bone conducted ocular-vestibular-evoked myogenic potentials (AC cVEMPs and BC oVEMPs) and video head impulse testing (vHIT) in all three canal planes. VEMP asymmetry ratios, latencies, and vHIT gains were used to determine the test sensitivity, relationship with tumour size and the pattern of vestibular nerve involvement. The percentage of abnormalities for each of the five tests for the entire sample ranged between 36.2-61.7%. In 58.3 % of patients, test abnormalities were referable to both superior and inferior vestibular nerve divisions. Selective inferior nerve dysfunction was identified in 10.4% and superior nerve dysfunction in 12.5%. The remaining 18.8% of patients demonstrated a normal test profile. The sensitivity of the 5-item battery increased with tumour size and all patients with medium to large (>14 mm) schwannoma had at least two abnormal vestibular test result. Our results indicate that dysfunction of the superior and inferior vestibular nerve evolves in parallel for most patients with schwannoma. Unexplained vHIT and VEMP asymmetry should alert otologists and neurologists to undertake imaging in patients presenting with non-specific disequilibrium or vertigo.

Posterior canal occlusion is a highly effective treatment for intractable benign positional vertigo, with what is probably an acceptable risk to hearing and balance: five of six patients will have no hearing problem and nine of 10 no balance problem after surgery.