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Abstract Introduction The coronavirus disease 2019 (COVID-19) has made otolaryngologists more susceptible than their counterparts to its effect. Objective This study aimed to find if COVID-19 had a different impact on ear, nose, and throat (ENT) physicians' of various categories (residents, registrars, and consultants ) regarding many aspects of the quality of life (protection, training, financial, and psychological aspects). Methods We included 375 ENT physicians, of different categories (residents, registrars, and consultants), from 33 general hospitals and 26 university hospitals in Egypt. The study was conducted using a 20-item questionnaire with a response scale consisting of three categories: yes, no, and not sure. It covered infection control and personal protective equipment (PPE) usage; medical practice and safety; online consultation and telemedicine,; webinars and online lectures; COVID-19 psychological, financial, and quarantine period effects; and future expectations. Results The results of the questionnaire showed that COVID-19 had a statistically significant impact on the daily life of the responders. There were statistically significant differences among the three involved categories, based on their answers. Conclusion This study showed a statistically significant difference regarding the impact of COVID-19 on many aspects of the quality of life (protection, training, financial, and psychological aspects) of ENT physicians of various categories (residents, registrars, and consultants), and these effects may persist for a long time.

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Introduction The coronavirus disease 2019 (COVID-19) has made otolaryngologists more susceptible than their counterparts to its effect. Objective This study aimed to find if COVID-19 had a different impact on ear, nose, and throat (ENT) physicians' of various categories (residents, registrars, and consultants ) regarding many aspects of the quality of life (protection, training, financial, and psychological aspects). Methods We included 375 ENT physicians, of different categories (residents, registrars, and consultants), from 33 general hospitals and 26 university hospitals in Egypt. The study was conducted using a 20-item questionnaire with a response scale consisting of three categories: yes, no, and not sure. It covered infection control and personal protective equipment (PPE) usage; medical practice and safety; online consultation and telemedicine,; webinars and online lectures; COVID-19 psychological, financial, and quarantine period effects; and future expectations. Results The results of the questionnaire showed that COVID-19 had a statistically significant impact on the daily life of the responders. There were statistically significant differences among the three involved categories, based on their answers. Conclusion This study showed a statistically significant difference regarding the impact of COVID-19 on many aspects of the quality of life (protection, training, financial, and psychological aspects) of ENT physicians of various categories (residents, registrars, and consultants), and these effects may persist for a long time.

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OBJECTIVE: To propose a numerical radiological scoring system of the pre-operative high-resolution computed tomography scan aiming to predict the surgical difficulty during cochlear implantation. METHODS: This was a retrospective study of 272 pediatric patients who underwent cochlear implantation in 3 tertiary referral centers from April 2017 to August 2019. The correlation was attempted between our proposed scoring system (consisting of 8 radiological features) and the intraoperative surgical difficulty both objectively and subjectively. RESULTS: our proposed scoring system showed a statistically significant correlation with surgical difficulty and also the duration of surgery. Scoring 5 or more predicted the surgical difficulty with a sensitivity of 80.85% and a specificity of 92.13%. The absence of air cells around the facial recess was the most independent predictor of difficulty (P value = .002). CONCLUSION: This proposed radiological scoring system is a simple reliable method to predict the difficulty which we may encounter during CI surgery. Scoring of 5 or more would predict intraoperative difficulty as opposed to less scoring which would predict a straightforward surgery.

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BACKGROUND: Posterior tympanotomy (PT) is an important step in cochlear implant (CI) surgery, as it is the main access to the round window. Some CI candidates, especially children, may have concomitant otitis media with effusion (OME) which may result in technical issues during PT. There is still a debate whether to wait for OME resolution preoperatively or to proceed to surgery with suspected difficulties. AIMS/OBJECTIVE: To evaluate the safety of PT during CI surgery in patients with OME. MATERIAL AND METHODS: we included 102 consecutive pediatric candidates in this retrospective study with an age range of 12 months to 6 years. All the patients underwent CI surgery using trans-mastoid, PT to access round window (RW) area. We investigated the effect of the pathology caused by OME on the operative procedure in PT and post-operative consequences. THE RESULTS: out of 102 patients included in this study, there were 22 patients with OME who had unilateral cochlear implantation with no major operative or post-operative events. Nevertheless, some minor intra operative events and difficulties were encountered. CONCLUSION AND SIGNIFICANCE: The presence of OME in CI surgery indicates possible surgical challenges such as difficult PT, minor intra-operative risks and with no major post-operative events.

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OBJECTIVES: To predict round window niche (RWN) visibility using high-resolution computed tomography (HRCT). MATERIALS AND METHODS: We retrospectively reviewed the pre-surgical axial HRCT scan of 110 patients who underwent cochlear implantation and compared the CT visibility of RWN with the intraoperative findings by reviewing the operative notes and replaying the surgical video recording. The shape of RWN was determined using the HRCT slice with maximum RWN visibility. Accordingly, it was classified as the O-shaped or C-shaped RWN. Based on the surgical view, RWN visibility was classified as clearly visible or difficult to visualize. Radiological findings were correlated with the surgical view. RESULTS: Seventy-six cases (69%) showed clear RWN visibility; of them, 66 correlated with the HRCT finding C-shaped RWN. Of the other 34 cases (31%) with difficult RWN visualization, 26 correlated with the HRCT finding O-shaped RWN. The sensitivity and specificity of the HRCT finding in predicting the difficulty in visualization of RWN were 79.4% and 86.8%, respectively. CONCLUSION: The RWN shape on HRCT can be a simple and useful method in predicting RWN visibility through posterior tympanotomy approach in cochlear implantation.

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OBJECTIVE: To evaluate early hearing outcomes using glass ionomer cement to fix the Teflon piston prosthesis onto the long process of incus to minimize residual conductive hearing loss after stapedotomy. STUDY DESIGN: Original report of prospective randomized control study. SETTING: Tertiary referral center. PATIENTS: A total of 80 consecutive patients with otosclerosis were randomized into two groups. Group A is a control group in which 40 patients underwent small fenestra stapedotomy using the classic technique. Group B included 40 patients who were subjected to small fenestra stapedotomy with fixation of the incus-prosthesis junction with glass ionomer bone cement. INTERVENTIONS: Stapedotomy with the classical technique in group A and the alternative technique in group B. PRIMARY OUTCOME MEASURE: The audiometric results before and after surgery. RESULTS: Analysis of the results was performed using the paired t test to compare between pre and postoperative results. χ test was used to compare the results of the two groups. A p value less than 0.05 was considered significant from the statistical standpoint. Significant postoperative improvement of both pure-tone air conduction thresholds and air-bone gaps were reported in the two studied groups. The postoperative average residual air-bone gap and hearing gain were statistically significant in group B (p < 0.05) compared with group A. CONCLUSION: The use of glass ionomer bone cement in primary otosclerosis surgery using the aforementioned prosthesis and the surgical technique is of significant value in producing maximal closure of the air-bone gap and better audiological outcomes.

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This study aimed to assess outcomes of revision endoscopic stapling and external excision of pharyngeal pouch. A 5-year prospective study was performed on all patients requiring revision pouch surgery following primary endoscopic stapling. Data were collected retrospectively. Eighteen patients underwent revision pouch surgery. In seven patients, pouch size was down-graded from 3 to 2, and these were stapled endoscopically. Two leaks resulted. Eleven patients with grade 1 or 3 pouches underwent external excision of pouch, with no post-operative complications. As per results external excision of pouch is safe for grade 1 and 3 pouches. It avoids risking redundant mucosa and recurrence of symptoms which can complicate stapling and enables a myotomy to be performed to reduce cricopharyngeal hypertonicity. The highest predictable success is with grade 2 pouches, whose size is amenable to adequate endoscopic stapling. However, the "staple over staple" effect of revision stapling leads to unpredictable fibrosis, which can contribute to risk of perforation.

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This is a retrospective study of 100 consecutive patients who attended our ENT outpatient clinic in 6 month-period from April to September 2006. All of them presented with Asymmetrical SNHL. They were all investigated with MRI scan of the IAM and CPA. We did not employ any guidelines or protocols as to when to request MRI in patients with Asymmetrical SNHL. The mean age for the studied group was 52.97. Gender distribution in the studied group was 53% for males and 47% for females. The pickup rate was 1% for CPA lesion which was vestibular schwannoma. However, incidentally, there were 15% of cases with vascular loop at the CPA.

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