Search

Environmental (e)DNA metabarcoding holds great promise for biomonitoring and ecotoxicological applications. However, few studies have compared the performance of eDNA versus eRNA metabarcoding in assessing organismal response to marine pollution, in experimental conditions. Here, we performed a chromium (Cr)-spiked mesocosm experimental test on benthic foraminiferal community to investigate the effects on species diversity by analysing both eDNA and eRNA metabarcoding data across different Cr concentrations in the sediment. Foraminiferal diversity in the eRNA data showed a significant negative correlation with the Cr concentration in the sediment, while a positive response was observed in the eDNA data. The foraminiferal OTUs exhibited a higher turnover rate in eRNA than in the eDNA-derived community. Furthermore, in the eRNA samples, OTUs abundance was significantly affected by the Cr gradient in the sediment (Pseudo-R2 = 0.28, p = 0.05), while no significant trend was observed in the eDNA samples. The correlation between Cr concentration and foraminiferal diversity in eRNA datasets was stronger when the less abundant OTUs (

International audience; Gypsum makes up about one fifth of giant salt deposits formed by evaporation of seawater throughout Earth’s history. Although thermodynamic calculations and precipitation experiments predict that gypsum precipitates when the salinity of evaporating seawater attains about 110 g kg-1, gypsum deposits of the Mediterranean Salt Giant often bear the geochemical signature of precipitation from less saline water masses. Addressing this geochemical riddle is important because marine gypsum deposition and continental gypsum erosion affect the global carbon cycle. We investigated gypsum deposits formed in the marginal basins of the Mediterranean Sea during the Messinian Salinity Crisis (about 6 million years ago). These often bear low-salinity fluid inclusions and isotopically light crystallization water, confirming previous published reports that the Mediterranean Salt Giant harbors low-salinity gypsum deposits. A geochemical model constrained by fluid inclusion salinity and isotope (87Sr/86Sr, d34SSO4, d18OH2O, dDH2O) measurements excludes that Ca2+- and SO42--enriched continental runoff alone provides the trigger for gypsum precipitation at low salinity. We propose that, concurrent with the prevalent evaporative conditions and with Ca2+- and SO42--bearing runoff, the biogeochemical sulfur cycle is capable of producing a spatially-restricted and temporally- transient increase of Ca2+ and SO42- within benthic microbial mats, creating local chemical conditions conductive to gypsum precipitation. This hypothesis is supported by the presence of dense packages of fossils of colorless sulfur bacteria within gypsum in several Mediterranean marginal basins, together with independent geochemical and petrographic evidence for an active biogeochemical sulfur cycle in the same basins. Should this scenario be confirmed, it would expand the range of environments that promote marine gypsum deposition; it would also imply that an additional, biological coupling between the calcium, sulfur and carbon cycles exists.

OBJECTIVES: To assess the effect of the position of the SS on CI regarding the ability to perform posterior tympanotomy, round window visibility, and mastoid pneumatization. MATERIALS AND METHODS: This is a prospective study, including 65 adult patients with CI performed at our center during 2017. We used 3 methods to assess SS position using a computed tomography (CT) scan. Lee’s line passing through the tympanic segment of the facial nerve. Park’s line passing through the facial nerve and round window membrane. Our proposed method using a parallel line from the external auditory canal and passing through the facial nerve. Relation to mastoid pneumatization on CT and to intraoperative round window visibility were assessed in relation to intraoperative position of the SS. RESULTS: The method by Park et al. was statistically significant (p

Identify the critical points that lead to recurrences and lack of radicality in endolymphatic sac tumors (ELSTs). Retrospective case study and review of the literature. Tertiary referral center. Thirteen cases of ELST were included in the study and their preoperative, intraoperative and postoperative data were analyzed and compared to a review of the literature. Therapeutical. Prevalence of recurrent and residual tumors, comparison to the literature and analysis of ELST characteristics. Diagnosis was made 26 ± 17 months after the onset of symptomatology, and an ELST was preoperatively suspected in only six cases. At the time of surgery, 10 patients suffered from hearing loss. Preoperative symptoms or audiometry could not predict labyrinth infiltration, although speech discrimination scores were significantly associated with labyrinth infiltration (p = 0.0413). The labyrinth was infiltrated in 8 cases (57.1%), and in 7 cases (46.7%) the tumor eroded the carotid canal, whereas 6 cases (40%) presented an intradural extension. A gross total resection was achieved in 11 cases. There were two residual tumors, one of which because of profuse bleeding, and one recurrence (23.1%). A mean of 22.8% of recurrent or residual tumors are described in the literature based on 242 published cases, in more than half of the cases as a consequence of subtotal tumor resection (STR). Recurrence derives mostly from the difficulty to identify the extension of the tumor due to the extensive bone infiltration. Accurate diagnosis and correct preoperative planning, with embolization when possible, will facilitate surgery and avoid STR due to intraoperative bleeding. Long follow-ups are important in order to avoid insidious recurrences.

Concetas Direitos Humanos A Clínica de Políticas de Diversidade da FGV Direito SP, coordenada pelo professor Thiago Amparo, tem o propósito de engajar alunas/os e membros da sociedade civil brasileira no desenvolvimento de produtos voltados à aplicação efetiva de direitos humanos. Em 2022, o escopo da Clínica de Políticas de Diversidade voltou-se para o estudo do sistema de justiça militar brasileiro, compilando em um só documento informações cruciais para a compreensão do seu funcionamento e formação de um olhar crítico. A pesquisa resgata o contexto histórico de criação da justiça militar, como também traz uma visão prática sobre sua atual estrutura e competência, comparando com a jurisdição de outros países. Na comparação, ateve-se a algumas particularidades e gargalos que a distanciam dos parâmetros internacionais que o Brasil assumiu o compromisso de cumprir.

Objectives: To assess the validity of the subtotal petrosectomy (STP) technique in problematic cases of cochlear implant (CI) surgery, and review indications, outcomes, and related controversies. Study Design: This is a retrospective review of data from a private quaternary referral center of otology and skull base surgery. Patients and Methods: A review of patients who underwent CI with STP (STP-CI) as the leading approach was performed. Demographics, indications, surgical details, and main outcomes were evaluated. The surgeries performed were usually single-stage procedures encompassing a comprehensive mastoidectomy, blind sac closure of the external auditory canal (EAC), and mastoid obliteration with autologous fat. Results: A total of 107 cases were included. Mean follow-up was 7.1 years (range 1–13 years). The most frequent indication for STP-CI was chronic otitis media with/without cholesteatoma (32.7%), followed by open mastoid cavity (26.1%), and cochlear ossification (17.7%). Other difficult conditions where STP facilitates successful implantation include inner-ear malformations, temporal-bone trauma, unfavorable anatomic conditions, and revision surgery. A planned staged procedure was performed in 3 cases. The rate of major complications was 5.6% (n = 6). Three patients developed postauricular wound dehiscence which eventually resulted in device extrusion. No cases of recurrent/entrapped cholesteatoma, EAC breakdown, or meningitis were encountered. This is the largest single-center series of STP-CI reported in the literature. Conclusions: When CI is intended in technically challenging cases or associated with a high risk of complications, STP is effective and reliable. Safe implantation and excellent long-term outcomes can be achieved provided surgical steps are properly followed. Single-stage procedures can be performed in most cases, even when there is active middle-ear disease.

Invasive alien species threaten biodiversity and ecosystem structure and functioning, but incomplete assessments of their origins and temporal trends impair our ability to understand the relative importance of different factors driving invasion success. Continuous time-series are needed to assess invasion dynamics, but such data are usually difficult to obtain, especially in the case of small-sized taxa that may remain undetected for several decades. In this study, we show how micropaleontologic analysis of sedimentary cores coupled with radiometric dating can be used to date the first arrival and to reconstruct temporal trends of foraminiferal species, focusing on the alien Amphistegina lobifera and its cryptogenic congener A. lessonii in the Maltese Islands. Our results show that the two species had reached the Central Mediterranean Sea several decades earlier than reported in the literature, with considerable implications for all previous hypotheses of their spreading patterns and rates. By relating the population dynamics of the two foraminifera with trends in sea surface temperature, we document a strong relationship between sea warming and population outbreaks of both species. We conclude that the micropaleontologic approach is a reliable procedure for reconstructing the bioinvasion dynamics of taxa having mineralized remains, and can be added to the toolkit for studying invasions., peer-reviewed

In this paper, a complete three-dimensional (3D) RF model of the cyclotron coaxial resonator—including the coaxial sliding shorts, the “Liner” vacuum chamber, the coupler, the trimmer, and the high RF voltage “Dee” structures—has been developed. An eigenmode analysis was used to simulate the tuning of the resonator in the operating frequency range of 15–48 MHz obtained by two movable sliding shorts and a trimmer. A driven analysis has been performed in order to compute the |S11| parameter (or impedance matching) of the cavity excited by a movable coaxial power coupler. The numerical simulations have been performed using the different peculiarities of two commercial tools, COMSOL Multiphysics and CST microwave studio. Experimental validation of the developed model is presented. The evidence of an unwanted electric field component, orthogonal to the accelerating field, was discovered and a mitigation is also proposed. The impact of the proposed modification was evaluated by using a 3D beam dynamics code under development in the framework of the Superconducting Cyclotron upgrade ongoing at INFN-LNS.

Large deposits of gypsum accumulated in the marginal basins of the Mediterranean Sea during the Messinian Salinity Crisis. These form the marginal portions of the Mediterranean Salt Giant (MSG) that also occupies the deep, central Mediterranean basins. Although the marine, evaporitic origin of the MSG is undisputed, the analysis of gypsum fluid inclusions and of gypsum-bound water (d18OH2O and dDH2O) suggest that marginal basin gypsum formed from low- to moderate-salinity water masses (5 - 60 ‰), rather than from high-salinity brines (130 - 320 ‰), as expected during the evaporation of seawater. We present a new set of water isotope and fluid inclusion salinity data that extends the low salinity signature of gypsum to include five Mediterranean Sea marginal basins: Caltanissetta Basin (Sicily), Sorbas Basin (Spain), Piedmont Basin and Vena del Gesso Basin (northern Italy) and Catanzaro Trough (Southern Italy). With a simple geochemical model we explore the salinity-d18OH2O-dDH2O evaporation path and the 87/86Sr and d34SSO4 composition of the Mediterranean Sea subject to a variety of evaporation conditions and mixing ratios with continental runoff. This approach suggests that evaporation and mixing with continental runoff - including freshwater transiting via the Paratethys - cannot lead to the observed geochemical signature of MSC gypsum deposits. An alternative process that decouples the saturation state with respect to gypsum from salinity must have been active. We are exploring the possibility that the biogeochemical sulfur cycle leads to spatially and temporally localized gypsum supersaturation conditions via the production of SO42- by the oxidation and disproportionation of reduced sulfur compounds.

The fresh new cores 3AGN2S02 and 3AGN2S04 located in the deformed foredeep of the Gela Thrust System, locally known as Caltanissetta Basin, represent an opportunity for a better comprehension of the Messinian events, as well as for the reconstruction of the Sicilian evaporitic Basin architecture. The entire ‘early Messinian stage’ (7.2-5.96Ma) preceding the Messinian Salinity Crisis (MSC) has been already investigated in the Caltanissetta Basin. Even though the Tripoli Formation and ‘Calcare di Base’ (‘CdB’) have been widely studied for a long period of time, many aspects remain unclear. The ‘CdB’ has been commonly considered to represent the first evaporitic unit of the Messinian succession in Sicily. Different ages obtained in the underlying Tripoli deposits from various Sicilian outcrops display a diachronous onset of the MSC (Rouchy & Caruso, 2006). However, Manzi et al. (2011) propose an alternative interpretation for the ‘CdB’, suggesting that it does not belong exclusively to the onset of the MSC, but it is made of three carbonate facies belonging to different MSC stages. A detailed sedimentological, geochemical and petrographic study of the two cores allowed us to evidence the paleoceanographic changes that affected the central Mediterranean Sea during the transition from marine to restricted conditions, up to the onset of the MSC, and to observe the differences between the marginal and the deep basins of the Caltanissetta Basin, enhanced by the ongoing regional tectonics. Facies characterization made it possible to confirm the nature of the sediments of the cores, reflecting distinct depositional environments. A lithological transition passing from the Tripoli Formation to the complex ‘CdB’ carbonates alternating with shales is observed (3AGN2S04). This CdB appears to be laterally equivalent to gypsum and salts at site 3AGN2S02. In the brecciated facies of the ‘CdB’, evaporite pseudomorphs are also present, implying early stage diagenesis. Furthermore, our analyses gave us insights of strong oscillations in hypersaline conditions with freshwater inputs controlled by Milankovitch’s cycles. Moreover, the 3AGN2S04 core is characterized by the repetition of sedimentary successions due to the later development of a thrust system, which can be an important hint concerning the morphological and structural evolution of the Caltanissetta Basin. These new data are fundamental for stratigraphic reconstructions, comparing them with the already well-calibrated reference section of Falconara-Gibliscemi but also with other outcrops located in the various depocenters of the Caltanissetta Basin. The local transition from the uppermost part of the Tripoli cycles to the ‘CdB’ reflects the worsening of the marine connections, implying that during late Messinian broadly constant stressed environmental conditions existed in the central Mediterranean shelves. We conclude that since the onset of the MSC, marine inputs were not important enough to balance the effects of the climate fluctuations and the evaporation/precipitation budget in the individualized semi-closed settings.

Unmanned aerial vehicles (UAVs) are autonomous devices employed as data collectors in precision agriculture to support a large number of applications. These UAVs gather data from on-the-ground wireless sensor networks, especially in scenarios that lack any kind of fixed communication infrastructure or where the available infrastructure does not fit the application requirements. Sensors on the ground can store sensing data, and in scenarios that do not require a real-time observation and analysis of the data, like in smart farming, a drone can be used maybe once or two times each day to collect and report the data to a command-and-control center that use them directly, without any other infrastructure (cloud or edges). In this article, we study analytically how close the drone, that uses a LoRa radio, needs to fly over the sensors to collect data with a given quality of data collection. This can be used to properly spacing the sensors on the field at deployment time, to select among different type of drones, and to properly solve some tradeoff related to field size vs autonomy of the drones and the path used by the latter when collecting the data.

In the eastern Mediterranean Sea, the early Holocene was characterized by major climatic and oceanographic changes that led to the formation of the last sapropel (S1) between 10.8 and 6.1 kyr cal. BP. These hydrographic changes might have altered the water exchange between the eastern and western Mediterranean sub-basins through the Strait of Sicily, but the existing evidences are inconclusive. In the present study we show new evidence from sediment core NDT-6-2016 located at the western flank of the Sicily channel, a key location to monitor the surface/intermediate water exchange between the two Mediterranean sub-basins. We perform paleo-hydrographic reconstructions based on planktic foraminifera ecology for the last 15 kyr cal. BP, including the S1 deposition interval. In addition, δ18O measurements in both Globigerina bulloides and Globigerinoides ruber and also major elements analyses in bulk sediment are presented. Our results show that significant changes in surface water properties occurred in W-Sicily characterized by a strong contrast in the seasonal hydrographic conditions during the S1 interval. This study proposes that the oceanographic changes in the eastern Mediterranean associated with the surface freshening promoted by the African monsoon likely triggered a restricted water exchange through the Strait of Sicily. This situation led to limited influence of the surface Atlantic waters into the studied area that favored the development of intense summer stratification and vertical winter mixing. This situation changed at about 7 kyr cal. BP when a decrease in the summer stratification probably reflected the influence of the eastward path of the surface Atlantic Waters. This situation would suggest a reinforcement of the water exchange through the Strait of Sicily that marked the end of the extreme conditions that prevailed in the eastern Mediterranean during the S1 formation.

International audience; Unlike most Neogene basins of the Betic Cordillera where the Salinity Crisis is dated to the Messinian, a contradictory Tortonian dating was proposed for evaporites of the Lorca Basin. As a consequence, complex structural models have been proposed in the literature to explain this discrepancy in the timing of evaporites. In order to integrate the Lorca Basin into the geological context of the western Mediterranean domain during the Late Miocene, new sedimentological and stratigraphical studies coupled with new dating were performed, which allow us to propose a Messinian age for both diatomite-bearing deposits and evaporites of the Lorca Basin. These new ages challenge the idea of a Tortonian salinity crisis in the Lorca Basin. Three main events of base-level drop were evidenced during the Messinian. Each event is correlated with successive steps of basin restriction. Shallow salina evaporites were deposited after a base-level fall during the Messinian before a final base-level drop, which led to the entire exposure of the basin. This last exposure is interpreted as coeval with the deposition of first evaporites and halite in the deep Mediterranean basins. The reflooding which allowed the deposition of brackish deposits and a short-lived marine incursion occurred at the end of the Messinian. Base-level drops occurred during eustatic falls amplified by the gradual uplift of the Betic Cordillera. The exhumation of the Tercia ridge along the strike-slip Alhama de Murcia fault system during the Messinian probably favoured the gradual restriction of the basin. A discussion on correlations of main unconformities between several Neogene basins of the Betics is proposed, suggesting a similar structural evolution at the regional scale.

Radiofrequency cavity is one of the most critical and complicated components in a cyclotron. Dee voltage of radiofrequency cavity accelerates charged particles to achieve required energy. Peak voltage of Dee is the key parameter of an radiofrequency cavity. Balanced Dee voltage is very important for effective beam cantering and beam extracting. An X-ray measurement has been made to calibrate and verify the peak voltage of Dee in a low-power ( 20 kW) test. The X-ray measurement for radiofrequency cavity was designed by means of bremsstrahlung. A suitable shielding cover was chosen for radiofrequency cavity and the X-ray measurement design was demonstrated according to the theory of photon transmission. Finally, the peak voltage of Dee was obtained at the power of 10-20 kW and the balance of Dee voltage was verified.

A detailed biostratigraphical and cyclostratigraphical study provided the opportunity of cycle-by-cycle correlations between sections from the marginal and deep areas of the Caltanissetta Basin (Sicily), and the northern Calabrian Rossano Basin. All the sections were compared with the Falconara-Gibliscemi composite section. We present new mineralogical and geochemical data on the transition from Tripoli to Calcare di Base (CdB), based on the study of several field sections. The outcrops display good record of the paleoceanographical changes that affected the Mediterranean Sea during the transition from slightly restricted conditions to the onset of the Mediterranean Salinity Crisis (MSC). This approach permitted to better constrain depositional conditions and highlighted a new palaeogeographical pattern characterized by separated sub-basins. The sedimentological and geochemical parameters of these basins introduced a different and diachronous response to the global constraints of the MSC. Our preliminary results display already evidences of paleoenvironmental changes: (1) a lithological transition passing from the Tripoli’s triplet (grey marls, reddish laminites and diatomites) to the complex carbonates of CdB; (2) the appearance of evaporite pseudomorphs implying early stage diagenesis; (3) the presence of sulphur-rich deposits involving process of bacterial sulphate reduction. The local transition from the uppermost part of the Tripoli cycles to the CdB reflects the worsening of the marine connections, leading to the individualisation of semi-closed settings where the marine inputs were not great enough to balance the effects of the climate fluctuations and especially of the evaporation/precipitation budget.

The Messinian Salinity Crisis (MSC) is a prominent and still misunderstood event that influenced the Mediterranean basin in the late Miocene leaving behind a Salt Giant (SG) widespread all over the Mediterranean basin. More than 90% of the Messinian Evaporitic deposits are located offshore with reduced access via boreholes, and thus has been studied mainly by seismic imaging. Onshore-Offshore should be considered a key for a better understanding and answering some of the controversies on the MSC.The Balearic Promontory (BP) contains a series of small perched basins presently lying at different water depths, stepped from the present-day coastline down to the deep basin. These topographic lows trapped sedimentary series up to 500m thick, interpreted as MSC in age.The reduced tectonic movements in the BP since the late Miocene (Messinian) till recent days, favored the conservation of the MSC records in this area. Moreover, recent studies revealed the presence of a Salt layer in the Central Mallorca Depression (CMD).Considering: 1- the bathymetry of the BP, classified as an intermediate perched basin; 2- the distribution of the MSC records accumulated in a series of sub-basins more or less connected between each other; 3- the geometries of the evaporitic formations, provided by how these records appear on the seismic data; this might recall similarities between the BP records (especially the ones in the CMD) and the MSC reference records outcropping in Sicily (especially in the Caltanissetta Basin).We perform seismic interpretation of a wide seismic reflection dataset in the study area with the aim of refining the mapping of the Messinian evaporites covering the study area. Four seismic units were identified in the BP based on their seismic facies and their seismo-stratigraphic position. We try to match up these units to the consensus Messinian 3-stages chrono-stratigraphic model proposed during the CIESM in 2008.We also attempt to find similarities in geometries, facies and distribution of the MSC between the sub-basins of the BP and those described in the Sicilian sub-basins.

Large deposits of gypsum accumulated in the marginal basins of the Mediterranean Sea during the Messinian Salinity Crisis. These form the marginal portions of the Mediterranean Salt Giant (MSG) that also occupies the deep, central Mediterranean basins. Although the marine, evaporitic origin of the MSG is undisputed, the analysis of gypsum fluid inclusions and of gypsum-bound water (d18OH2O and dDH2O) suggest that marginal basin gypsum formed from low- to moderate-salinity water masses (5 - 60 ‰), rather than from high-salinity brines (130 - 320 ‰), as expected during the evaporation of seawater. The formation of low-salinity gypsum poses a fundamental geochemical problem: how can gypsum saturation conditions be met in marginal basins if evaporation does not concentrate marine water to high salinity? In other words, can gypsum saturation be attained by adding Ca2+ and/or SO42- ions rather than by extracting water? We are exploring two geochemical scenarios to explain this phenomenon: (1) the addition of Ca2+ and SO42- to marginal basins by continental runoff, and (2) the non-steady state addition of SO42- to marginal basins via the biogeochemical oxidation of reduced sulfur. Both scenarios may lead - at least theoretically - to the decoupling of saturation state from salinity that is suggested by gypsum geochemical signatures.

Sulfur is a key element to understand ocean biogeochemical processes. Since decades, numerous studies have explained sulfur isotopic variations registred in the geological record as reflecting changes in continental sulfur inputs, biogeochemical recycling of sulfur and the relative proportion of oxidized (gypsum) vs reduced (e.g. pyrite) sulfur burial fluxes. Geochemical and petrographic studies have showed that these processes were active during the formation of the Mediterranean Salt Giant (MSG), a giant salt deposit formed at the end of the Messinian period (5.9-5.33 Ma) following the restriction of hydrological exchanges between the Mediterranean Sea and the Atlantic Ocean. To date, the biogeochemical sulfur cycle during the formation of the MSG has been investigated by analyzing the sulfur and oxygen isotope composition (δ34S and δ18O, respectively) of the sulfate ion in gypsum accumulated in the deep and marginal Mediterranean basins. In the uppermost gypsum layers (Upper Gypsum unit), significantly higher δ18O isotopic ratios (averaging at 12,7‰) than Messinian marine values suggest implications of microbial sulfate reduction activity followed by complete re-oxidation of sulfide back to sulfate in evaporated marine waters. Nevertheless, these different microbial processes can overprint each other δ34S and δ18O isotopic signatures and could have been provoked by various type of microbial metabolisms, involving different hydrological and environmental conditions. Here we present for the first time a multiple sulfur isotope (δ34S, Δ33S, Δ36S) investigation of samples from the well-known sections of Vena del Gesso (Apennines) and Pollenzo (Piedmont basin) in order to identify and understand how microbial mechanisms were coupled during the MSG formation. We designed a simple steady-state, three-box model representing the analysed S-bearing fractions (SO42-, S0, FeS2) and the different hydrological and biogeochemical S fluxes involved in marginal basin S-cycling. This system of 18 equations allows us to explain the strong isotopic variations we measured (-40.2 to 25.4‰ in δ34S, -0.001 to 0.160‰ in Δ33S and -1.79 to 0.001 in Δ36S‰) as produced by a huge variability in sulfate reduction activity reflecting fluctuations in the availability of organic matter. Moreover, our results, with relatively high λ33net (0.513 to 0.516) suggest than more than 90% of the hydrogen sulfide produced was re-oxidized by disproportionation reactions. Large, cyclic fluctuations of the Mediterranean hydrological cycle, and the presence of easily accessible S-compounds with a variety of oxidation states, makes the MSG a key system to understand the dynamics of the S biogeochemical cycle in the geological past.

Objective We present an extremely rare report of congenital cholesteatoma (CC) in identical twins with atypical location. Methods Two consecutive cases of CC in identical twins from diagnosis to treatment and a literature review are presented. Results The twin children presented to our otology and lateral skull base clinic with different clinical picture. Both underwent thorough audiological workup and imaging and early surgical intervention. The 6-year follow-up of these two children has been uneventful with no recurrence of disease and hearing restoration. Conclusion Multiple theories exist to explain this rare pathology. Modified Levenson’s criteria define it as white mass behind intact tympanic membrane. Atypical location of CC with recurrent otitis media is not uncommon; hence, further study is required. To our best knowledge, this is the second reported occurrence in identical twins but first report with differential presentation and atypical location in both cases.