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Objectives: This study aimed to assess the ability of preoperative computed tomography (CT) to predict the crista fenestra (CF) type during cochlear implantation and correlate these types with intraoperative findings. This may allow for precise preoperative planning with better surgical outcomes., Study Design: A prospective observational study., Settings: The study was done in multiple tertiary centers between September 2021 and March 2024., Method: ology: We correlated the preoperative radiological type of the CF with the intraoperative CF type to evaluate the accuracy and sensitivity of the HRCT to predict the CF type. We also assessed the need for CF drilling in each case., Results: Our study included 154 patients who underwent CI. They were 90 (58.4 %) males and 64 (41.5 %) females with ages ranging from 2.1 to 7.6 years, with a mean of 4.69 ± 1.19. The intra-class correlation coefficient between both radiological evaluators was 0.985, which indicated a high agreement between them. The intraoperative surgical types of CF were significantly related to the radiological types as the Spearman correlation coefficient was 0.976, and the P-value was <0.001., Conclusions: Our study revealed that preoperative CT is a precise tool for predicting the intraoperative type of CF during cochlear implantation type with a sensitivity of 96.67 % and an accuracy of 94.17 %. Moreover, drilling of the CF is recommended in type A3 and type B2 CF., Competing Interests: Declaration of competing interest With the submission of this manuscript, I would like to undertake that., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: We aimed to identify the role of bacterial biofilms in the chronicity of otitis media with effusion and its resistance to antibiotics. We illustrated this role by reviewing, analyzing, and correlating the findings with the results of the included studies to reach clear evidence., Methods: A comprehensive search of electronic databases (Scopus, PubMed, Web of Science, Cochrane, and GHL databases) was performed for all studies using the following strategy till April 2021 with the search terms: Biofilm and Middle ear effusion. We found 935 references, 421 were duplicates, and 514 were needed for further screening, and it was as follows: PubMed 215, Scopus 18, Cochrane 130, Web of Science 136, and GHL 15., Results: The pooled prevalence of culture-positive effusions was estimated to be 40% (95% CI [28%, 53%]) of the total OME population. Overall, the prevalence of PCR-positive effusions was estimated to be 97% (95% CI [95%, 99%]) of the total OME population. The pooled prevalence of EM-positive effusions was estimated to be 82% (95% CI [69%, 95%]) of the total OME population., Conclusion: The data presented in this study coincide with the significant role of bacterial biofilms in the pathogenesis of chronic otitis media with effusion. The involvement of bacterial biofilm as a component of the OME pathogenic process can help us to explain why antimicrobial therapy is not always effective in the eradication of the disease process and, also explain the recurrence of middle ear effusion after treatment with tympanostomy tubes either with or without adenoidectomy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: This study aimed to propose a radiological classification of the incudo-stapedial angle by preoperative high-resolution computed tomography (HRCT) images and to highlight its importance for predicting the use of reversal-steps stapedotomy (RSS) rather than the traditional non-reversal technique., Methods: We included 83 candidates for stapedotomy operation. Two physicians measured the radiological incudo-stapedial joint angle in the preoperative HRCT. According to this measurement, the radiological incudo-stapedial joint was classified into three types: obtuse, right, and acute. In addition, this radiological classification was correlated with the intraoperative use of the stapedotomy technique, either reversal or non-reversal., Results: The RSS technique was used in forty-two (97.7%) cases with an obtuse angle and twenty-six (89.7%) with a right angle. At the same time, the traditional non-reversal technique was used in all patients with an acute angle. The three groups differed significantly regarding the method used for stapedotomy (P value < 0.001). Moreover, Spearman's correlation coefficient revealed a significant correlation between the used technique and the radiological type of the incudo-stapedial angle (P value < 0.001)., Conclusions: This prospective study proposed a preoperative radiological classification of the incudo-stapedial angle. This classification was significantly correlated with the type of stapedotomy technique. The RSS technique was feasible in most cases with an obtuse and right radiological incudo-stapedial angle. In contrast, the non-reversal method was used in all patients with an acute radiological incudo-stapedial angle. This radiological classification could predict the choice for the stapedotomy technique with an accuracy of 95.18%, a sensitivity of 73.33%, and a specificity of 100%., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)