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Objectives: Cerumen production is a protective process for the ear canal. Cerumen impaction causes unpleasant symptoms. There are various cerumen removal practices. These include irrigation, application of softeners/solvents, mechanical removal, and micro-suction. However, during the lockdown period of the COVID-19 pandemic, some patients opted for some procedures, such as ear candling, which are not evidence-based. This study aimed to explore the awareness of ear candling among otolaryngology doctors and record cases with complications of such practice in the Kingdom of Saudi Arabia (KSA). Methods: This was a cross-sectional study. A questionnaire was developed after an extensive literature search, and distributed to otolaryngology residents, fellows, and consultants of different hospitals across the country. A total of 80 respondents agreed to participate in the study. Results: A total of 16 doctors reported seeing cases of ear candling, of which 13 patients had different complications, of which ear pain was the most commonly reported. The majority of participants (42.5%) thought the lack of medical access during lockdown enhanced the practice of alternative medicine for ear-related complaints in society compared to 35% of participants who had a neutral response regarding this idea and 22.5% who disagreed. Conclusions: Although the practice of ear candling is not widely spread in KSA, different types of ear complications were recorded by the otolaryngologist. We would like to encourage the doctors to report such complications, especially after the lockdown period. [ABSTRACT FROM AUTHOR]

Background: Facial nerve monitoring system has enabled facial muscle activity detection using electrodes placed over the target muscles. In an effort to enable the best and minimally invasive surgical approach, a midline facial nerve monitor was applied during bilateral cochlear implantation surgical intervention in our center and the feasibility of placing midline facial nerve monitor electrodes during bilateral cochlear implantation operations was evaluated., Methods: The medical records and operative notes of all patients who underwent bilateral cochlear implantation surgery between January 2017 and April 2018 in a quaternary care center were retrospectively reviewed and divided into 2 groups based on the facial nerve monitoring methods: facial nerve monitoring with the midline (midline facial nerve monitor) or bilateral (bilateral facial nerve monitor) electrode placements. Basic demographic information, comorbidities, and facial nerve status (pre- and postoperatively) were collected from patient electronic medical charts. The operative notes were reviewed for abnormal facial nerve findings, as well as for any reported difficulties with the identification or stimulation of facial nerve. The primary outcome was facial nerve identification postoperative function., Results: Seventy-eight patients met our inclusion criteria. Midline facial nerve monitor was used in 49 patients and bilateral facial nerve monitor was used in 29 patients. No documented difficulty was identified at the step of facial nerve identification in either group, and none of the patients developed facial nerve weakness postoperatively., Conclusion: Midline facial nerve monitor is a safe and reliable method that can be used in bilateral cochlear implantation surgeries and other surgeries requiring facial nerve monitoring.