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Aim To assess the complications of cochlear implantation (CI) during our 7 years of experience since the start of the CI program in our institute. Patients and methods The study included 602 CI procedures performed from April 2013 to January 2020. The follow-up period ranged between 12 and 73 months. Complications were classified into perioperative, major complications requiring reimplantation, major complications not requiring reimplantation, and minor complications. Collected data were statistically analyzed. Results Of the 602 implantations, 509 were children. Age ranged between 1.2 and 64 years. Mean implantation age in pediatrics was 4.4 and 31.07 years in adults. A total of 76 (12.62%) complications were recorded, 49 (8.13%) in children and 27 (4.49%) in adults. Of these, 17 (2.83%) were major, 24 (3.99%) were minor, and 35 (5.81%) were perioperative complications. Five (0.83%) of the major complications required reimplantation (two cases of device failure 0.33%), and 12 did not need reimplantation. Our study's most common cause of minor complications was partial facial nerve paresis (11 patients, 1.83%). Conclusion Our 7 years of experience have shown that CI is a successful and safe procedure that can be performed with low major complication rates. It is important to know the possible complications and to manage them properly.

Purpose To evaluate the modifications in the indications and technique of tracheostomy for prolonged-intubated COVID-19-infected patients. Methodology Commissioned by the Ministry of Health in Egypt, different guidelines for tracheostomy for COVID-19 patients were revised. A guideline was adopted and modified to meet the equipment provided by facilities assigned to contain the current pandemic. The understanding of staff and the applicability of the new guidelines were evaluated using a mini-summative quiz answered by 117 tracheostomy team members in facilities around Grand Cairo, Egypt. Results The percentages of consistent answers for questions 1–6 were 94, 90.60, 89.70, 95.70, 61.50, and 93.20%, respectively. A total of 86 (73.5%) individuals achieved score more than 80%. Moreover, 41 (35%) individuals achieved perfect score. Conclusion The novel guidelines are well understood and applicable. Remarks that emerged regarding diathermy use should be taken in consideration. Continuous assessment of these guidelines is needed as the pandemic goes on altering its manner and our strategies along with it.

Purpose To evaluate the effect of dried amniotic membrane grafting on healing of radical cavity after canal wall-down procedure. Patients and methods A total of 24 cases were included. All had canal wall-down surgery done with the use of dried amniotic membrane at the end of procedure to line the radical cavity. According to the course of healing, cases were divided into four groups regarding wideness and dryness of cavity. Results were statistically analyzed. Results Among the 24 patients in the postoperative follow-up period of 6 months, only three (12.5%) patients needed revision meatoplasty for having narrow and wet cavities. Sixteen (66.7%) patients achieved the optimum goal of wide and dry cavity. Two (8.3%) patients had dry but narrow cavities. Three (12.5%) patients had wide but wet cavity, with recurrence of cholesteatoma. Conclusion Dried amniotic membrane graft can be used safely to line the radical cavity. Further comparative studies are needed to evaluate efficacy among other materials used to achieve safe and dry cavities.

Purpose The aim was to analyze demographic and perioperative data of patients who underwent cochlear implantation (CI) at the Hearing and Speech Institute in the period between November 2019 and January 2020. Materials and methods Files of all patients undergoing CI in the period between November 2019 and January 2020 were collected used a specially designed checklist to record demographic, preoperative, operative, and early postoperative data. Data were recorded and analyzed using proper statistical analysis. Results Of 80 files reviewed, the data of 73 files were included. Average age was 4.3 ± 3.3 years, and 41 (56.2%) of them were males. Positive consanguinity was seen in 37 (50.7%) cases, positive family history was seen in 29 (39.73%), 13 (17.8%) cases had wide vestibular aqueduct, four (5.5%) cases had auditory neuropathy, and two (2.74%) cases had intracochlear anomalies. The average operative time was 85 ± 24 min. A total of 66 (90.4%) right ears were operated on. Difference in the operative time between wide vestibular aqueduct cases and normal cases was insignificant, whereas difference between right vs left ear operative time was significant. Early complications were reported in seven (9.6%) cases, and majority were partial facial palsy (5.5%). Conclusion Condensed CI work is possible in suitable environment of team discipline and adequate equipment, with comparable performance and outcome. In addition, it provides favorable conditions for training new surgeons.

Background Proper eradication of allergic fungal sinusitis (AFS) depends on three factors: first is proper preoperative evaluation and mapping via computed tomography and MRI. Second is the availability of adequate surgical tools in experienced hands. Third is the proper postoperative endoscopic follow-up to detect and remove recurrence if possible. Aim To evaluate the role of inferior turbinectomy (IT) and partial middle turbinectomy (PMT) in patients with AFS managed by endoscopic sinus surgery (ESS) for the prevention of recurrence and adequate management of residual disease (postoperative salvage). Patients and methods A prospective, comparative, randomized study conducted from March 2016 to April 2018. In all, 28 patients suffering from AFS were included. All patients have been presented and managed at the Department of Otolaryngology, Hearing and Speech Institute. Patients have been randomized into two groups of 14 patients each (groups A and B). The patients in group A have undergone ESS only, while the patients in group B have undergone ESS plus bilateral IT and PMT. Regular follow-up visits were done every 2 months for at least 6 months for both groups. Results In group A, there was difficulty in proper assessment in 11 patients out of 14. Recurrence occurred in five patients who showed rigorous assessment, which was managed via ESS adding to the maneuver bilateral IT and PMT. In group B, only two patients were difficult out of the 14. Recurrence occurred in two patients only and was managed easily in the outpatient office. No significant complications were detected in both groups. Conclusion IT and PMT may be considered as essential steps in the surgery for AFS as they play a role in lowering the recurrence rate and facilitating better, more comfortable, and more effective postoperative management of recurrence if happened.

This trial aimed to assess the efficacy of on-demand oral dapoxetine versus topical lidocaine treatments for lifelong PE. Cases with lifelong PE were randomised to start treatment by oral dapoxetine 60 mg or topical lidocaine 10% spray. The intravaginal ejaculatory latency time (ILET), validated Arabic Index for PE (AIPE), Sexual Health Inventory for Men (SHIM) and frequency of intercourse/week were recorded at the baseline and after 12 weeks treatment period of the first medication before two weeks washout period and then crossing over to the other one for another 12 weeks. Results showed that both medications significantly increased both IELT and AIPE scores compared with the baseline being significantly better with topical lidocaine (63.44 s, 179.4 s versus 21.87 s, p < .05). Significant decrease of SHIM score was recorded with lidocaine but not with dapoxetine. Global Efficacy Question for the patient's assessment of the effectiveness of drugs showed that lidocaine was described as being effective by 43 cases and ineffective by 12 cases, oral dapoxetine was described as being effective by 16 cases and ineffective by 39 cases. From these accumulated data, it is concluded that topical lidocaine is more effective on-demand therapy for lifelong PE compared with oral dapoxetine., (© 2020 Blackwell Verlag GmbH.)