Patients with far-advanced otosclerosis (FAO) may appear to be suffering from profound sensorineural hearing loss and are frequently directed to cochlear implantation programmes. In order to avoid such misdiagnosis, FAO should be considered in patients with non-measurable bone-conduction levels and airconduction levels exceeding 85 dB. Specific clues can lead the clinician to suspect otosclerosis as the aetiology of hearing loss. A review of eight patients (nine ears) with FAO who underwent stapedectomy from 1985–1995 reveals that six of the eight (75 per cent) who had been unable to use a hearing aid preoperatively obtained serviceable hearing with a hearing aid after surgery. This confirms that cochlear implantation is not the best treatment for all profoundly deaf patients; some are better off with stapedectomy.

Aim: To access the usage of the endoscopy in round window (RW) orientation during cochlear implant (CI). Methodology: This was a retrospective case series study done in Otolaryngology Department, Tanta University, Egypt in 2018 and 2019. Inclusion criterion was all cases with CI surgery in which the endoscopy was used to locate the round window (RW) when this was difficult through the transmastoid approach. Results: The total cohort consisted of 13 CI patients in which endoscopy was used. Age mean was 35.5 years. Situations necessitating the usage of endoscope were: 6/13 with cochlear rotation, 4/13 with very narrow mastoid cavity, and 3/13 with narrow facial recess. By using the endoscope, the RW was fully visualized in all patients and CI insertion done through it. Conclusion: The endoscopy was of great value in some difficult CI cases.

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.

No abstract