Purpose Implantable hearing devices are indicated for candidates who could not benefit from conventional hearing aids. This study aimed at evaluating their effectiveness in rehabilitation of hearing loss. Methods This study included patients who received bone conduction implants at Tertiary Teaching Hospitals, between December 2018 and November 2020. Data were collected prospectively, and patients were assessed both subjectively using COSI and GHABP questionnaires and objectively using bone conduction and air conduction thresholds, unaided and aided free field speech thresholds. Outcomes of transcutaneous (tBCHD) and percutaneous (pBCHD) bone conduction hearing devices were compared as well as outcomes of unilateral versus bilateral fitting. Postoperative skin complications were recorded and compared. Results A total of seventy patients were included, thirty-seven of them were implanted with tBCHD and thirty-three with pBCHD. Fifty-five patients were fitted unilaterally compared to 15 bilateral fitting. Preoperative mean of bone conduction (BC) of the overall sample was 23.27 ± 10.91 dB, the Air conduction (AC) mean was 69.27 ± 13.75 dB. There was significant difference between unaided free field speech score (88.51% ± 7.92) and the aided score (96.79 ± 2.38) with P value = 0.00001. The postoperative assessment using GHABP showed a benefit score mean of 70.95 ± 18.79, patient satisfaction score mean of 78.15 ± 18.39. The disability score improved significantly from a mean of 54.08 ± 15.26 to residual score of only 12.50 ± 10.22 with P < 0.00001 postoperatively. There was significant improvement in all parameters of COSI questionnaire following fitting. Comparison of pBCHDs vs tBCHDs showed a non-significant difference regarding FF speech as well as GHABP parameters. Comparison of the post-operative skin complications was in favor of tBCHDs as (86.5%) of the patients had normal skin postoperatively, compared to 45.5% of patients with pBCHDs devices. Bilateral implantation showed significant improvement of FF speech scores, GHABP satisfaction score, as well as COSI score results. Conclusion Bone conduction hearing devices are effective solution for rehabilitation of hearing loss. Bilateral fitting yields satisfactory outcomes in suitable candidates. Transcutaneous devices carry significantly lower skin complication rates compared to percutaneous devices.

Objective: To assess the validity of the Arabic version of the University of Pennsylvania Smell Identification Test in the Egyptian population. Patients and Methods: This was a cross sectional study including 124 normal Egyptian subjects. Socioeconomic standard was assessed, and patients were categorized into three categories; low, moderate and high socioeconomic levels. The total number of correct answers for the 40 odorants presented was used to determine the test score. The difficulty level of the test was checked by a visual analogue scale. The percentage of the study sample detecting every odor was calculated. Internal consistency of the test was checked by cronbach's alpha test. Results:The study group included 87 females and 37 males with a mean age of 29.28 ±5.92 years. The average smell identification test score for all participants was 31.49 ± 1.74. The average visual analog scale score for ease of applicability of the test was 7.13 ± 0.58 with no significant difference between males and females. The smell identification test score was higher among males than females with little significance. Participants with high and moderate socio-economic standards reported significantly higher test score. Thirty-one odors were correctly identified by at least 70% of the volunteers, Overall alpha was 0.749. Conclusion:The Arabic version of University of Pennsylvania Smell Identification Test is an adequate tool for assessment of olfaction in the Egyptian population. But 9 Odorants of this test needs further revision. Males and higher socioeconomic levels were associated with better test results.

Objective: To compare electric drilling versus cold steel instruments in management of spur of maxillary crest of the nasal septum regarding operative details and postoperative complications. Patients and Methods: This was a prospective comparative study evaluating two techniques for management of spur of maxillary crest of the nasal septum. Patients of the study were divided into two groups 32 patients each. In group I, the spur of the maxillary crest was removed using surgical instruments. In group II, the spur was removed using electric drilling. The two groups were compared regarding duration of maxillary crest spur removal, the amount of blood loss, the incidence of unilateral and bilateral flap injury, the incidence of anesthesia of the upper incisors and the incidence of septal perforations. Results: In the current study, operative blood loss was less in group II with a highly significant difference (p =0.0002). However, operative duration was less in group I with a highly significant difference (p < 0.0001). There was a nonsignificant difference between the two groups regarding flap injury with higher incidence in group I (p = 0.6). The incidence of upper incisors anesthesia was significantly more in group I (p = 0.03). There was a non-significant difference regarding the incidence of septal perforation (p =1). Conclusion: Both techniques are effective for correction of spurs of the maxillary crest with significantly better control of intraoperative bleeding and less postoperative central incisors anesthesia with electric drilling. However, the drilling technique consumed significantly more time.

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