The interaction between the incoming winds with high mountainous islands produces a wind-sheltered area in the leeward side, known as the atmospheric wake. In addition to weaker winds, the wake is also characterized by a clearing of clouds, resulting in intense solar radiation reaching the sea surface. As a consequence, a warm oceanic wake forms on the leeward side. This phenomenon detectable from space can extend 100 km offshore of Madeira, where the sea surface temperature can be 4⁰C higher than the surrounding oceanic waters. This study considers in-situ, remote sensing, and ocean circulation model data, to investigate the effects of the warm wake in the vertical structure of the upper ocean. To characterize the convective layer (25-70m) developing within the oceanic wake, 200 vertical profiles of temperature, salinity and turbulence were considered, together with the computation of the Density Ratio and Turner-angle. In comparison to the open-ocean water column, wake waters are strongly stratified with respect to temperature although highly unstable. The vertical profiles of salinity show distinct water parcels that sink and/or rise as a response to the intense heat fluxes. During the night, the ocean surface cools, leading to the stretching of the mixed layer which was replicated by the ocean circulation model. In exposed, non-wake regions however, particularly in the southeast and north coast of the island, the stretching of the mixed layer is not detectable.

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Background: Middle ear aeration level is an important precursor of chronic otitis media (COM) and one predictive factor for tympanoplasty success. Tympanometry measures the volume of the external ear canal, middle ear cavity, aditus, and mastoid air cells in patients with tympanic membrane (TM) perforation. The aim of the study was to determine whether the pre-operative tympanometric volume and the interaural tympanometric volume differences in unilateral simple COM can predict the success of type I tympanoplasty. Methods: Retrospective analysis of type I tympanoplasties performed in adults between January 2017 and December 2020 in a tertiary hospital. Bilateral COM, revision surgery and tympanoplasty using cartilage grafts or associated with other procedures were excluded. Success was defined as no evidence of TM perforation on otoscopic examination and tympanogram, at least six months after surgery.    Results: Sixty-one patients were evaluated. The mean age was 43 years old, and there was a female predominance (55.7%). The overall success rate was 77%. Location or size of perforation weren’t different among patients with and without surgical success. We found a statistically significant result (p=0.009) regarding interaural tympanometric volume differences, with a median of 2.7 ml (IQR 3.6) in the surgical success group and a median of 1.3 ml (IQR 1.26) in the recurrence group. 90.6% of patients with interaural tympanometric volume difference greater than 2 ml had successful surgery. Conclusions: A good aeration of middle ear, demonstrated by higher interaural tympanometric volume differences, can predict success of type I tympanoplasty.