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Background: Due to the short duration of effect, simple myringotomy and aspiration of fluid do not yield significant therapeutic outcomes. Objective: To compare the efficacy of myringotomy with intratympanic dexamethasone injection versus grommet tube insertion in treatment of Otitis Media with effusion (OME).

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Purpose: The aim of this study is to assess the role of Magnetic resonance imaging (MRI) and high resolution CT (HRCT) in patients with congenital hearing loss. Patients and methods: Sixty patients who having congenital hearing loss (CHL) will be included in our study. Full history taking, clinical examination, Oto-laryngology examination and audiological evaluation tests, MRI and non-enhanced HRCT. Results :The results of this study cannot be analysed from an epidemiological point of view due to the absence of a comprehensive repeated investigation, but they illustrate and clearly justify the need to perform a standardized aetiological work-up. HRCT was superior in detection of bony landmarks of the temporal bones. These findings were the shape and orientation of the petro-temporal bones, the patency of the external auditory canal (bony atresia), associated tympanic cavity and ossicular chain anomaly. MRI of the both temporal bones were accurate in detection of abnormalities in the membranous labyrinth and inner ear malformations. The use of balanced-Fast Field Echo (b-FFE) series on the internal auditory canals to evaluate the cochlear nerve. Our MRI studies were unable to evaluate the condition of the middle ear and mastoid cavity, which appears as intermediate and bright signals seen in both T1-and T2-weighted images. However, HRCT clearly shows the condition of the bone cavity and bone marrow of the tympanic cavity, and the pneumatization of the mastoid process if present. Conclusion :Imaging plays an important role in diagnosis and work-up of patients with congenital hearing loss. There are a whole lot of etiologies, many of which have typical findings on HRCT and MRI, which help in differentiation of these causes and therefore guides the treating surgeon in further management. Both HRCT and MRI are complimentary to each other and should be judiciously used by the radiologist in diagnosing the various congenital malformations.

Background: fibro-osseous lesions of craniofacial bones are a challenging group of pathological conditions that are difficult to classify and treat. Unfortunately, there are no universally accepted clinical, radiological, or histopathological criteria that distinguish these lesions from one another. It is often quite challenge to establish their biologic behavior and treatment. Objective: To outline the the different surgical modalities for management of the most common symptomatic craniofacial fibro-osseous lesions and to evaluate the appropriate surgical management with follow up results. Patients and methods: Sixteen patients with biopsy confirmed craniofacial fibro-osseous lesions were enrolled in our study from Mars 2009 to Mars 2012 in otorhinolaryngology department zagazig university hospital. They were operated using endoscopic and open surgery. All patients were submitted in thorough history taking, clinical, radiological, and histopathological examinations, with a follow up period from six months to two years. Results: The most common cases were osteoma 10 cases (62.5%), the fibrous dysplasia was the second most common 6 case (37.5%). Ethmoid and frontal sinus were the most common sinuses involved with osteoma, the maxillary sinus was the most common sinus involved with fibrous dysplasia. There were 3 complications the first was CSF leak, the second was incomplete removal of fibrous dysplasia, and the third was diminution of vision in the epsilateral eye of the huge ethmoidal osteoma due to optic nerve oedema resolved by medical treatment. Conclusion: management of craniofacial fibro-osseous lesions is highly individualized and it is the task of the surgeon to tailor the surgical procedure according to the clinical and radiological data.