For optimum sensitivity, the Mangham protocol is preferred (sensitivity, 91.58%; specificity A, 44.23%; specificity B, 44.91%), which proposes a ≥10-dB interaural difference, averaging 1 to 8 kHz. For optimum specificity, the American Academy of Otolaryngology-Head and Neck Surgery protocol is preferred (sensitivity, 87.37%; specificity A, 65.38%; specificity B, 66.04%), which proposes ≥15 dB between ears, averaging 0.5 to 3 kHz.

ORAL PRESENTATIONSand the Mangham protocol (91.58%). Eleven of 15 protocols for Specificity-A and 12 of 15 protocols for Specificity-B achieved ≥ 50%. Clinical risks were 6.84% to 18.95% while financial wastes were 33.56% to 68.37% for Specificity-A and 31.76% to 66.86% for Specificity-B. Interaural difference parameters indicating highest mean sensitivity rates in the order of ≥ 10dB, ≥ 15dB, and ≥ 20dB, while frequencycomparison parameters were in the order of "two adjacent frequency," "single frequency," and "averaged multifrequency" comparison. Mean specificity patterns were the exact opposite. Conclusion:Mangham protocol, proposing ≥ 10dB interaural difference averaged 1 to 8khz, is the preferred recommendation (sensitivity 91.58%; specificity-A 44.23%; specificity-B 44.91%). As representation of the local patient population and clinical resource allocation priorities, each center is encouraged to conduct audiometric protocol and symptomatology analysis of its own clinical cohort in deciding diagnostic protocol policy. Results: Out of 33 patients, 16 had no hearing loss, 9 had mild hearing loss, and 8 had moderate hearing loss posttreatment. Ten patients received intratympanic steroid injections for mild (n = 3) or moderate (n = 7) hearing loss. Of those with mild hearing loss all but one recovered fully. Five of 8 patients with moderate hearing loss recovered to baseline hearing levels and 3 had partial recovery. There was vestibular dysfunction in 7 patients who underwent vestibular testing, one recovered fully, and the others showed partial recovery or no recovery. The number of modified T-cells infused for therapy correlated with the degree of audiovestibular deficit. Otology/Neurotology AudiovestibularConclusion: ACT targeting pigmented cell antigens is a novel therapy for melanoma that is associated with hearing loss and vestibular dysfunction. The presumed mechanism of autoimmune attack on normal melanocytes in the stria vascularis of the cochlea and vestibular organs demonstrates the importance of melanocytes in normal inner ear function. Method: Twenty-two TB from 12 patients with otogenic meningitis and 27 TB from 17 patients with otitis media without meningitis were histopathologically examined. The presence, the amount, and localization of biofilm, fluid, and pathologic diagnosis have been noted. Data were compared between the groups with and without otogenic meningitis. Otology/Neurotology Biofilm in Human TemporalResults: Biofilm formation has been observed in 19 of 22 TB with otogenic meningitis group and 7 of 27 TB with otitis media/without otogenic meningitis group (P .05). The most common localization of biofilm was in the round window, and it was least common in the Eustachian tube. Biofilm was also present in other areas, including the oval window, facial recess, sinus tympani, mastoid, and inner ear. Conclusion:Biofilm is a very frequent finding in patients with otogenic meningitis. It seems that the eradication of the biofilm from the hidden areas of the middle ear cleft could be impor...