Osteomas of the temporal bone are rare benign tumors that, in a small minority of cases, may give rise to secondary cholesteatoma. We report a case in which two independent pathological mechanisms appeared to coexist, resulting in a configuration not previously described in the literature. A 51-year-old woman presented with one year of right-sided otorrhoea and progressive mixed hearing loss unresponsive to antibiotic therapy. High-resolution computed tomography (HRCT) demonstrated a giant sessile osteoma arising from the anterior mastoid cortex with complete external auditory canal (EAC) obstruction. Non-echo-planar diffusion-weighted MRI (non-EPI DWI-MRI) identified cholesteatoma restricted to the middle ear and mastoid antrum, clearly distinct from chronically inflamed mastoid air cells. Intraoperatively, a near-intact tympanic membrane with a small attic retraction pocket formed the anterior boundary; no canal-wall cholesteatoma was present. Canal wall-down (CWD) radical mastoidectomy with osteoma excision and meatoconchoplasty achieved complete disease eradication. Histopathology confirmed compact osteoma and cholesteatoma. The cavity was dry and stable at the three-month follow-up. Upon review of the published case reports of temporal bone osteoma with associated cholesteatoma, no previously reported case combined a giant osteoma of the anterior mastoid cortex with cholesteatoma confined entirely to the middle ear and mastoid behind a structurally preserved tympanic membrane. The intraoperative finding of an attic retraction pocket suggests that Eustachian tube dysfunction may have played an independent contributory role alongside the osteoma. Combined HRCT and non-EPI DWI-MRI was essential for preoperative characterization and surgical planning.

Glomangioma (true glomus tumour) is a benign perivascular neoplasm that rarely arises in the head or neck. A man in his 70s presented with long-standing, unilateral, serous otorrhoea, progressive hearing loss and intermittent tinnitus. Otoscopy revealed a soft-tissue mass completely occluding the external auditory canal. Contrast-enhanced CT demonstrated an enhancing lesion filling the external auditory canal with extension into the middle ear, attic, mastoid antrum and tympanic opening of the Eustachian tube without bony erosion. The patient underwent canal-wall-down mastoidectomy with gross total excision. Histology showed a well-circumscribed, unencapsulated tumour composed of thin-walled branching vessels rimmed by uniform round cells, and immunohistochemistry revealed diffuse smooth muscle actin positivity, supporting the diagnosis of glomangioma. The symptoms resolved postoperatively and structured surveillance was arranged because of a close excision margin. This case highlights that not all vascular-appearing otologic masses are paragangliomas and underscores the diagnostic value of histopathology with immunostaining.

Otitis media is one of the most common causes of fever as a presentation in the pediatric population. Chronic suppurative otitis media, also known as chronic otitis media, is a stage of ear disease in which there is an on-going chronic infection of the middle ear without an intact tympanic membrane. This disease is a chronic inflammation of the middle ear and mastoid cavity. The characteristic presentation is chronic or persistent otorrhoea over 2 to 6 weeks through a perforated tympanic membrane.[1] The Eustachian tube plays an important role in this disease, and dysfunction of this tube is found in 70% of patients undergoing middle ear surgery. When dysfunction of the Eustachian tube occurs, the pressure equilibration in the middle ear is impaired, and the middle ear aeration is perturbed, resulting in the classic symptoms of chronic suppurative otitis media.[2] Acquired hearing-loss is also characteristically found in patients with this condition and, if left untreated, can lead to further morbidity and mortality.[3]

U.S. states that regulate methamphetamine (meth) contamination in residences require remediation to reduce meth surface concentrations to below a concentration limit. Existing limits vary widely, by 30-fold. States that have regulatory limits usually have a single limit that does not account for the extent of human contact with contaminated surfaces in different parts of residences (e.g., bedroom vs. attic). Actual exposure in low contact areas does not contribute to total occupant dose as much as that in high contact areas, yet contributes similarly to remediation costs under the single limit paradigm. Heating, ventilation, and air-conditioning (HVAC) systems are also usually subject to the same limits despite low contact and without a basis in risk analysis. Methods for averaging test results into a compliance metric also affect remediation cost. This study analyzes the changes in total occupant meth dose and the concomitant reduction in remediation cost for various alternative concentration limits relative to these four issues. Residences were subdivided into normal occupancy areas (NOAs), low occupancy areas (LOAs) such as attics, moderate occupancy areas (MOAs) such as exterior hallways, and HVAC systems. Dose calculations were based on existing risk assessment methodologies, and cost reductions were based on contractor survey data and random residence sampling data. Raising only the conservative remediation limits adopted by some states to the California single limit would reduce the average cost to remediate a contaminated house from $21,000 to $10,000. Further raising limits to concentrations that remain below risk assessment boundaries is estimated to save an additional $5,000 on LOA and $2,000 on HVAC per remedial project. If all recommended alternate concentration limits are implemented, an estimated 50% cost reduction is possible with tiered limits based on contact time. These alternate limits still allow the occupant dose to fall below the recommended dose levels, which implies that these LOAs, MOAs, and HVAC systems are being over-remediated when they are required to be remediated to the same limit as NOAs.

The FM fault-controlled fractured-vuggy volatile oil reservoir is characterized by strong heterogeneity and insufficient natural energy, which limits the effectiveness of conventional water flooding due to early water breakthrough and significant attic oil retention. To optimize post-waterflood development strategies, this study conducted a series of full-diameter physical simulation experiments using multi-fractured-vuggy cores under reservoir conditions. Experiments with different gas injection media revealed that the stage recovery rates for N2, hydrocarbon gases, and CO2 are 78.85%, 64.36%, and 59.96%, with an identical gas injection volume of 0.77 HCPV. Based on these findings, along with the results from phase behavior experiments, N2 is recommended as the preferred gas injection medium. The cumulative oil recovery after continuous water flooding was about 75%. The subsequent water-alternating-gas (WAG) injection effectively increased oil recovery by approximately 6.6–8.8% relative to waterflooding alone by improving sweep efficiency and mobilizing residual oil in branch fractures. Finally, connectivity-controlled case studies demonstrate that gas injection in upper-connected fractured-vuggy unit provides an additional 11.68% incremental recovery compared with lower-connected unit due to delayed gas breakthrough and expanded sweep volume. Overall, direct continuous gas injection results in earlier gas breakthroughs, premature oil production at the core outlet, reduced gas consumption per ton of oil, and favorable extraction outcomes. Therefore, it is recommended to implement a direct continuous gas injection in the well group following water flooding to enhance crude oil recovery.

One of the biggest hydrocarbon accumulations in the Gulf of Suez, the huge October Oil Field, has a structurally complex syn-rift sequence with poorly limited reservoir distribution and quality. One of the most important target reservoirs is the Nukhul Formation. However, the field development is challenged by facies architecture, porosity, shale distribution, and fault geometries that complicate replication of the Nukhul reservoir’s reported heterogeneity. These difficulties are crucial for enhancing and improving field development, particularly from the Nukhul reservoir, which was depleted and had a very low oil rate. It was thought that this type of reservoir had disappeared, leaving little opportunity for development. This study aims to manage and increase oil production from the Nukhul reservoir by updating structural interpretation, which reveals revised fault geometry and compartment configurations, providing better restrictions on trap integrity and reservoir continuity. Historical datasets collected by multiple operators (1980–2020), combined with recently reprocessed seismic interpretations, were integrated to reconstruct stratigraphic geometries more accurately than previously achievable. It was crucial to update and modify the structural model to preserve favourable reservoir quality and extension across different locations, forming the basis for improved facies and static modelling. The Nukhul Formation was divided into four zones (K1–K4) based on detailed correlation integrated with petrological descriptions and dynamic data. This division highlights the dominance of low-porosity limestone–shale units in K1–K2, discontinuous fluvial sandstone bodies in K3, and thick, laterally linked channelized sandstones in K4. Model results identify undrilled reservoir extensions, attic accumulations, and high-quality sandstone corridors. These results provide actionable targets for near-field exploration and infill drilling, significantly reducing uncertainty in reservoir extent and quality, improving dynamic behaviour prediction, and supporting volumetric calculations, flow-unit delineation, and uncertainty quantification. The findings demonstrate that the Nukhul reservoir still retains production potential and can contribute to field redevelopment. The approach used here offers a stable and portable framework for characterizing heterogeneous syn-rift reservoirs in structurally dynamic basin-margin environments and promotes optimal field redevelopment plans.

This study presents an integrated 3D structural modelling workflow as a quantitative framework for applying advanced geological understanding to the spatial distribution of discrete and continuous reservoir properties of the underexplored, structurally complex Nukhul Formation in the October Oil Field. The updated 3D structural model was constructed by integrating high-resolution seismic interpretation with multidisciplinary subsurface datasets, including electric logs, detailed stratigraphic correlations, petrophysical evaluation, and production performance data from drilled wells. The current study specifically evaluates the structural controls on reservoir distribution and trapping styles within the field by combining 3D seismic interpretation with well-log and core-derived information. The refined model reveals a fault architecture dominated by a NNW–SSE (Clysmic) trend, with major faults dipping south-southwest (SSW) and horizons oriented northeast (NE), as determined from dipmeter data and seismic interpretation. The Nukhul reservoir is defined by a three-way dip closure, bounded by fault-dependent seals, where sealing capacity is governed by fault throw that juxtaposes permeable sand layers against impermeable lithologies. This configuration effectively inhibits cross-fault hydrocarbon migration, preserving attic accumulations. By integrating geological, geophysical, and petrophysical datasets, the new model significantly improves the delineation of attic targets, fault-bounded compartments, and reservoir–seal juxtapositions. Consequently, it provides refined well-placement recommendations, including high-potential attic infill drilling locations. Furthermore, the model establishes a technically robust basis for reservoir management and depletion planning, aiming to maximize recovery while minimizing water-handling risks. These outcomes demonstrate the value of incorporating new seismic and well datasets into legacy models and highlight their potential for reducing uncertainty in structurally complex syn-rift settings. Beyond the October Field, the updated structural modelling approach has broader implications for syn-rift petroleum systems in the Gulf of Suez and analogous rift basins, offering a predictive tool for fault-seal analysis, volumetric assessment, reservoir performance evaluation, and optimized drilling strategies.

U.S. states that regulate methamphetamine (meth) contamination in residences require remediation to reduce meth surface concentrations to below a concentration limit. Existing limits vary widely, by 30-fold. States that have regulatory limits usually have a single limit that does not account for the extent of human contact with contaminated surfaces in different parts of residences (e.g., bedroom versus attic). Actual exposure in low contact areas does not contribute to total occupant dose as much as that in high contact areas, yet contributes similarly to remediation costs under the single limit paradigm. Heating, ventilation, and air-conditioning (HVAC) systems are also usually subject to the same limits despite low contact and without a basis in risk analysis. Methods for averaging test results into a compliance metric also affect remediation cost. This study analyzes the changes in total occupant meth dose and the concomitant reduction in remediation cost for various alternative concentration limits relative to these four issues. Residences were subdivided into normal occupancy areas (NOAs), low occupancy areas (LOAs) such as attics, moderate occupancy areas (MOAs) such as exterior hallways, and HVAC systems. Dose calculations were based on existing risk assessment methodologies and cost reductions were based on contractor survey data and random residence sampling data. Raising only the conservative remediation limits adopted by some states to the California single limit would reduce the average cost to remediate a contaminated house from $21,000 to $10,000. Further raising limits to concentrations that remain below risk assessment boundaries is estimated to save an additional $5,000 on LOA and $2,000 on HVAC per remedial project. If all recommended alternate concentration limits are implemented, an estimated 50% additional cost reduction is possible with tiered limits based on contact time. These alternate limits still allow the occupant dose to fall below the recommended dose levels, which implies that these LOAs, MOAs, and HVAC systems are being over remediated when they are required to be remediated to the same limit as NOAs.

Introduction Chronic otitis media with cholesteatoma (COMC) is a progressive and potentially destructive middle ear disease, with surgery as the treatment of choice. Its auditory, emotional, and social consequences significantly affect patients' quality of life. The Chronic Otitis Media Questionnaire-12, Mexican version (COMQ-12-Mx), allows a validated assessment of this impact in the Mexican population. Objective The main objective of this study is to evaluate the effect of surgical treatment on quality of life and auditory function in patients with COMC, using the COMQ-12-Mx. Material and methods A prospective cohort study was conducted at the University Center of Otolaryngology and Head and Neck Surgery, "Dr. José Eleuterio González" University Hospital, Monterrey, Mexico, from May to October 2025. Twenty-five adults with clinically and radiologically confirmed COMC were included. The COMQ-12-Mx and audiometric tests were applied before and three months after surgery. Results Twenty-five affected ears were analyzed (median age 47 years; 56% female). The most frequent comorbidities were type 2 diabetes (32%), bilateral chronic otitis media (28%), and hypertension (16%). Main symptoms included tinnitus (68%), otalgia (64%), and otorrhea (64%). The attic-antral region was most commonly involved (68%). Simple mastoidectomy (76%) and type III tympanoplasty (78.6%) were the predominant techniques. Postoperative complications occurred in 24%, mainly graft perforation (16%). The pure-tone average (PTA) showed a trend toward improvement (48 dB preoperative vs 42 dB postoperative; p = 0.059). Total COMQ-12-Mx scores significantly decreased (29 vs 21; p < 0.001), with improvement across all subdomains and a large effect size (r = 0.87). Both canal wall up (CWU) and endoscopic techniques improved global scores, while only CWU showed significant PTA improvement (p = 0.041). Conclusions Surgery for COMC was associated with within-group improvement in quality of life, particularly in symptoms and emotional impact. The COMQ-12-Mx adequately detected postoperative changes and served as a reliable tool to assess clinical and functional outcomes after surgical treatment.

Extraskeletal chondroma, also known as soft tissue chondroma, is a benign cartilaginous tumor most commonly found in the hands and feet. The occurrence of extraskeletal chondroma in the external auditory canal is extremely rare. We report the first case of extraskeletal chondroma arising in the left middle ear. A 68-year-old female was referred to our department with a diagnosis of a left external - middle ear tumor accompanied by left-sided hearing loss. Otoscopic examination revealed a mass contacting the posterior surface of the anterosuperior quadrant of the tympanic membrane, protruding outward into the external ear canal. Computed tomography imaging demonstrated a soft tissue mass occupying the attic and tympanic cavity, extending into the external ear canal, without evidence of ossicular or bony erosion. The tumor was removed surgically using transcanal endoscopic ear surgery under general anesthesia. In addition to the prominent mass observed from the external ear canal, several smaller white and translucent tumors were identified deeper within the tympanic cavity and were meticulously removed individually. Careful monitoring may be appropriate in asymptomatic cases because malignant transformation of extraskeletal chondroma is rare. While recurrence of chondromas in the external auditory canal has not been reported, recurrence and malignant transformation have been observed in other anatomical sites. Therefore, long-term follow-up is necessary to monitor for potential recurrence or pathological progression.