One-stage coclear implantation via a facial recess approach in children with otitis media with effusion

Objective:To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME). Material and methods:This is a retrospective review of records of 24children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital, using one-stage implantation via the facial recess approach and round window insertion. The incus was removed in 8 cases during the implantation procedure. Local infiltration of dexamethasone and adrenaline in the middle ear was also performed. Postoperative complications were examined. Preoperative and postoperative questionnaires including Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Meaningful Auditory Integration Scale (MAIS) were collected. Results: All electrodes were implanted successfully without any immediate or delayed complications. Inflammatory changes of middle ear mucosa with effusion were noted in all implanted ears. The scores of post-implant CAP and SIR increased significantly in all 24 cases (t ? ?25.95 and ?14.09, respectively for CAP and SIR, p<0.05). Conclusions:One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME, as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI. Copyright ? 2015, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Predicting a novel pathogenicity island in Helicobacter pylori by genomic barcoding

AIM:To apply a new,integrated technique for visualizing bacterial genomes to identify novel pathogenicity islands in Helicobacter pylori(H.pylori).METHODS:A genomic barcode imaging method(converting frequency matrices to grey-scale levels)was designed to visually distinguish origin-specific genomic regions in H.pylori.The complete genome sequences of the six H.pylori strains published in the National Center for Biotechnological Information prokaryotic genome database were scanned,and compared to the genome barcodes of Escherichia coli(E.coli)O157:H7 strain EDL933 and a random nucleotide sequence.The following criteria were applied to identify potential pathogenicity islands(PAIs):(1)barcode distance distinct from that of the general background;(2)length greater than 10000 continuous base pairs;and(3)containing genes with known virulence-related functions(as determined by PfamScan and Blast2GO).RESULTS:Comparison of the barcode images generated for the 26695,HPAG1,J99,Shi470,G27 and P12 H.pylori genomes with those for the E.coli and random sequence controls revealed that H.pylori genomes contained fewer anomalous regions.Among the H.pylorispecific continuous anomalous regions(longer than 20 kbp in each strain's genome),two fit the criteria for identifying candidate PAIs.The bioinformatic-based functional analyses revealed that one of the two anomalous regions was the known pathogenicity island cag PAI,this finding also served as proof-of-principle for the utility of the genomic barcoding approach for identifying PAIs,and characterized the other as a novel PAI,which was designated as tfs3-PAI.Furthermore,the cag-PAI and tfs3-PAI harbored genes encoding type IV secretion system proteins and were predicted to have potential for functional synergy.CONCLUSION:Genomic barcode imaging represents an effective bioinformatic-based approach for scanning bacterial genomes,such as H.pylori,to identify candidate PAIs.