Middle ear microbiome differences in indigenous Filipinos with chronic otitis media due to a duplication in the A2ML1 gene

Background:Previously rare A2ML1 variants were identified to confer otitis media susceptibility in an indigenous Filipino community and in otitis-prone US children.The goal of this study is to describe differences in the middle ear microbiome between carriers and non-carriers of an A2ML1 duplication variant that increases risk for chronic otitis media among indigenous Filipinos with poor health care access.Methods:Ear swabs were obtained from 16 indigenous Filipino individuals with chronic otitis media,of whom 11 carry the A2ML1 duplication variant.Ear swabs were submitted for 16S rRNA gene sequencing.Results:Genotype-based differences in microbial richness,structure,and composition were identified,but were not statistically significant.Taxonomic analysis revealed that the relative abundance of the phyla Fusobacteria and Bacteroidetes,and genus Fusobacterium were nominally increased in carriers compared to non-carriers,but were non-significant after correction for multiple testing.We also detected rare bacteria including Oligella that was reported only once in the middle ear.Conclusions:These findings suggest that A2ML1-related otitis media susceptibility may be mediated by changes in the middle ear microbiome.Knowledge of middle ear microbial profiles according to genetic background can be potentially useful for therapeutic and prophylactic interventions for otitis media and can guide public health interventions towards decreasing otitis media prevalence within the indigenous Filipino community.

Otologic and vestibular symptoms in COVID-19:A scoping review

Background:Otologic and vestibular symptoms have been seen in patients confirmed to have COVID-19 disease.Further discussion of these symptoms may provide insight into short-and long-term management for these patients.Objective:The aim of this review was to describe the otologic and vestibular symptoms that present in patients with COVID-19.The primary outcomes of this review were onset,duration and clinical outcomes of these symptoms.Sources of Evidence:Pub Med,APAMed Central,Herdin,CINAHL,Scopus,Springer Link,ProQuest Coronavirus Research Database,and Google Scholar were searched for the articles to be included.Eligibility Criteria:Studies included were those involving adult patients diagnosed with COVID-19 who experienced hearing loss,ear pain,ear discharge,otitis media,vertigo,or tinnitus.Studies were eligible for inclusion if there was a description of the otologic dysfunction,specifically onset,duration,or clinical outcomes.Results:The majority of patients who experienced hearing loss(68%),tinnitus(88%),vertigo/dizziness(30%),ear pain(8%),and discharge(100%)did so within a month of experiencing the typical symptoms of COVID-19.A majority also experienced complete resolution of their symptoms within 2 weeks.Standard treatment for COVID-19 was usually provided but when specific diagnoses are made for these symptoms(e.g.,sudden sensorineural hearing loss,otitis media,vestibular neuritis),they are treated in the same manner as one would for non-COVID-19 cases,in addition to the management for COVID-19.In certain cases,there may be a need for additional work-up to rule out other causes.Conclusions:Otologic and vestibular symptoms were present in COVID-19 patients,majority as part of the systemic nature of the disease.The onset,duration,and course were consistent with the natural history of a systemic viral infection.COVID-19 should be considered in any patient with a new-onset hearing loss,tinnitus,or vertigo/dizziness,even in the absence of infectious or respiratory symptoms.