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Yuan L, Yang R, Deng H. Auricular fistula: a review of its clinical manifestations, genetics, and treatments. J Mol Med (Berl) 2023; 101:1041-1058. [PMID: 37458758 DOI: 10.1007/s00109-023-02343-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
Auricular fistula is a common congenital auricular malformation, characterized as a small opening in the skin and a subcutaneous cyst. It can be classified in different ways according to positions of pits and directions of fistula tracts. The term preauricular fistula and variant type of preauricular fistula (postauricular fistula) are used. Auricular fistula prevalence varies in countries and populations, and its actual prevalence is presently unknown. The most accepted and widely cited theory of auricular fistula etiopathogenesis is an incorrect or incomplete fusion of six auricular hillocks that are mesenchymal proliferations. Auricular fistula can occur either sporadically or genetically. The pattern in inherited cases is thought to be incomplete autosomal dominant, with variable expressions, reduced penetrance, and inapparent gender differences. Auricular fistula has several forms and is reported as being a component of many syndromes. In the field of genetics, currently, there is no related review to comprehensively summarize the genetic basis of auricular fistula and related disorders. This article provides a comprehensive review of auricular fistula, especially congenital preauricular fistula, which accounts for the majority of auricular fistula, by summarizing the clinical manifestations, histological and embryological development, genetics, examinations, and treatments, as well as syndromes with auricular fistula.
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Affiliation(s)
- Lamei Yuan
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Disease Genome Research Center, Central South University, Changsha, 410013, China
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Ruikang Yang
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Disease Genome Research Center, Central South University, Changsha, 410013, China
| | - Hao Deng
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
- Disease Genome Research Center, Central South University, Changsha, 410013, China.
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
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Hsueh HW, Kao HJ, Chao CC, Hsueh SJ, Huang YN, Lin WJ, Su JP, Shy HT, Yeh TY, Lin CC, Kwok PY, Lee NC, Hsieh ST. Identification of an 85-kb Heterozygous 4p Microdeletion With Full Genome Analysis in Autosomal Dominant Charcot-Marie-Tooth Disease. Neurol Genet 2023; 9:e200078. [PMID: 37346931 PMCID: PMC10281236 DOI: 10.1212/nxg.0000000000200078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/06/2023] [Indexed: 06/23/2023]
Abstract
Background and Objectives Charcot-Marie-Tooth disease (CMT) is a syndrome of a hereditary neurodegenerative condition affecting the peripheral nervous system and is a single gene disorder. Deep phenotyping coupled with advanced genetic techniques is critical in discovering new genetic defects of rare genetic disorders such as CMT. Methods We applied multidisciplinary investigations to examine the neurophysiology and nerve pathology in a family that fulfilled the diagnosis of CMT2. When phenotype-guided first-tier genetic tests and whole-exome sequencing did not yield a molecular diagnosis, we conducted full genome analysis by examining phased whole-genome sequencing and whole-genome optical mapping data to search for the causal variation. We then performed a systematic review to compare the reported patients with interstitial microdeletion in the short arm of chromosome 4. Results In this family with CMT2, we reported the discovery of a heterozygous 85-kb microdeletion in the short arm of chromosome 4 (4p16.3)[NC_000004.12:g.1733926_1819031del] spanning 3 genes [TACC3 (intron 6-exon 16), FGFR3 (total deletion), and LETM1 (intron 10-exon14)] that cosegregated with disease phenotypes in family members. The clinical features of peripheral nerve degeneration in our family are distinct from the well-known 4p microdeletion syndrome of Wolf-Hirschhorn syndrome, in which brain involvement is the major phenotype. Discussion In summary, we used the full genome analysis approach to discover a new microdeletion in a family with CMT2. The deleted segment contains 3 genes (TACC3, FGFR3, and LETM1) that likely play a role in the pathogenesis of nerve degeneration.
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Affiliation(s)
- Hsueh Wen Hsueh
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Hsiao-Jung Kao
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Chi-Chao Chao
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Sung-Ju Hsueh
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Yu-Ning Huang
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Wan-Jia Lin
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Jen-Ping Su
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Horng-Tzer Shy
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Ti-Yen Yeh
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Cheng-Chen Lin
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Pui-Yan Kwok
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Ni-Chung Lee
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
| | - Sung-Tsang Hsieh
- From the Department of Neurology (H.W.H., C.-C.C., Y.-N.H., S.-T.H.), Department of Anatomy and Cell Biology (H.W.H., H.-T.S., T.-Y.Y., C.-C.L., S.-T.H.), National Taiwan University College of Medicine; Institute of Biomedical Sciences (H.-J.K., W.-J.L., J.-P.S., P.-Y.K.), Academia Sinica, Taipei; Department of Neurology (S.-J.H.), National Taiwan University Hospital Yunlin Branch; Institute for Human Genetics (P.-Y.K.), Cardiovascular Research Institute, and Department of Dermatology, University of California, San Francisco; and Department of Medical Genetics (N.-C.L.), National Taiwan University Hospital, Taipei
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