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Raidt J, Staar BO, Omran H, Ringshausen FC. [Primary ciliary dyskinesia]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2024; 65:545-559. [PMID: 38801438 DOI: 10.1007/s00108-024-01726-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
Primary ciliary dyskinesia (PCD) is a rare genetic disorder with a variable clinical phenotype that is accompanied by reduced motility of the cilia in the respiratory tract and numerous other organs. This leads to various characteristic symptoms and disease manifestations, primarily affecting the lungs (chronic persistent productive cough, bronchiectasis), the nose and paranasal sinuses (chronic persistent rhinitis or rhinosinusitis) as well as the middle ear (chronic otitis media, middle ear effusion). Moreover, PCD is associated with impaired fertility or lateralization defects (situs anomalies, congenital heart defects). The diagnostics of PCD are complex and require a combination of several sophisticated instrument-based diagnostic procedures. Through thorough history taking and evaluation, suspected cases can be comparatively well identified based on typical clinical features and referred to further diagnostics. In recent years, molecular genetic analysis through panel diagnostics or whole exome and whole genome sequencing, has gained in importance as this enables affected individuals to participate in disease-specific and genotype-specific clinical trials. Although the current treatment is purely symptomatic, the earliest possible diagnosis is crucial for connecting patients to specialized PCD centers, which can have a significant impact on the clinical course of the affected individuals.
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Affiliation(s)
- Johanna Raidt
- Klinik für Kinder- und Jugendmedizin, Allgemeine Pädiatrie, Universitätsklinikum Münster, Münster, Deutschland
- European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Deutschland
| | - Ben O Staar
- European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Deutschland
- Klinik für Pneumologie und Infektiologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), Deutsches Zentrum für Lungenforschung (DZL), Hannover, Deutschland
| | - Heymut Omran
- Klinik für Kinder- und Jugendmedizin, Allgemeine Pädiatrie, Universitätsklinikum Münster, Münster, Deutschland
- European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Deutschland
| | - Felix C Ringshausen
- European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Deutschland.
- Klinik für Pneumologie und Infektiologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland.
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), Deutsches Zentrum für Lungenforschung (DZL), Hannover, Deutschland.
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Shen C, Shen Y, Huang W, Zhang A, Zou T, Guo D, Wang H, Wu J, Hu H, Xiang M, Ye B. A novel homozygous RSPH4A variant in a family with primary ciliary dyskinesia and literature review. Front Genet 2024; 15:1364476. [PMID: 38818043 PMCID: PMC11137616 DOI: 10.3389/fgene.2024.1364476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/10/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction: Primary ciliary dyskinesia (PCD) is a rare heterogeneous disease caused by abnormalities in motile cilia. In this case report, we first analyzed the clinical and genetic data of a proband who was suspected of having PCD on the basis of her clinical and radiological findings. Methods: Whole-exome sequencing was performed, and a variant in the RSPH4A gene was identified in the proband. Sanger sequencing was used for validation of RSPH4A variants in the proband, her sister, her daughter and her parents. Finally, the phenotypic features of the patient were analyzed, and the current literature was reviewed to better understand the gene variants in PCD related to hearing loss and the clinical manifestations of the RSPH4A variant in PCD. Results: The chief clinical symptoms of this proband included gradual mixed hearing loss, otitis media, anosmia, sinusitis, recurrent cough and infertility. Her DNA sequencing revealed a novel homozygous T to C transition at position 1321 within exon 3 of RSPH4A according to genetic testing results. This variant had never been reported before. The homozygous variant resulted in an amino acid substitution of tryptophan by arginine at position 441 (p.Trp441Arg). The same variant was also found in the proband's sister, and a heterozygous pathogenic variant was identified among immediate family members, including the proband's daughter and parents. Discussion: A literature review showed that 16 pathogenic variants in RSPH4A have been reported. Hearing loss had only been observed in patients with the RSPH4A (c.921+3_6delAAGT) splice site mutation, and the specific type of hearing loss was not described.
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Affiliation(s)
- Chenling Shen
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Otolaryngology and Head and Neck Surgery, Shanghai Children’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilin Shen
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiyi Huang
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Tianyuan Zou
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Otolaryngology and Head and Neck Surgery, Shanghai Children’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongye Guo
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Wang
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jichang Wu
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haixia Hu
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingliang Xiang
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ye
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Audiology and Speech-Language Pathology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Raidt J, Loges NT, Olbrich H, Wallmeier J, Pennekamp P, Omran H. Primary ciliary dyskinesia. Presse Med 2023; 52:104171. [PMID: 37516247 DOI: 10.1016/j.lpm.2023.104171] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 07/24/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Primary ciliary dyskinesia (PCD, ORPHA:244) is a group of rare genetic disorders characterized by dysfunction of motile cilia. It is phenotypically and genetically heterogeneous, with more than 50 genes involved. Thanks to genetic, clinical, and functional characterization, immense progress has been made in the understanding and diagnosis of PCD. Nevertheless, it is underdiagnosed due to the heterogeneous phenotype and complexity of diagnosis. This review aims to help clinicians navigate this heterogeneous group of diseases. Here, we describe the broad spectrum of phenotypes associated with PCD and address pitfalls and difficult-to-interpret findings to avoid misinterpretation. METHOD Review of literature CONCLUSION: PCD diagnosis is complex and requires integration of history, clinical picture, imaging, functional and structural analysis of motile cilia and, if available, genetic analysis to make a definitive diagnosis. It is critical that we continue to expand our knowledge of this group of rare disorders to improve the identification of PCD patients and to develop evidence-based therapeutic approaches.
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Affiliation(s)
- Johanna Raidt
- Department of General Pediatrics, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Niki Tomas Loges
- Department of General Pediatrics, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Heike Olbrich
- Department of General Pediatrics, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Julia Wallmeier
- Department of General Pediatrics, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Petra Pennekamp
- Department of General Pediatrics, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Heymut Omran
- Department of General Pediatrics, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
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Goutaki M, Lam YT, Alexandru M, Anagiotos A, Armengot M, Boon M, Burgess A, Caversaccio N, Crowley S, Dheyauldeen SAD, Emiralioglu N, Erdem E, van Gogh C, Gunaydin O, Haarman EG, Harris A, Hayn I, Ismail-Koch H, Karadag B, Kempeneers C, Kim S, Lorent N, Ozcelik U, Pioch C, Poirrier ALML, Reula A, Roehmel J, Yiallouros P, Yumusakhuylu AC, Papon JF. Characteristics of Otologic Disease Among Patients With Primary Ciliary Dyskinesia. JAMA Otolaryngol Head Neck Surg 2023; 149:587-596. [PMID: 37166807 PMCID: PMC10176184 DOI: 10.1001/jamaoto.2023.0841] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/17/2023] [Indexed: 05/12/2023]
Abstract
Importance Otologic disease is common among people with primary ciliary dyskinesia (PCD), yet little is known about its spectrum and severity. Objective To characterize otologic disease among participants with PCD using data from the Ear-Nose-Throat Prospective International Cohort. Design, Setting, and Participants This cross-sectional analysis of baseline cohort data from February 2020 through July 2022 included participants from 12 specialized centers in 10 countries. Children and adults with PCD diagnoses; routine ear, nose, and throat examinations; and completed symptom questionnaires at the same visit or within 2 weeks were prospectively included. Exposures Potential risk factors associated with increased risk of ear disease. Main Outcomes and Measures The prevalence and characteristics of patient-reported otologic symptoms and findings from otologic examinations, including potential factors associated with increased risk of ear inflammation and hearing impairment. Results A total of 397 individuals were eligible to participate in this study (median [range] age, 15.2 [0.2-72.4] years; 186 (47%) female). Of the included participants, 204 (51%) reported ear pain, 110 (28%) reported ear discharge, and 183 (46%) reported hearing problems. Adults reported ear pain and hearing problems more frequently when compared with children. Otitis media with effusion-usually bilateral-was the most common otoscopic finding among 121 of 384 (32%) participants. Retracted tympanic membrane and tympanic sclerosis were more commonly seen among adults. Tympanometry was performed for 216 participants and showed pathologic type B results for 114 (53%). Audiometry was performed for 273 participants and showed hearing impairment in at least 1 ear, most commonly mild. Season of visit was the strongest risk factor for problems associated with ear inflammation (autumn vs spring: odds ratio, 2.40; 95% CI, 1.51-3.81) and age 30 years and older for hearing impairment (41-50 years vs ≤10 years: odds ratio, 3.33; 95% CI, 1.12-9.91). Conclusion and Relevance In this cross-sectional study, many people with PCD experienced ear problems, yet frequency varied, highlighting disease expression differences and possible clinical phenotypes. Understanding differences in otologic disease expression and progression during lifetime may inform clinical decisions about follow-up and medical care. Multidisciplinary PCD management should be recommended, including regular otologic assessments for all ages, even without specific complaints.
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Affiliation(s)
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Paediatric Respiratory Medicine, Children’s University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Yin Ting Lam
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Mihaela Alexandru
- Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Hôpital Bicêtre, Service d’ORL, Le Kremlin-Bicêtre, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Andreas Anagiotos
- Department of Otorhinolaryngology, Nicosia General Hospital, Nicosia, Cyprus
| | - Miguel Armengot
- Department of Otorhinolaryngology and Primary Ciliary Dyskinesia Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
- University of Valencia Medical School, Valencia, Spain
| | - Mieke Boon
- Department of Paediatrics, University Hospital, Leuven, Belgium
| | - Andrea Burgess
- Primary Ciliary Dyskinesia Centre, Southampton Children’s Hospital, Southampton NHS Foundation Trust, Southampton, England, United Kingdom
| | - Nathalie Caversaccio
- Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Suzanne Crowley
- Paediatric Department of Allergy and Lung Diseases, Oslo University Hospital, Oslo, Norway
| | - Sinan Ahmed D. Dheyauldeen
- Department of Otorhinolaryngology–Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nagehan Emiralioglu
- Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ela Erdem
- Department of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Christine van Gogh
- Department of Otorhinolaryngology–Head and Neck Surgery, Amsterdam UMC, Amsterdam, the Netherlands
| | - Onder Gunaydin
- Department of Otorhinolaryngology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Eric G. Haarman
- Department of Pediatric Pulmonology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Amanda Harris
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, England, United Kingdom
| | - Isolde Hayn
- Department of Otorhinolaryngology–Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hasnaa Ismail-Koch
- Primary Ciliary Dyskinesia Centre, Southampton Children’s Hospital, Southampton NHS Foundation Trust, Southampton, England, United Kingdom
| | - Bulent Karadag
- Department of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Céline Kempeneers
- Division of Respirology, Department of Pediatrics, University Hospital Liège, Liège, Belgium
| | - Sookyung Kim
- Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Hôpital Bicêtre, Service d’ORL, Le Kremlin-Bicêtre, France
| | - Natalie Lorent
- Department of Respiratory Diseases, University Hospital, Leuven, Belgium
| | - Ugur Ozcelik
- Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Charlotte Pioch
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ana Reula
- Biomedical Sciences Department, CEU-Cardenal Herrera University, Castellón, Spain
- Molecular, Cellular and Genomic Biomedicine Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Jobst Roehmel
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Panayiotis Yiallouros
- University of Cyprus Medical School, Nicosia, Cyprus
- Pediatric Pulmonology Unit, Archbishop Makarios III Hospital, Nicosia, Cyprus
| | | | - Jean-François Papon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Hôpital Bicêtre, Service d’ORL, Le Kremlin-Bicêtre, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
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Hong G, Fu X, Chen X, Zhang L, Han X, Ding S, Liu Z, Bi X, Li W, Chang M, Qiao R, Guo S, Tu H, Chai R. Dyslexia-Related Hearing Loss Occurs Mainly through the Abnormal Spontaneous Electrical Activity of Spiral Ganglion Neurons. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2205754. [PMID: 37068190 DOI: 10.1002/advs.202205754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/25/2023] [Indexed: 06/04/2023]
Abstract
Dyslexia is a reading and spelling disorder due to neurodevelopmental abnormalities and is occasionally found to be accompanied by hearing loss, but the reason for the associated deafness remains unclear. This study finds that knockout of the dyslexia susceptibility 1 candidate 1 gene (Dyx1c1-/- ) in mice, the best gene for studying dyslexia, causes severe hearing loss, and thus it is a good model for studying the mechanism of dyslexia-related hearing loss (DRHL). This work finds that the Dyx1c1 gene is highly expressed in the mouse cochlea and that the spontaneous electrical activity of inner hair cells and type I spiral ganglion neurons is altered in the cochleae of Dyx1c1-/- mice. In addition, primary ciliary dyskinesia-related phenotypes such as situs inversus and disrupted ciliary structure are seen in Dyx1c1-/- mice. In conclusion, this study gives new insights into the mechanism of DRHL in detail and suggests that Dyx1c1 may serve as a potential target for the clinical diagnosis of DRHL.
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Affiliation(s)
- Guodong Hong
- State Key Laboratory of Bioelectronics, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, 210096, Nanjing, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Xiaolong Fu
- State Key Laboratory of Bioelectronics, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, 210096, Nanjing, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Xin Chen
- State Key Laboratory of Bioelectronics, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, 210096, Nanjing, China
| | - Liyan Zhang
- State Key Laboratory of Bioelectronics, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, 210096, Nanjing, China
| | - Xuan Han
- State Key Laboratory of Bioelectronics, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, 210096, Nanjing, China
| | - Shuqin Ding
- State Key Laboratory of Bioelectronics, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, 210096, Nanjing, China
| | - Ziyi Liu
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Xiuli Bi
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Wen Li
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Miao Chang
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Ruifeng Qiao
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Siwei Guo
- School of Life Science, Shandong University, 266237, Qingdao, China
| | - Hailong Tu
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, 250000, Jinan, China
| | - Renjie Chai
- State Key Laboratory of Bioelectronics, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, 210096, Nanjing, China
- Co-Innovation Center of Neuroregeneration, Nantong University, 226001, Nantong, China
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 610072, Chengdu, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Science, 100101, Beijing, China
- Beijing Key Laboratory of Neural Regeneration and Repair, Capital Medical University, 100069, Beijing, China
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Günaydın RÖ, Eroğlu E, Tellioğlu B, Emiralioğlu N, Özçelik HU, Yalçın E, Doğru D, Kiper N. Evaluation of otorhinolaryngological manifestations in patients with primary ciliary dyskinesia. Int J Pediatr Otorhinolaryngol 2023; 168:111520. [PMID: 36990030 DOI: 10.1016/j.ijporl.2023.111520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/19/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Primary ciliary dyskinesia (PCD) is a genetic disease characterized by congenital impairment of mucociliary clearance causing recurrent respiratory tract infections. Pulmonary manifestations of PCD are well-known whereas adequate data on otorhinolaryngological complications is lacking. The aim of this study was to investigate clinical features, course and related factors of otorhinolaryngologic domains in PCD patients. METHODS Patients with a diagnosis of PCD who were on follow-up in the ear-nose-throat (ENT) department of our center between 2000 and 2021 were enrolled. Demographic and clinical data, frequency of sinonasal and otological complaints, examination findings and possible risk factors associated with otorhinolaryngological diseases were obtained via electronic medical charts retrospectively. RESULTS Of the 121 patients, 53% were male, median age at PCD diagnosis was 7 years (1 month - 20 yrs). The most common ENT manifestation was otitis media with effusion (OME) (66.1%, n = 80), followed by acute otitis media (43.8%, n = 53), acute rhinosinusitis (ARS) (28.9%, n = 35), chronic rhinosinusitis (CRS) (27.3%, n = 33) and chronic otitis media (10.7%, n = 13). Patients with ARS and CRS were significantly older than patients who did not have ARS and CRS (p = 0.045 and p = 0.028, respectively). The annual number of ARS attacks also correlated with age of patients positively (r = 0.170, p = 0.06). Of the 45 patients with pure-tone audiometry, most common finding was conductive hearing loss (CHL) in 57,8% (n = 26). Presence of OME significantly increased tympanic membrane injury which was observed as sclerosis, perforation, retraction or changes due to ventilation tube insertion (VTI). (OR: 8.6, 95% CI: 3.6-20.3, p < 0.001). CONCLUSIONS Otorhinolaryngologic diseases are common, variable and complicated in PCD patients, consequently ENT physicians' awareness should be improved through shared experiences. ARS and CRS seem to appear in older PCD patients. Presence of OME is the most important risk factor for tympanic membrane damage.
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Affiliation(s)
- Rıza Önder Günaydın
- Department of Otolaryngology - Head and Neck Surgery, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Ergin Eroğlu
- Department of Otolaryngology - Head and Neck Surgery, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Burçay Tellioğlu
- Department of Otolaryngology - Head and Neck Surgery, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Nagehan Emiralioğlu
- Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Hayriye Uğur Özçelik
- Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Ebru Yalçın
- Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Deniz Doğru
- Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Nurol Kiper
- Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey.
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7
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Alexandru M, de Boissieu P, Benoudiba F, Moustarhfir M, Kim S, Bequignon É, Honoré I, Garcia G, Mitri-Frangieh R, Legendre M, Crestani B, Taillé C, Escudier E, Maitre B, Papon JF, Nevoux J. Otological Manifestations in Adults with Primary Ciliary Dyskinesia: A Controlled Radio-Clinical Study. J Clin Med 2022; 11:jcm11175163. [PMID: 36079093 PMCID: PMC9456589 DOI: 10.3390/jcm11175163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 12/05/2022] Open
Abstract
Primary ciliary dyskinesia (PCD) is a rare genetical disease characterized by an abnormal structure or function of the cilia, causing sinusitis, otitis, and bronchiectasis. Hearing loss affects 60% of PCD patients, but data are lacking concerning hearing and temporal bone imaging in adults. Our aim was to describe clinical and radiological ear disease in adults with genetically confirmed PCD. Data were recorded from January 2018 to December 2019. PCD patients were compared with controls with bronchiectasis without PCD. Clinical examination included otomicroscopy and auditory tests. A temporal bone CT scan (TBCT) was systematically performed. Seventeen patients (34 ears) were included in each group. The eardrums were abnormal in 25 (74%) PCD ears versus 8 (24%) ears in the controls (p < 0.05). Conductive hearing loss was more frequent in the PCD group (24% vs. 12% in controls). TBCT were abnormal in 94% PCD patients vs. 32% in the controls (p < 0.05). The Main CT-scan images in PCD were middle ear inflammation (65%), mastoid condensation (62%), or ossicular anomalies (35%). With its excellent sensitivity, TBCT gives typical arguments for PCD diagnosis, adding otological signs to the usual sinus CT signs (hypoplasia, aplasia). Systematic TBCT could be useful in the initial evaluation of patients with suspicion of PCD.
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Affiliation(s)
- Mihaela Alexandru
- ENT Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
- Correspondence: ; Tel.: +33-145-213-688
| | - Paul de Boissieu
- Epidemiology and Public Health Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
| | - Farida Benoudiba
- Diagnostic Neuroradiology Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
| | - Malik Moustarhfir
- Diagnostic Neuroradiology Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
| | - Sookyung Kim
- ENT Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
| | - Émilie Bequignon
- ENT Department, Henri Mondor Hospital, Intercommuncal Hospital of Créteil, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Est University, 94010 Créteil, France
- Mondor Institute of Biomedical Research INSERM-UPEC UMR 955, CNRS ERL7000, 94010 Créteil, France
| | - Isabelle Honoré
- Pneumology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 75014 Paris, France
| | - Gilles Garcia
- Pneumology Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
| | - Rana Mitri-Frangieh
- Department of Anatomy and Cytology Pathology, Intercommuncal Hospital of Créteil, 94010 Créteil, France
| | - Marie Legendre
- Molecular Genetics Functional Unit, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, 75012 Paris, France
- INSERM, UMR-S933 Genetic Diseases of Pediatric Expression, Sorbonne University, 75005 Paris, France
| | - Bruno Crestani
- Rare Pulmonary Diseases (FHU APOLLO) Pneumology A Department, Bichat Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 75877 Paris, France
- Laboratory of Excellence Inflamex, 75013 Paris, France
- INSERM U1152, Paris Cité University, 75018 Paris, France
| | - Camille Taillé
- Rare Pulmonary Diseases (FHU APOLLO) Pneumology A Department, Bichat Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 75877 Paris, France
- INSERM U1152, Paris Cité University, 75018 Paris, France
- INSERM 12, F-CRIN, Clinical Research Initiative in Severe Asthma: A Lever for Innovation & Science (CRISALIS), 31059 Toulouse, France
| | - Estelle Escudier
- Molecular Genetics Functional Unit, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, 75012 Paris, France
- INSERM, UMR-S933 Genetic Diseases of Pediatric Expression, Sorbonne University, 75005 Paris, France
| | - Bernard Maitre
- Mondor Institute of Biomedical Research INSERM-UPEC UMR 955, CNRS ERL7000, 94010 Créteil, France
- Pneumology Department, Henri Mondor Hospital, Intercommuncal Hospital of Créteil, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Est University, 94010 Créteil, France
| | - Jean-François Papon
- ENT Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
- Mondor Institute of Biomedical Research INSERM-UPEC UMR 955, CNRS ERL7000, 94010 Créteil, France
| | - Jérôme Nevoux
- ENT Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
- INSERM, U1120, Pasteur Institute, 75724 Paris, France
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Kos R, Israëls J, Gogh CDL, Altenburg J, Diepenhorst S, Paff T, Boon EMJ, Micha D, Pals G, Neerincx AH, Maitland‐van der Zee AH, Haarman EG. Primary ciliary dyskinesia in Volendam: Diagnostic and phenotypic features in patients with a
CCDC114
mutation. AMERICAN JOURNAL OF MEDICAL GENETICS PART C: SEMINARS IN MEDICAL GENETICS 2022; 190:89-101. [PMID: 35343062 PMCID: PMC9314105 DOI: 10.1002/ajmg.c.31968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/07/2022] [Accepted: 03/17/2022] [Indexed: 11/20/2022]
Abstract
Primary ciliary dyskinesia (PCD) is a heterogeneous disease, with impaired mucociliary clearance causing respiratory tract infections. A founding CCDC114 mutation has led to a relatively homogeneous and large Dutch PCD population in Volendam. Our aim was to describe their phenotype. Therefore, all Volendam PCD patients seen at the Amsterdam UMC were included in this study. Data were collected on lung function, microbiology, radiology, and ear‐nose‐throat (ENT) symptoms. A mixed effects model estimated lung function decline in %point per year (95% confidence interval [CI]). Thirty‐three (60%) out of approximately 56 Volendam PCD patients were treated at our center and included in this study. Only 30% of patients had situs inversus. FEV1 declined in children (−1.43%/year, CI: −1.80/−1.05), but not in adults (0.01%/year, CI: −0.36/0.38). Pseudomonas aeruginosa was cultured in 21% of children and 60% of adults, respectively. Patients who have been infected at some point with P. aeruginosa had a steeper decline in FEV1 as compared to patients that have never been infected. Neonatal symptoms (79%) and ENT problems (94%) were common; fertility issues however, were not (11%) common. Compared to other PCD cohorts, the Volendam/CCDC114 patients have a moderately severe phenotype with lung function decline predominantly occurring in childhood.
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Affiliation(s)
- Renate Kos
- Department of Respiratory Medicine Amsterdam University Medical Centers – locatie AMC Amsterdam The Netherlands
| | - Joël Israëls
- Department of Pediatric Respiratory Medicine and Allergy Emma Children's Hospital, Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Christine D. L. Gogh
- Department of Otolaryngology, Head and Neck Surgery Amsterdam University Medical Centers – locatie VUmc Amsterdam The Netherlands
| | - Josje Altenburg
- Department of Respiratory Medicine Amsterdam University Medical Centers – locatie AMC Amsterdam The Netherlands
| | - Sandra Diepenhorst
- Department of Pediatric Respiratory Medicine and Allergy Emma Children's Hospital, Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Tamara Paff
- Department of Pediatric Respiratory Medicine and Allergy Emma Children's Hospital, Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Elles M. J. Boon
- Department of Human Genetics Amsterdam University Medical Centers – locatie VUmc Amsterdam The Netherlands
| | - Dimitra Micha
- Department of Human Genetics Amsterdam University Medical Centers – locatie VUmc Amsterdam The Netherlands
| | - Gerard Pals
- Department of Human Genetics Amsterdam University Medical Centers – locatie VUmc Amsterdam The Netherlands
| | - Anne H. Neerincx
- Department of Respiratory Medicine Amsterdam University Medical Centers – locatie AMC Amsterdam The Netherlands
| | - Anke H. Maitland‐van der Zee
- Department of Respiratory Medicine Amsterdam University Medical Centers – locatie AMC Amsterdam The Netherlands
- Department of Pediatric Respiratory Medicine and Allergy Emma Children's Hospital, Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Eric G. Haarman
- Department of Pediatric Respiratory Medicine and Allergy Emma Children's Hospital, Amsterdam University Medical Centers Amsterdam The Netherlands
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Goutaki M, Hüsler L, Lam YT, Koppe HM, Jung A, Lazor R, Müller L, Pedersen ESL, Kuehni CE. Respiratory symptoms of Swiss people with Primary Ciliary Dyskinesia. ERJ Open Res 2022; 8:00673-2021. [PMID: 35415187 PMCID: PMC8995537 DOI: 10.1183/23120541.00673-2021] [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: 11/29/2021] [Accepted: 02/06/2022] [Indexed: 11/08/2022] Open
Abstract
Background Mostly derived from chart reviews, where symptoms are recorded in a nonstandardised manner, clinical data about primary ciliary dyskinesia (PCD) are inconsistent, which leads to missing and unreliable information. We assessed the prevalence and frequency of respiratory and ear symptoms and studied differences by age and sex among an unselected population of Swiss people with PCD. Methods We sent a questionnaire that included items from the FOLLOW-PCD standardised questionnaire to all Swiss PCD registry participants. Results We received questionnaires from 74 (86%) out of 86 invited persons or their caregivers (median age 23 years, range 3–73 years), including 68% adults (≥18 years) and 51% females. Among participants, 70 (94%) reported chronic nasal symptoms; most frequently runny nose (65%), blocked nose (55%) or anosmia (38%). Ear pain and hearing problems were reported by 58% of the participants. Almost all (99%) reported cough and sputum production. The most common chronic cough complications were gastro-oesophageal reflux (n=11; 15%), vomiting (n=8; 11%) and urinary incontinence (n=6; 8%). Only nine (12%) participants reported frequent wheeze, which occurred mainly during infection or exercise, while 49 (66%) reported shortness of breath, and 9% even at rest or during daily activities. Older patients reported more frequent nasal symptoms and shortness of breath. We found no difference by sex or ultrastructural ciliary defect. Conclusion This is the first study to describe patient-reported PCD symptoms. The consistent collection of standardised clinical data will allow us to better characterise the phenotypic variability of the disease and study disease course and prognosis. Detailed information about patient-reported PCD symptoms will help characterise the phenotypic variability of the disease and could inform the development of individualised treatment strategies for patientshttps://bit.ly/363Zb4T
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11
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Melo SCSD, Vieira FS. Critérios para a classificação do grau da perda auditiva e proteção social de pessoas com essa deficiência. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222437321s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivos: identificar critérios adotados nacional e internacionalmente para classificação do grau da perda auditiva, compará-los com o estabelecido na legislação brasileira e discutir as possíveis consequências dessa legislação para a proteção social de Pessoas com Deficiência (PcD) auditiva. Métodos: realizou-se uma revisão narrativa para a identificação dos critérios utilizados nessa classificação. A busca foi realizada em abril de 2020, a partir das plataformas BVS e PUBMED. Foram incluídos estudos publicados entre 2015 e 2019, em inglês, espanhol e português, sobre pesquisas primárias realizadas com seres humanos e menção explícita aos critérios utilizados para a classificação do grau da perda auditiva. Revisão da Literatura: observou-se que há uma predileção pela média entre as frequências de 0,5, 1, 2 e 4 kHz. A legislação brasileira não segue esse critério, o que pode ser uma barreira para o acesso das PcD auditiva aos programas de proteção social. Considerações Finais: não há consenso sobre qual é o melhor critério, todavia há predominância de utilização do considerado mais abrangente para a avaliação auditiva, que não é o legalmente adotado no Brasil. É necessário um debate sobre o critério legal brasileiro, a fim de promover os direitos sociais instituídos para parte das PcD auditiva no Brasil.
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Affiliation(s)
| | - Fabiola Sulpino Vieira
- Universidade Federal de Pernambuco, Brazil; Instituto de Pesquisa Econômica Aplicada, Brasil
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12
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Melo SCSD, Vieira FS. Criteria to classify degrees of hearing loss and the social protection of people with this disability. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222437321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Purpose: to identify criteria used nationally and internationally to classify degrees of hearing loss, compare them with what is established in the Brazilian law, and discuss possible consequences of such a law on the social protection of people with hearing loss. Methods: a narrative review was conducted to identify the criteria used in this classification, by searching the platforms VHL and PubMed in April 2020. It included primary human research explicitly mentioning the criteria used to classify the degree of hearing loss, published between 2015 and 2019 in English, Spanish, and Portuguese. Literature Review: there is a preference for the four-frequency mean at 0.5, 1, 2, and 4 kHz. The Brazilian law does not follow these criteria, which may pose a barrier to people with hearing loss, hindering their access to social protection programs. Final Considerations: there is no consensus on the best criteria, although the most encompassing ones in hearing assessment predominate - which are not the ones legally used in Brazil. It is necessary to debate the Brazilian legal criteria to ensure existing social rights to part of people with hearing loss in Brazil.
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Affiliation(s)
| | - Fabiola Sulpino Vieira
- Universidade Federal de Pernambuco, Brazil; Instituto de Pesquisa Econômica Aplicada, Brasil
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13
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Hyland RM, Brody SL. Impact of Motile Ciliopathies on Human Development and Clinical Consequences in the Newborn. Cells 2021; 11:125. [PMID: 35011687 PMCID: PMC8750550 DOI: 10.3390/cells11010125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 12/12/2022] Open
Abstract
Motile cilia are hairlike organelles that project outward from a tissue-restricted subset of cells to direct fluid flow. During human development motile cilia guide determination of the left-right axis in the embryo, and in the fetal and neonatal periods they have essential roles in airway clearance in the respiratory tract and regulating cerebral spinal fluid flow in the brain. Dysregulation of motile cilia is best understood through the lens of the genetic disorder primary ciliary dyskinesia (PCD). PCD encompasses all genetic motile ciliopathies resulting from over 60 known genetic mutations and has a unique but often underrecognized neonatal presentation. Neonatal respiratory distress is now known to occur in the majority of patients with PCD, laterality defects are common, and very rarely brain ventricle enlargement occurs. The developmental function of motile cilia and the effect and pathophysiology of motile ciliopathies are incompletely understood in humans. In this review, we will examine the current understanding of the role of motile cilia in human development and clinical considerations when assessing the newborn for suspected motile ciliopathies.
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Affiliation(s)
- Rachael M. Hyland
- Department of Pediatrics, Division of Newborn Medicine, Washington University in Saint Louis School of Medicine, Saint Louis, MO 63110,USA;
| | - Steven L. Brody
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University in Saint Louis School of Medicine, Saint Louis, MO 63110, USA
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14
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Goutaki M, Lam YT, Alexandru M, Anagiotos A, Armengot M, Bequignon E, Boon M, Burgess A, Coste A, Emiralioglu N, Erdem E, Haarman EG, Harris A, Hool SL, Karadag B, Kim S, Latzin P, Lorent N, Ozcelik U, Reula A, Roehmel J, van Gogh C, Yiallouros P, Zappe SM, Papon JF. Study protocol: the ear-nose-throat (ENT) prospective international cohort of patients with primary ciliary dyskinesia (EPIC-PCD). BMJ Open 2021; 11:e051433. [PMID: 34635525 PMCID: PMC8506890 DOI: 10.1136/bmjopen-2021-051433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Primary ciliary dyskinesia (PCD) is a rare, genetic, multiorgan disease with an estimated prevalence of 1 in 10 000. It affects mainly the upper and lower airways due to impaired mucociliary clearance. Almost all patients have sinonasal or otologic (ear-nose-throat, ENT) problems, although the ENT clinical phenotype may present great variability. Despite that, data on PCD ENT manifestations are scarce and based on small single-centre studies. To date, we know little about the spectrum and severity of PCD ENT disease, its association with lung disease, its course over life and its determinants of prognosis.This study protocol describes the aims and methods of the first prospective, observational, multinational cohort study focusing on ENT disease in patients with PCD. METHODS AND ANALYSIS The ENT prospective international cohort of patients with PCD (EPIC-PCD) is a prospective standardised observational clinical cohort set up as a multinational multicentre study, embedded into routine patient care. It aims to longitudinally characterise ENT disease in patients with PCD and its association with lung disease, and to identify determinants of its prognosis. Patients of all ages, diagnosed with PCD who undergo an ENT clinical assessment at least once a year at one of the participating centres will be invited to participate. Collected data include diagnostic test results, results of ENT examinations, lung function measurements, information on management of ENT disease and patient-reported data on clinical symptoms and health-related quality of life (QoL). Data are collected using the standardised PCD-specific FOLLOW-PCD form and the validated QoL-PCD questionnaire. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Human Research Ethics Committees at all participating centres, based on local legislation. The results of the study will be published in scientific journals, presented at scientific conferences and disseminated to participants and national patient organisations. TRIAL REGISTRATION NCT04611516.
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Affiliation(s)
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Yin Ting Lam
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Mihaela Alexandru
- Hôpital Kremlin-Bicetre, Service d'ORL et de Chirurgie Cervico-Faciale, AP-HP, Paris, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, Paris, France
| | - Andreas Anagiotos
- Department of Otorhinolaryngology, Nicosia General Hospital, Nicosia, Cyprus
| | - Miguel Armengot
- Department of Otorhinolaryngology, and Primary Ciliary Dyskinesia Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
- Medical School, University of Valencia, Valencia, Spain
| | - Emilie Bequignon
- Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, AP-HP, Creteil, France
| | - Mieke Boon
- Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Andrea Burgess
- Primary Ciliary Dyskinesia Centre, Southampton Children's Hospital, Southampton NHS Foundation Trust, Southampton, UK
| | - Andre Coste
- Hôpital Henri Mondor et Centre Hospitalier Intercommunal de Créteil, Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, AP-HP, Creteil, France
- Faculté de médecine, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Hôpital Henri Mondor, Université Paris-Est Créteil Val de Marne, Creteil, France
| | - Nagehan Emiralioglu
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ela Erdem
- Department of Pediatric Pulmonology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Eric G Haarman
- Department of Paediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amanda Harris
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sara-Lynn Hool
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Bulent Karadag
- Department of Pediatric Pulmonology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Sookyung Kim
- Hôpital Kremlin-Bicetre, Service d'ORL et de Chirurgie Cervico-Faciale, AP-HP, Paris, France
| | - Philipp Latzin
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Natalie Lorent
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Ugur Ozcelik
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ana Reula
- Biomedical Sciences Department, CEU Cardenal Herrera University, Castellón, Spain
- Molecular, Cellular and Genomic Biomedicine Group, IIS La Fe, Valencia, Spain
| | - Jobst Roehmel
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christine van Gogh
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Panayiotis Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus
- Pediatric Pulmonology Unit, Hospital 'Archbishop Makarios III', Nicosia, Cyprus
| | - Soeren Marian Zappe
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jean Francois Papon
- Hôpital Kremlin-Bicetre, Service d'ORL et de Chirurgie Cervico-Faciale, AP-HP, Paris, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, Paris, France
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Current and Future Treatments in Primary Ciliary Dyskinesia. Int J Mol Sci 2021; 22:ijms22189834. [PMID: 34575997 PMCID: PMC8470068 DOI: 10.3390/ijms22189834] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 01/05/2023] Open
Abstract
Primary ciliary dyskinesia (PCD) is a rare genetic ciliopathy in which mucociliary clearance is disturbed by the abnormal motion of cilia or there is a severe reduction in the generation of multiple motile cilia. Lung damage ensues due to recurrent airway infections, sometimes even resulting in respiratory failure. So far, no causative treatment is available and treatment efforts are primarily aimed at improving mucociliary clearance and early treatment of bacterial airway infections. Treatment guidelines are largely based on cystic fibrosis (CF) guidelines, as few studies have been performed on PCD. In this review, we give a detailed overview of the clinical studies performed investigating PCD to date, including three trials and several case reports. In addition, we explore precision medicine approaches in PCD, including gene therapy, mRNA transcript and read-through therapy.
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Pennington JW, Ruth B, Miller JM, Peterson J, Xu B, Masino A, Krantz I, Manganella J, Gomes T, Stiles D, Kenna M, Hood LJ, Germiller J, Crenshaw EB. Perspective on the Development of a Large-Scale Clinical Data Repository for Pediatric Hearing Research. Ear Hear 2021; 41:231-238. [PMID: 31408044 PMCID: PMC7007829 DOI: 10.1097/aud.0000000000000779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The use of "big data" for pediatric hearing research requires new approaches to both data collection and research methods. The widespread deployment of electronic health record systems creates new opportunities and corresponding challenges in the secondary use of large volumes of audiological and medical data. Opportunities include cost-effective hypothesis generation, rapid cohort expansion for rare conditions, and observational studies based on sample sizes in the thousands to tens of thousands. Challenges include finding and forming appropriately skilled teams, access to data, data quality assessment, and engagement with a research community new to big data. The authors share their experience and perspective on the work required to build and validate a pediatric hearing research database that integrates clinical data for over 185,000 patients from the electronic health record systems of three major academic medical centers.
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Affiliation(s)
- Jeffrey W. Pennington
- Department of Biomedical and Health Informatics, The Children’s Hospital Of Philadelphia, Philadelphia, PA, USA
| | - Byron Ruth
- Department of Biomedical and Health Informatics, The Children’s Hospital Of Philadelphia, Philadelphia, PA, USA
| | - Jeffrey M. Miller
- Department of Biomedical and Health Informatics, The Children’s Hospital Of Philadelphia, Philadelphia, PA, USA
| | - Joy Peterson
- Center for Childhood Communication, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Baichen Xu
- Center for Childhood Communication, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Aaron Masino
- Department of Biomedical and Health Informatics, The Children’s Hospital Of Philadelphia, Philadelphia, PA, USA
| | - Ian Krantz
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Juliana Manganella
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Tamar Gomes
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Derek Stiles
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Margaret Kenna
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Linda J. Hood
- Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University, Nashville, TN, USA
| | - John Germiller
- Division of Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Otorhinolaryngology: Head and Neck Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - E. Bryan Crenshaw
- Center for Childhood Communication, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Otorhinolaryngology: Head and Neck Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Understanding Primary Ciliary Dyskinesia and Other Ciliopathies. J Pediatr 2021; 230:15-22.e1. [PMID: 33242470 PMCID: PMC8690631 DOI: 10.1016/j.jpeds.2020.11.040] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022]
Abstract
Ciliopathies are a collection of disorders related to cilia dysfunction. Cilia are specialized organelles that project from the surface of most cells. Motile and primary (sensory) cilia are essential structures and have wide ranging functions. Our understanding of the genetics, pathophysiology, and clinical manifestations of motile ciliopathies, including primary ciliary dyskinesia (PCD), has rapidly advanced since the disease was linked to ciliary ultrastructural defects nearly five decades ago. We will provide an overview of different types of cilia, their role in child health and disease, focusing on motile ciliopathies, and describe recent advances that have led to improved diagnostics and may yield therapeutic targets to restore ciliary structure and function.
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Hamberis AO, Mehta CH, Valente TA, Dornhoffer JR, Nguyen SA, Meyer TA. The pattern and progression of hearing loss in Marfan Syndrome: A study of children and young adults. Int J Pediatr Otorhinolaryngol 2020; 138:110207. [PMID: 32795729 DOI: 10.1016/j.ijporl.2020.110207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVE (s): To describe the prevalence, type, severity, and progression of hearing loss (HL) in children and young adults with Marfan Syndrome (MFS), and to evaluate the influence of comorbidities on HL. STUDY DESIGN Retrospective database analysis. RESULTS Of 70 patients with MFS, 52.8% (N = 37) had HL. Within the HL group, 75.7% (N = 28) had bilateral HL, while 24.3% (N = 9) had unilateral HL. 21.4% (N = 15) had moderate or more severe HL. The overall prevalence of CHL was 40.5% (N = 15), SNHL 13.5% (N = 5), and mixed HL 37.8% (N = 14). The mean initial age of HL was 8.4 years (range 0.8-24.0). HL was more prevalent in patients with MFS who also experienced chronic otitis media (ES 1.00, 95% CI, 0.32-1.68) and skull anomalies (ES 0.75, 95% CI, 0.07-1.44) as well as for patients with hypertension (ES 2.17, 95% CI, -1.29-5.64). CONCLUSIONS Children and young adults with Marfan syndrome have a high likelihood of hearing loss, with high rates of CHL, chronic otitis media, and Eustachian tube dysfunction. SNHL is also prevalent in this syndrome; hypertension increased the likelihood of SNHL. Early audiologic screening is needed to ascertain type of HL and to efficiently direct patient care in this population.
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Affiliation(s)
- Alexandra O Hamberis
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, USA.
| | - Charmee H Mehta
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, USA
| | - Thomas A Valente
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, USA
| | - James R Dornhoffer
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, USA
| | - Ted A Meyer
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, USA
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Abstract
Motile cilia are highly complex hair-like organelles of epithelial cells lining the surface of various organ systems. Genetic mutations (usually with autosomal recessive inheritance) that impair ciliary beating cause a variety of motile ciliopathies, a heterogeneous group of rare disorders. The pathogenetic mechanisms, clinical symptoms and severity of the disease depend on the specific affected genes and the tissues in which they are expressed. Defects in the ependymal cilia can result in hydrocephalus, defects in the cilia in the fallopian tubes or in sperm flagella can cause female and male subfertility, respectively, and malfunctional motile monocilia of the left-right organizer during early embryonic development can lead to laterality defects such as situs inversus and heterotaxy. If mucociliary clearance in the respiratory epithelium is severely impaired, the disorder is referred to as primary ciliary dyskinesia, the most common motile ciliopathy. No single test can confirm a diagnosis of motile ciliopathy, which is based on a combination of tests including nasal nitric oxide measurement, transmission electron microscopy, immunofluorescence and genetic analyses, and high-speed video microscopy. With the exception of azithromycin, there is no evidence-based treatment for primary ciliary dyskinesia; therapies aim at relieving symptoms and reducing the effects of reduced ciliary motility.
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Abstract
OBJECTIVE Characterize relations between vitamin D deficiency (VDD), hypocalcemia, and hearing loss (HL) in children. STUDY DESIGN Retrospective review. SETTING Tertiary referral hospital. PATIENTS Children in the Audiological and Genetic Database with a diagnosis of VDD, rickets, or osteomalacia. INTERVENTION None. MAIN OUTCOME MEASURES Prevalence, type, severity (4-tone pure-tone average, PTA), and progression of HL. HL was defined as greater than 15 dB HL at any threshold by pure tone, greater than 20 dB HL by sound field audiometry, or greater than 25 dB in infants less than 1 year of age. RESULTS Of 888 children with VDD, 474 (53.4%) had HL, with 17% having moderate-profound HL. Compared with an age-matched cohort of 13,320 children drawn from the same database, children with VDD were significantly more likely to have sensorineural HL (SNHL) (adjusted odds ratios [aOR] 1.26 [95% confidence interval [CI] 1.01-1.58]). Among children with VDD, children with femur fracture had a significantly higher rate of HL (81% versus 53%, p = 0.008) and children with hypocalcemia had a significantly higher rate of moderate-profound HL (36% versus 18%, p = 0.016). Additionally, hypocalcemia with and without VDD was associated with SNHL (aOR 2.30 [1.07-4.56]). CONCLUSIONS Both vitamin D deficiency and hypocalcemia were found to be independently associated with SNHL, a type of HL that is less likely to improve over time. Recognition of VDD and hypocalcemia as independent risk factors for the development of SNHL could allow for better evaluation and treatment of this patient population. Routine audiological evaluation should be considered in this population.
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Lee JA, Mehta CH, Nguyen SA, Meyer TA. Hearing outcomes in children of diabetic pregnancies. Int J Pediatr Otorhinolaryngol 2020; 132:109925. [PMID: 32035347 DOI: 10.1016/j.ijporl.2020.109925] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Children of diabetic pregnancies (CDPs) face numerous risk factors for hearing loss (HL). The objective of this study was to investigate the hearing outcomes of CDPs on a population scale. METHODS Using the Audiological and Genetic Database, the prevalence, severity, and progression of HL in CDPs was compared against children of non-diabetic pregnancies (CNDPs) who served as controls. RESULTS Among 311 CDPs, 71.1% demonstrated evidence of HL compared to 45.5% in CNDPs (p < 0.001). The mean age at which CDPs received audiograms was 3.6 years compared to 5.4 years for CNDPs (p < 0.001). Compared to CNDPs, CDPs were similarly affected by common otologic conditions such as acute otitis media (25.7%), chronic otitis media (38.3%), and Eustachian tube dysfunction (41.8%) (all p > 0.05). CDPs were more likely to have bilateral HL (81%) and sensorineural hearing loss (SNHL) (8%) relative to CNDPs (p < 0.001 and p = 0.004, respectively). Rates of conductive HL and mixed HL were not significantly different between groups (p = 0.952 and p = 0.058, respectively). CDPs were at significant risk for the development of HL (aOR 1.66 [1.28-2.17], SNHL (aOR 1.63 [1.01-2.52], and high-frequency HL (aOR 1.32 [1.03-1.68]). Of the comorbidities evaluated, CDPs with hyperbilirubinemia (aOR 1.85 [1.18-2.84]), perinatal asphyxia (aOR 1.90 [1.06-3.16]), or congenital heart disease (aOR 1.21 [1.07-1.37]) demonstrated higher risk of SNHL. CONCLUSION Children of diabetic pregnancies face increased risks of developing HL, particularly bilateral and sensorineural hearing loss. Given these findings, we recommend close audiologic follow-up for these children, especially those with complicated birth histories or additional medical problems.
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Affiliation(s)
- Joshua A Lee
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
| | - Charmee H Mehta
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Shaun A Nguyen
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Ted A Meyer
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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Abstract
OBJECTIVE To characterize the relation between protein-calorie malnutrition (PCM) and hearing loss (HL) in children. STUDY DESIGN Retrospective review. SETTING Tertiary referral hospital. PATIENTS Children in the Audiological and Genetic Database with a diagnosis of protein-calorie malnutrition, marasmus, and/or kwashiorkor. INTERVENTIONS None. MAIN OUTCOME MEASURES Prevalence, type, severity (4-tone pure-tone average, PTA), and progression of HL. RESULTS Of 770 children with PCM, 57.8% had HL, compared to 45.5% of children without PCM (p < 0.001). Severely malnourished children had significantly higher odds of moderate-profound HL (aOR 2.27, 95% CI 1.47-3.43), high-frequency HL (aOR 1.82, 95% CI 1.21-2.75), and sensorineural or mixed HL (aOR 1.60, 95% CI 1.05-2.41) compared to children without PCM. Severely malnourished children had significantly worse initial (35.0 dB vs 25.0 dB, p < 0.001), and final median PTA (31.3 dB vs 20.0 dB, p < 0.001) compared to children without PCM. Additionally, HL in children who were moderately and severely malnourished was significantly less likely to improve (aOR 0.47, 95% CI 0.25-0.82 and aOR 0.4, 95% CI 0.2-0.9) when compared to those without PCM. CONCLUSIONS Given the greater prevalence and severity of hearing loss, children with PCM should be considered an at-risk group for poor audiological outcomes, and clinical practice should focus on early treatment and intervention for malnourished children. Routine audiological evaluation should be considered in this population.
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Hamberis AO, Mehta CH, Dornhoffer JR, Meyer TA. Characteristics and progression of hearing loss in children with turner's syndrome. Laryngoscope 2019; 130:1540-1546. [DOI: 10.1002/lary.28264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/23/2019] [Accepted: 08/12/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Alexandra O. Hamberis
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
| | - Charmee H. Mehta
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
| | - James R. Dornhoffer
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
| | - Ted Albert Meyer
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South Carolina Charleston South Carolina U.S.A
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Bush A, Hogg C. The answer is cilia, whatever the question may be! ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:S32. [PMID: 30613607 DOI: 10.21037/atm.2018.09.39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Andrew Bush
- Head of Section (Paediatrics), Imperial College, London, UK.,National Heart and Lung Institute, London, UK.,Departments of Paediatrics and Paediatric Respiratory Medicine, NHLI at Imperial College, London, UK
| | - Claire Hogg
- Departments of Paediatrics and Paediatric Respiratory Medicine, NHLI at Imperial College, London, UK.,National PCD Diagnostic Service, Royal Brompton Hospital, London, UK
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