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Kaneshiro S, Hiraumi H, Kobayashi Y, Kanno T, Akasaka M, Shiga K. Childhood fever and hearing loss associated with CAPOS syndrome. Auris Nasus Larynx 2024; 51:724-727. [PMID: 38821025 DOI: 10.1016/j.anl.2024.04.004] [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: 09/29/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 06/02/2024]
Abstract
CAPOS (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) syndrome is a rare genetic disorder caused by the heterozygous mutation, c.2452G > A, in the ATP1A3 gene. CAPOS syndrome involves a characteristic episode in which neuropathy develops after a fever in childhood, and here, we describe the case of a patient with CAPOS syndrome. The patient had repeated episodes of a fever around 74 months of age. Although he could speak at 23 months of age, he presented with hearing difficulty after the fever. Pure-tone audiometry revealed moderate-to-severe bilateral sensorineural hearing loss, and auditory brainstem response (ABR) showed poor response in the both ears. Auditory stead-state response (ASSR) produced relatively consistent results compared to pure-tone audiometry. A mutation in the ATP1A3 gene was detected through genetic testing. In CAPOS syndrome, a genetic mutation leads to desynchronization during neural firing. We believe that this desynchronization in neural firing is responsible for the lack of response in the ABR and the presence of a response in the ASSR. In this patient, we attribute the response detection in ASSR to its greater tolerance for errors in the timing of neural firing compared to ABR.
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Affiliation(s)
- Shinsuke Kaneshiro
- Department of Otorhinolaryngology - Head and Neck Surgery, Iwate Medical University, 2-1-1, Nishitokuda, Yahaba-cho, Shiwa-gun, Iwate 238-3694, Japan.
| | - Harukazu Hiraumi
- Department of Otorhinolaryngology - Head and Neck Surgery, Tenri Hospital, 200 Banchi, Mishima-cho, Tenri, Nara, Japan
| | - Yumiko Kobayashi
- Department of Clinical Genetics - Head and Neck Surgery, Iwate Medical University, 2-1-1, Nishitokuda, Yahaba-cho, Shiwa-gun, Iwate, Japan
| | - Tomoko Kanno
- Department of Otorhinolaryngology - Head and Neck Surgery, Iwate Medical University, 2-1-1, Nishitokuda, Yahaba-cho, Shiwa-gun, Iwate 238-3694, Japan
| | - Manami Akasaka
- Department of Clinical Pediatrics - Head and Neck Surgery, Iwate Medical University, 2-1-1, Nishitokuda, Yahaba-cho, Shiwa-gun, Iwate, Japan
| | - Kiyoto Shiga
- Department of Otorhinolaryngology - Head and Neck Surgery, Iwate Medical University, 2-1-1, Nishitokuda, Yahaba-cho, Shiwa-gun, Iwate 238-3694, Japan
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Orsucci D, Tessa A, Caldarazzo Ienco E, Trovato R, Natale G, Bilancieri G, Giuntini M, Napolitano A, Salvetti S, Vista M, Santorelli FM. Clinical and genetic features of dominant Essential Tremor in Tuscany, Italy: FUS, CAMTA1, ATXN1 and beyond. J Neurol Sci 2024; 460:123012. [PMID: 38626532 DOI: 10.1016/j.jns.2024.123012] [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: 02/03/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE Essential Tremor (ET) is one of the most common neurological disorders. In most instances ET is inherited as an autosomal dominant trait with age-related penetrance (virtually complete in advanced age); however, ET genetics remains elusive. The current study aims to identify possibly pathogenic genetic variants in a group of well-characterized ET families. METHODS 34 individuals from 14 families with dominant ET were clinically evaluated and studied by whole exome sequencing studies (after excluding trinucleotide expansion disorders). RESULTS Most patients had pure ET. In 4 families, exome studies could identify a genetic variant potentially able to significantly alter the protein structure (CADD >20, REVEL score > 0.25), shared by all the affected individuals (in CAMTA1, FUS, MYH14, SGCE genes). In another family there were two variants in dominant genes (PCDH9 and SQSTM1). Moreover, an interrupted "intermediate" trinucleotide expansion in ATXN1 ("SCA1") was identified in a further family with pure ET. CONCLUSION Combining our observations together with earlier reports, we can conclude that ET genes confirmed in at least two families to date include CAMTA1 and FUS (reported here), as well as CACNA1G, NOTCH2NLC and TENM4. Most cases of familial ET, inherited with an autosomal dominant inheritance, may result from "mild" variants of many different genes that, when affected by more harmful genetic variants, lead to more severe neurological syndromes (still autosomal dominant). Thus, ET phenotype may be the "mild", incomplete manifestation of many other dominant neurogenetic diseases. These findings further support evidence of genetic heterogeneity for such disease(s). Author's keywords: cerebellar ataxias, movement disorders, neurogenetics, rare neurological disorders, tremor.
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Affiliation(s)
- D Orsucci
- Unit of Neurology, San Luca Hospital, Lucca, Italy.
| | - A Tessa
- IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | | | - R Trovato
- IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - G Natale
- IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - G Bilancieri
- IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - M Giuntini
- Unit of Neurology, San Luca Hospital, Lucca, Italy
| | - A Napolitano
- Unit of Neurology, Apuane Hospital, Massa Carrara, Italy
| | - S Salvetti
- Unit of Neurology, San Luca Hospital, Lucca, Italy
| | - M Vista
- Unit of Neurology, San Luca Hospital, Lucca, Italy
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Wu CC. Application of Genetic Information to Cochlear Implantation in Clinical Practice. J Audiol Otol 2024; 28:93-99. [PMID: 38695054 PMCID: PMC11065544 DOI: 10.7874/jao.2024.00080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/22/2024] [Indexed: 05/05/2024] Open
Abstract
Cochlear implantation is currently the treatment of choice for children with severe-to-profound sensorineural hearing impairment (SNHI). However, the outcomes with cochlear implant (CI) vary significantly among recipients. Genetic diagnosis offers direct clues regarding the pathogenesis of SNHI, which facilitates the development of personalized medicine for potential candidates for CI. In this article, I present a comprehensive overview of the usefulness of genetic information in clinical decision-making for CI. Genetically confirmed diagnosis enables clinicians to: 1) monitor the evolution of SNHI and determine the optimal surgical timing, 2) predict the potential benefits of CI in patients with identified genetic etiology, and 3) select CI devices/electrodes tailored to patients with specific genetic mutations.
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Affiliation(s)
- Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University College of Medicine, Taipei, Taiwan
- Hearing and Speech Center, National Taiwan University Hospital, Taipei, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
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Nowariak M, Strack N, Greenlund L, Hegde S, Novak JL, Meyer A, Roby BB. Risk factors and outcomes in patients with cochlear nerve deficiency. Int J Pediatr Otorhinolaryngol 2024; 176:111797. [PMID: 38056092 DOI: 10.1016/j.ijporl.2023.111797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/30/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Cochlear nerve deficiency (CND) is a cause of sensorineural hearing loss made by radiologic criteria. There is sparse literature involving audiological outcomes and cochlear implantation (CI) success in patients with CND. METHODS A retrospective chart review of all patients with sensorineural hearing loss at a tertiary children's hospital from 2000 to 2020 was conducted. Patients with CND on radiographic imaging were included and categorized as hypoplastic, aplastic, or indeterminate. RESULTS In this study, 53 patients were identified with CND, totaling 70 ears. Of the 53 patients, 30 (56.6 %) were male, 8 (16.0 %) had a family history of childhood hearing loss, 6 (11.3 %) were born preterm, and 11 (23.4 %) required neonatal intensive care admission. The median maternal age was 29 years old [IQR: 27, 35], and 8 (15 %) patients were born to mothers with diabetes. Of the 70 ears, 49 (70 %) utilized conventional hearing aids, 12 (17.1 %) utilized a bone-anchored hearing aid, and 10 (14.3 %) underwent CI. Of the 10 ears implanted, 4 (40 %) ears had nerves classified as hypoplastic, 3 (30 %) as aplastic, and 3 (30 %) as indeterminate. Improvement in pure tone averages compared to preoperative testing was demonstrated in 8 (80 %), and 6 (60 %) displayed improved speech awareness thresholds. CONCLUSION This study demonstrates that there may be an association between CND and maternal diabetes and NICU admission. There are variable results with hearing amplification options in patients with CND, and further research is needed to better describe the role of CI, bone-anchored hearing aids and conventional hearing aids in patients with CND.
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Affiliation(s)
- Meagan Nowariak
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Natalie Strack
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA
| | | | - Shilpa Hegde
- Children's Minnesota Radiology, Minneapolis, MN, USA
| | - Jessica Ls Novak
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA
| | - Abby Meyer
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA; University of Minnesota Dept of Otolaryngology-Head and Neck Surgery, Minneapolis, MN, USA
| | - Brianne Barnett Roby
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA; University of Minnesota Dept of Otolaryngology-Head and Neck Surgery, Minneapolis, MN, USA.
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Wu K, Lan L, Shi W, Li J, Xie L, Xiong F, Wang H, Wang Q. The audiological characteristics of infant auditory neuropathy patients without otoacoustic emission. Laryngoscope Investig Otolaryngol 2022; 7:2095-2102. [PMID: 36544924 PMCID: PMC9764789 DOI: 10.1002/lio2.978] [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: 07/06/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/26/2022] Open
Abstract
Objective To explore the audiological characteristics of infant auditory neuropathy (AN) patients with cochlear microphonic (CM) recorded but absent otoacoustic emission (OAE), clinically reducing the rate of missed diagnosis of AN. Methods We retrospectively analyzed the audiological characteristics of infant AN patients in our medical center between 2003 and 2020. A total of 18 infant AN patients were OAE absent group, with CM present and distortion product otoacoustic emission (DPOAE) absent in both ears. A total of 44 infant AN patients were OAE present group, with CM and DPOAE present in both ears. Results (1) The found age in OAE absent group was 0.9 (0.02) years old, which was younger than 1.11 (1.63) years old in OAE present group (p = .041). (2) The CM threshold of OAE absent group was 80 (10) dB nHL, which was significantly higher (p < .001) than OAE present group. CM amplitude were smaller (p < .05), and CM duration were shorter (p < .05) in OAE absent group. (3) The thresholds of auditory steady-state response (ASSR) at 0.5, 1, 2, and 4 kHz were 94 (10), 94 (10), 87 (20), and 81 (10) dB HL cg, respectively in OAE absent group, which were higher than those in OAE present group (p < .01). Conclusions Infant AN patients with CM present and OAE absent showed earlier detection and different audiological performance, which was manifested in ASSR thresholds, audiometric configurations and CM performance. CM thresholds were increased, amplitude and duration were decreased, non-linearity of I/O function was reduced. Level of Evidence 4.
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Affiliation(s)
- Kaili Wu
- School of Medical Technology and Information EngineeringZhejiang Chinese Medical UniversityHangzhouChina,Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina
| | - Lan Lan
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina,National Clinical Research Center for Otolaryngologic DiseasesChinese PLA General HospitalBeijingChina
| | - Wei Shi
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina,National Clinical Research Center for Otolaryngologic DiseasesChinese PLA General HospitalBeijingChina
| | - Jin Li
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina,National Clinical Research Center for Otolaryngologic DiseasesChinese PLA General HospitalBeijingChina
| | - Linyi Xie
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina,National Clinical Research Center for Otolaryngologic DiseasesChinese PLA General HospitalBeijingChina
| | - Fen Xiong
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina,National Clinical Research Center for Otolaryngologic DiseasesChinese PLA General HospitalBeijingChina
| | - Hongyang Wang
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina,National Clinical Research Center for Otolaryngologic DiseasesChinese PLA General HospitalBeijingChina
| | - Qiuju Wang
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck SurgeryChinese PLA General Hospital, Medical School of Chinese PLABeijingChina,National Clinical Research Center for Otolaryngologic DiseasesChinese PLA General HospitalBeijingChina
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Cochlear nerve deficiency is an important cause of auditory neuropathy spectrum disorder at a population level in children. Int J Pediatr Otorhinolaryngol 2022; 158:111171. [PMID: 35552163 DOI: 10.1016/j.ijporl.2022.111171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To determine the incidence, prevalence and describe risk factors and etiology for childhood Auditory Neuropathy Spectrum Disorder using population level data from a statewide universal newborn hearing program. METHODS A retrospective statewide universal newborn hearing screening database review and descriptive analysis from 2012 to 2019 of demographic, risk factors and hearing loss etiology for babies with sensorineural hearing loss and ANSD was completed. A 2 stage aABR protocol was used and ANSD was classified when click evoked ABR were absent or grossly abnormal but otoacoustic emissions and or cochlear microphonics were present. Medical evaluation and investigation by a pediatrician or otolaryngologist was performed and etiology was assigned using a coding scheme. Next generation genetic sequencing was not available. RESULTS From 2012 to 2019, 487 636 babies were screened for congenital hearing loss (99.1%) and 1150 were confirmed to have permanent SNHL, 80 of whom were diagnosed with ANSD (52 unilateral and 28 bilateral). The prevalence of ANSD was 7.0% and population prevalence was 0.16 per 1000 live births. The only demographic or risk factor significantly more likely to be associated with ANSD than SNHL was hyperbilirubinemia. The most common etiology for ANSD was hypoplasia or absence of the cochlear nerve with 37 cases (46.3%), and it was significantly more likely with unilateral than bilateral ANSD. CONCLUSION At a population level, ANSD was more likely to be unilateral and the only perinatal risk factor significantly associated was hyperbilirubinemia. Cochlear nerve deficiency was the most common etiology. Given that this can occur in well babies, this provides further evidence for aABR as a preferred mode for newborn hearing screening.
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Lin PH, Wu HP, Wu CM, Chiang YT, Hsu JS, Tsai CY, Wang H, Tseng LH, Chen PY, Yang TH, Hsu CJ, Chen PL, Wu CC, Liu TC. Cochlear Implantation Outcomes in Patients with Auditory Neuropathy Spectrum Disorder of Genetic and Non-Genetic Etiologies: A Multicenter Study. Biomedicines 2022; 10:biomedicines10071523. [PMID: 35884828 PMCID: PMC9313466 DOI: 10.3390/biomedicines10071523] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 01/04/2023] Open
Abstract
With diverse etiologies and clinical features, the management of pediatric auditory neuropathy spectrum disorder (ANSD) is often challenging, and the outcomes of cochlear implants (CIs) are variable. This study aimed to investigate CI outcomes in pediatric patients with ANSD of different etiologies. Thirty-six children with ANSD who underwent cochlear implantation between 2001 and 2021 were included. Comprehensive etiological analyses were conducted, including a history review, next-generation sequencing-based genetic examinations, and imaging studies using high-resolution computed tomography and magnetic resonance imaging. Serial behavioral and speech audiometry were performed before and after surgery, and the outcomes with CI were evaluated using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores. By etiology, 18, 1, 1, and 10 patients had OTOF-related, WFS1-related, OPA1-related, and cochlear nerve deficiency (CND)-related ANSD, respectively. Six patients had no definite etiology. The average CI-aided behavioral threshold was 28.3 ± 7.8 dBHL, and those with CND-related ANSD were significantly worse than OTOF-related ANSD. The patients’ median CAP and SIR scores were 6 and 4, respectively. Favorable CI outcomes were observed in patients with certain etiologies of ANSD, particularly those with OTOF (CAP/SIR scores 5–7/2–5), WFS1 (CAP/SIR score 6/5), and OPA1 variants (CAP/SIR score 7/5). Patients with CND had suboptimal CI outcomes (CAP/SIR scores 2–6/1–3). Identifying the etiologies in ANSD patients is crucial before surgery and can aid in predicting prognoses.
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Affiliation(s)
- Pei-Hsuan Lin
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; (P.-H.L.); (P.-L.C.)
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Otolaryngology, National Taiwan University Hospital Yunlin Branch, Yunlin 64041, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
| | - Che-Ming Wu
- Department of Otolaryngology & Head and Neck Surgery, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 23652, Taiwan;
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taoyuan 33305, Taiwan
| | - Yu-Ting Chiang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Jacob Shujui Hsu
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Cheng-Yu Tsai
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Han Wang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Li-Hui Tseng
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Pey-Yu Chen
- Department of Otolaryngology, MacKay Memorial Hospital, Taipei 10449, Taiwan;
- Department of Audiology and Speech-Language Pathology, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Ting-Hua Yang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Chuan-Jen Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
| | - Pei-Lung Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; (P.-H.L.); (P.-L.C.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 10002, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30261, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30261, Taiwan
- Hearing and Speech Center, National Taiwan University Hospital, Taipei 10002, Taiwan
- Correspondence: (C.-C.W.); (T.-C.L.)
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Correspondence: (C.-C.W.); (T.-C.L.)
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Savenko IV, Garbaruk ES, Boboshko MY. [The issue of auditory neuropathy: from origins to the present]. Vestn Otorinolaringol 2022; 87:60-69. [PMID: 35274894 DOI: 10.17116/otorino20228701160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The issue of auditory neuropathy spectrum disorders (ANSD) has been in a focus of specialists attention for a relatively short time, but during this time a huge amount of scientific and practical knowledge about this hearing disorder has been accumulated. ANSD is a specific auditory deficit caused by dysfunction of periphery part of the auditory system, which may affect the inner hair cells, the spiral ganglion neurons and the auditory nerve, as well as the area of synaptic contact between them, while the outer hair cells, as a rule, remain intact. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, electrophysiological data may not correlate with hearing level, the discrepancy between pure tone audiometry and speech discrimination is observed. ANSD prevalence, epidemiology, contemporary views on its etiology, including detailed information on hereditary forms of the disorder and its risk factors are considered in the review. The data on the basic rungs of the ANSD pathogenesis, which underlie the development of various forms of the disorder and mainly determine the rehabilitation approach, are presented. The detailed clinical and audiological characteristics of ANSD are presented; contemporary approach to ANSD diagnosis and rehabilitation, including indications for surgical treatment, are considered.
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Affiliation(s)
- I V Savenko
- Pavlov State Medical University, St. Petersburg, Russia
| | - E S Garbaruk
- Pavlov State Medical University, St. Petersburg, Russia.,St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - M Yu Boboshko
- Pavlov State Medical University, St. Petersburg, Russia.,Mechnikov North-Western State Medical University, St. Petersburg, Russia
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Savenko IV, Garbaruk ES, Boboshko MY. [Auditory neuropathy and prematurity: modern view of the issue (literature review)]. Vestn Otorinolaringol 2022; 87:63-71. [PMID: 35818948 DOI: 10.17116/otorino20228703163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a specific auditory disorder caused by dysfunction of periphery part of the auditory system, in which the function of the outer hair cells is preserved, but the afferent input at the cochlear level suffers due to the pathology of the inner hair cells, neurons of the spiral ganglion and/or the auditory nerve, as well as synaptic contact between them. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, the discrepancy between the hearing level and the electrophysiological data, poor speech perception which may not correlate with the hearing thresholds. ANSD is a multifactorial disease. One of the main risk factors is perinatal pathology and, in particular, prematurity. The possible factors associated with prematurity that provoke the onset of the disease, features of the pathogenesis, clinical and audiological peculiarities of ANSD in premature infants, contemporary approaches to the habilitation of such patients are discussed in the article. The necessity of an individual, patient-oriented approach to the treatment of premature infants with ANSD is substantiated; such an approach should be based both on the genesis of the disorder, taking into account possible points of lesion in the auditory system, and the developmental peculiarities of a premature baby considering the presence of concomitant diseases associated with prematurity. In the article attention is focused on the main directions of habilitation work with such children, including a multidisciplinary approach, regular careful monitoring of the auditory, speech and language skills, intensive psychological and speech therapist support, the choice of an adequate way of intervention and its improvement as necessary.
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Affiliation(s)
- I V Savenko
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
| | - E S Garbaruk
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
- St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - M Yu Boboshko
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
- Mechnikov North-West State Medical University, St. Petersburg, Russia
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