1
|
Wener ER, McLennan JD, Papsin BC, Cushing SL, Stavropoulos DJ, Mendoza-Londono R, Quercia N, Gordon KA. Variants in Genes Associated with Hearing Loss in Children: Prevalence in a Large Canadian Cohort. Laryngoscope 2024; 134:3832-3838. [PMID: 38426810 DOI: 10.1002/lary.31373] [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: 07/20/2023] [Revised: 01/17/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE The objective of this study was to assess the prevalence of genetic variants associated with hearing loss in a large cohort of children in Canada using high throughput next generation sequencing (NGS). METHODS A total of 485 children with hearing loss underwent NGS testing with an 80 gene panel of syndromic and non-syndromic variants known to be associated with hearing loss. Genetic variants were classified as pathogenic, likely pathogenic, likely benign, benign, or variants of uncertain significance (VUS), according to the American College of Medical Genetics and Genomics guidelines. RESULTS Across the 80 genes tested, 923 variants, predominantly in 28 genes, were identified in 324 children. Pathogenic variants occurred in 19/80 (23.8%) of the hearing loss related genes tested and confirmed the etiology of hearing loss in 73/485 (15.1%) of children. GJB2 was the most prevalent gene, affecting 28/73 (38.4%) children with confirmed genetic hearing loss in our cohort. Most identified variants (748/923, 81.0%, in 76/80 genes) were of uncertain significance. CONCLUSION Genetic testing using NGS identified the etiology in approximately 15% of childhood hearing loss in a Canadian cohort which is lower than what is typically reported. GJB2 was the most common genetic cause of hearing loss. VUS are commonly identified, presenting clinical challenges for counseling. LEVEL OF EVIDENCE 4 Laryngoscope, 134:3832-3838, 2024.
Collapse
Affiliation(s)
- Emily R Wener
- Archie's Cochlear Implant Laboratory, Neuroscience & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jacob D McLennan
- Archie's Cochlear Implant Laboratory, Neuroscience & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake C Papsin
- Archie's Cochlear Implant Laboratory, Neuroscience & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon L Cushing
- Archie's Cochlear Implant Laboratory, Neuroscience & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Dimitri James Stavropoulos
- Genome Diagnostics Paediatric Laboratory Medicine, Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Roberto Mendoza-Londono
- Genome Diagnostics Paediatric Laboratory Medicine, Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nada Quercia
- Division of Clinical & Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karen A Gordon
- Archie's Cochlear Implant Laboratory, Neuroscience & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
2
|
North L, Olivier M, Runge CL. Cochlear Implant Outcomes in Patients With TMTC2 -Associated Sensorineural Hearing Loss and Auditory Neuropathy/Auditory Dys-Synchrony. Otol Neurotol 2024; 45:e478-e482. [PMID: 38769084 PMCID: PMC11168879 DOI: 10.1097/mao.0000000000004208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To investigate the outcomes of cochlear implantation in patients with TMTC2 -associated sensorineural hearing loss and auditory neuropathy/auditory dys-synchrony. PATIENTS Adult and pediatric cochlear implant (CI) patients followed in an academic center who tested positive for TMTC2 genetic variant rs35725509. INTERVENTION Cochlear implantation. MAIN OUTCOME MEASURES Speech perception scores in quiet. RESULTS Ten CI patients were identified with TMTC2 variant rs35725509 out of 157 patients who underwent genetic testing (i.e., 6.3% of patients tested). All demonstrated progressive, bilateral hearing loss with severe-to-profound audiometric thresholds preoperatively. Pre-CI and 1-year post-CI speech recognition percent correct scores were compared. Post-CI speech perception (mean 61.0%, standard deviation 31.4%) was significantly higher than pre-CI speech perception (mean 21.0%, standard deviation 27.0%) ( p = 0.002). Individually, 9 of the 10 subjects experienced significant improvements in speech perception pre- to post-CI ( p < 0.05). Electrically evoked compound action potential measures were available for five patients, and all showed normal electrically evoked compound action potential thresholds. CONCLUSION Patients with TMTC2 -associated sensorineural hearing loss and auditory neuropathy/auditory dys-synchrony have significantly improved speech perception outcomes with cochlear implantation and should be considered candidates for this intervention if there are no other contraindications.
Collapse
Affiliation(s)
- Lauren North
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael Olivier
- Department of Internal Medicine-Section of Molecular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Christina L Runge
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Lorens A, Skarzynski PH, Obrycka A, Skarzynski H. Can an individual with low frequency hearing in the candidate ear benefit from a cochlear implant even if they have normal hearing in the other ear? Eur Arch Otorhinolaryngol 2023; 280:4895-4902. [PMID: 37221309 PMCID: PMC10562342 DOI: 10.1007/s00405-023-08011-y] [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: 03/01/2023] [Accepted: 05/08/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE To determine hearing preservation and subjective benefit after cochlear implant (CI) surgery in patients with low frequency hearing in the ear to be implanted (i.e., they have partial deafness, PD) and close to normal hearing in the other. METHODS There were two study groups. The test group was made up of 12 adult patients (mean age 43.4 years; SD 13.6) with normal hearing or mild hearing loss in one ear, and with PD in the ear to be implanted. The reference group consisted of 12 adult patients (mean age 44.5 years; SD 14.1) who had PD in both ears and who underwent unilateral implantation in their worse ear. Hearing preservation was assessed 1 and 14 months after CI surgery using the Skarzynski Hearing Preservation Classification System. The APHAB questionnaire was used to evaluate the benefit from the CI. RESULTS The differences in HP% between the groups were not significant: mean hearing preservation (HP%) in the test group was 82% one month after CI surgery and 75% some 14 months after implantation; corresponding results in the reference group were 71% and 69%. However, on the APHAB background noise subscale, the benefit in the test group was significantly larger than in the reference group. CONCLUSION To a large extent it was possible to preserve low-frequency hearing in the implanted ear. This means that individuals with low frequency hearing in the implanted ear (partial deafness) and with normal hearing in the other generally received more benefits from cochlear implantation than did patients with partial deafness in both ears. We conclude that residual low frequency hearing in the ear to be implanted should not be considered a contraindication for a CI in a patient with single-sided deafness.
Collapse
Affiliation(s)
- Artur Lorens
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
| | - Piotr Henryk Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
- Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
- Institute of Sensory Organs, Kajetany, Poland
| | - Anita Obrycka
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland.
| | - Henryk Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
| |
Collapse
|
5
|
Tropitzsch A, Schade-Mann T, Gamerdinger P, Dofek S, Schulte B, Schulze M, Fehr S, Biskup S, Haack TB, Stöbe P, Heyd A, Harre J, Lesinski-Schiedat A, Büchner A, Lenarz T, Warnecke A, Müller M, Vona B, Dahlhoff E, Löwenheim H, Holderried M. Variability in Cochlear Implantation Outcomes in a Large German Cohort With a Genetic Etiology of Hearing Loss. Ear Hear 2023; 44:1464-1484. [PMID: 37438890 PMCID: PMC10583923 DOI: 10.1097/aud.0000000000001386] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/04/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES The variability in outcomes of cochlear implantation is largely unexplained, and clinical factors are not sufficient for predicting performance. Genetic factors have been suggested to impact outcomes, but the clinical and genetic heterogeneity of hereditary hearing loss makes it difficult to determine and interpret postoperative performance. It is hypothesized that genetic mutations that affect the neuronal components of the cochlea and auditory pathway, targeted by the cochlear implant (CI), may lead to poor performance. A large cohort of CI recipients was studied to verify this hypothesis. DESIGN This study included a large German cohort of CI recipients (n = 123 implanted ears; n = 76 probands) with a definitive genetic etiology of hearing loss according to the American College of Medical Genetics (ACMG)/Association for Molecular Pathology (AMP) guidelines and documented postoperative audiological outcomes. All patients underwent preoperative clinical and audiological examinations. Postoperative CI outcome measures were based on at least 1 year of postoperative audiological follow-up for patients with postlingual hearing loss onset (>6 years) and 5 years for children with congenital or pre/perilingual hearing loss onset (≤6 years). Genetic analysis was performed based on three different methods that included single-gene screening, custom-designed hearing loss gene panel sequencing, targeting known syndromic and nonsyndromic hearing loss genes, and whole-genome sequencing. RESULTS The genetic diagnosis of the 76 probands in the genetic cohort involved 35 genes and 61 different clinically relevant (pathogenic, likely pathogenic) variants. With regard to implanted ears (n = 123), the six most frequently affected genes affecting nearly one-half of implanted ears were GJB2 (21%; n = 26), TMPRSS3 (7%; n = 9), MYO15A (7%; n = 8), SLC26A4 (5%; n = 6), and LOXHD1 and USH2A (each 4%; n = 5). CI recipients with pathogenic variants that influence the sensory nonneural structures performed at or above the median level of speech performance of all ears at 70% [monosyllable word recognition score in quiet at 65 decibels sound pressure level (SPL)]. When gene expression categories were compared to demographic and clinical categories (total number of compared categories: n = 30), mutations in genes expressed in the spiral ganglion emerged as a significant factor more negatively affecting cochlear implantation outcomes than all clinical parameters. An ANOVA of a reduced set of genetic and clinical categories (n = 10) identified five detrimental factors leading to poorer performance with highly significant effects ( p < 0.001), accounting for a total of 11.8% of the observed variance. The single strongest category was neural gene expression accounting for 3.1% of the variance. CONCLUSIONS The analysis of the relationship between the molecular genetic diagnoses of a hereditary etiology of hearing loss and cochlear implantation outcomes in a large German cohort of CI recipients revealed significant variabilities. Poor performance was observed with genetic mutations that affected the neural components of the cochlea, supporting the "spiral ganglion hypothesis."
Collapse
Affiliation(s)
- Anke Tropitzsch
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Center for Rare Hearing Disorders, Centre for Rare Diseases, University of Tübingen, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Thore Schade-Mann
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Philipp Gamerdinger
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Saskia Dofek
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Björn Schulte
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Martin Schulze
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Sarah Fehr
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Saskia Biskup
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Tobias B. Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Petra Stöbe
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Andreas Heyd
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Jennifer Harre
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Anke Lesinski-Schiedat
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Andreas Büchner
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Athanasia Warnecke
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Marcus Müller
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Barbara Vona
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Ernst Dahlhoff
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Hubert Löwenheim
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Martin Holderried
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Department of Medical Development and Quality Management, University Hospital Tübingen, Tübingen, Germany
| |
Collapse
|
6
|
Friis IJ, Aaberg K, Edholm B. Causes of hearing loss and implantation age in a cohort of Danish pediatric cochlear implant recipients. Int J Pediatr Otorhinolaryngol 2023; 171:111640. [PMID: 37441990 DOI: 10.1016/j.ijporl.2023.111640] [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: 03/09/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Sensorineural hearing loss (SNHL) is the most common birth disorder. The cause of SNHL is heterogeneous and varies in different populations. Understanding the causes of a hearing loss (HL) predict the outcome of cochlear implantation and is of great importance in understanding the mechanism of the disease and in providing the best treatment. Undiagnosed and untreated HL has a profound effect on the acquisition of early communication skills, speech, language, academic, emotional, and psychosocial development in children. OBJECTIVES To determine the cause of HL and implantation age in pediatric cochlear implant (CI) users in a Danish population. METHODS Data of 100 children (54 females and 46 males), age 0-17 years, was analyzed. All of the children were implanted during 2020-2022. RESULTS Hereditary HL was diagnosed in 44 cases (44%), with pathogenic variants in the SLC26A4 gene found in 14 cases (14%). Syndromic HL was diagnosed in 23 children (23%). Non-syndromic HL was diagnosed in 21 children (21%), where the most common genetic variation was found in the GJB2 gene. Acquired prenatal and postnatal sensory disorders TORCH risk factors were associated with HL in 25 cases (25%). Congenital CMV DNA was diagnosed in 23 samples (23%). The cause of the HL remained unknown for 31 (31%) children. In 70 (70%) of the participants the HL was diagnosed at time of newborn hearing screening (NHS). Twenty-three of the children were diagnosed with congenital severe to profound bilateral HL and were simultaneously implanted between 8 and 14 months (mean age 10.5 months). In the remaining 47 cases, the HL was progressive and the children were implanted when the HL reached the criteria for implantation. CONCLUSIONS In the current study, the major causes of HL were alterations in the SLC26A4 gene: 13% with Pendred syndrome and 1% non-syndromic. Thirty-one (31%) had HL of unknown origin and almost half of these cases had inner ear malformations (n = 16).
Collapse
Affiliation(s)
- Ida Jensen Friis
- Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus C, Denmark.
| | - Kirsten Aaberg
- Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus C, Denmark
| | - Bjarke Edholm
- Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus C, Denmark
| |
Collapse
|
7
|
Shinagawa J, Yoshimura H, Nishio SY, Takumi Y, Usami SI. The relationship between preoperative factors and the pattern of longitudinal improvement in speech perception following cochlear implantation. Acta Otolaryngol 2023; 143:402-407. [PMID: 37083037 DOI: 10.1080/00016489.2023.2200850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Many studies have discussed the factors influencing hearing outcomes after cochlear implantation, but few have addressed improvements in speech perception for these patients over time. OBJECTIVE To investigate the relationship between preoperative factors and the pattern of longitudinal improvement in speech perception following cochlear implantation (CI). MATERIALS AND METHODS This study enrolled 83 patients (96 ears) who underwent CI at Shinshu University Hospital. The patients were assessed up to 12 months after CI by a monosyllable test, and showed either delayed improvement (DI), early improvement (EI), or stable improvement (SI) when compared with their preoperative score. Eight preoperative variables were also examined for their effects on speech perception over time. RESULTS The DI, EI, SI groups comprised 35.4%, 43.8%, and 20.8% of all patients, respectively. Patients in the DI group were older at surgery than those in the EI and SI groups, and their onset age were also older than that in the SI group. No other preoperative variables showed significant differences across the three groups. CONCLUSIONS AND SIGNIFICANCE Our findings revealed that age at implantation and age at onset of hearing loss significantly affected the improvement pattern of speech perception. Age may be useful in predicting recovery of speech perception after CI.
Collapse
Affiliation(s)
- Jun Shinagawa
- Department of Otorhinolaryngology - Head and Neck Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hidekane Yoshimura
- Department of Otorhinolaryngology - Head and Neck Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ya Nishio
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yutaka Takumi
- Department of Otorhinolaryngology - Head and Neck Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
8
|
Carlson RJ, Walsh T, Mandell JB, Aburayyan A, Lee MK, Gulsuner S, Horn DL, Ou HC, Sie KCY, Mancl L, Rubinstein J, King MC. Association of Genetic Diagnoses for Childhood-Onset Hearing Loss With Cochlear Implant Outcomes. JAMA Otolaryngol Head Neck Surg 2023; 149:212-222. [PMID: 36633841 PMCID: PMC9857764 DOI: 10.1001/jamaoto.2022.4463] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/10/2022] [Indexed: 01/13/2023]
Abstract
Importance In the US, most childhood-onset bilateral sensorineural hearing loss is genetic, with more than 120 genes and thousands of different alleles known. Primary treatments are hearing aids and cochlear implants. Genetic diagnosis can inform progression of hearing loss, indicate potential syndromic features, and suggest best timing for individualized treatment. Objective To identify the genetic causes of childhood-onset hearing loss and characterize severity, progression, and cochlear implant success associated with genotype in a single large clinical cohort. Design, Setting, and Participants This cross-sectional analysis (genomics) and retrospective cohort analysis (audiological measures) were conducted from 2019 to 2022 at the otolaryngology and audiology clinics of Seattle Children's Hospital and the University of Washington and included 449 children from 406 families with bilateral sensorineural hearing loss with an onset younger than 18 years. Data were analyzed between January and June 2022. Main Outcomes and Measures Genetic diagnoses based on genomic sequencing and structural variant analysis of the DNA of participants; severity and progression of hearing loss as measured by audiologic testing; and cochlear implant success as measured by pediatric and adult speech perception tests. Hearing thresholds and speech perception scores were evaluated with respect to age at implant, months since implant, and genotype using a multivariate analysis of variance and covariance. Results Of 406 participants, 208 (51%) were female, 17 (4%) were African/African American, 32 (8%) were East Asian, 219 (54%) were European, 53 (13%) were Latino/Admixed American, and 16 (4%) were South Asian. Genomic analysis yielded genetic diagnoses for 210 of 406 families (52%), including 55 of 82 multiplex families (67%) and 155 of 324 singleton families (48%). Rates of genetic diagnosis were similar for children of all ancestries. Causal variants occurred in 43 different genes, with each child (with 1 exception) having causative variant(s) in only 1 gene. Hearing loss severity, affected frequencies, and progression varied by gene and, for some genes, by genotype within gene. For children with causative mutations in MYO6, OTOA, SLC26A4, TMPRSS3, or severe loss-of-function variants in GJB2, hearing loss was progressive, with losses of more than 10 dB per decade. For all children with cochlear implants, outcomes of adult speech perception tests were greater than preimplanted levels. Yet the degree of success varied substantially by genotype. Adjusting for age at implant and interval since implant, speech perception was highest for children with hearing loss due to MITF or TMPRSS3. Conclusions and Relevance The results of this cross-sectional study suggest that genetic diagnosis is now sufficiently advanced to enable its integration into precision medical care for childhood-onset hearing loss.
Collapse
Affiliation(s)
- Ryan J. Carlson
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Tom Walsh
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Jessica B. Mandell
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Amal Aburayyan
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Ming K. Lee
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Suleyman Gulsuner
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - David L. Horn
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Henry C. Ou
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Kathleen C. Y. Sie
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Lisa Mancl
- Center on Human Development and Disability, University of Washington Medical Center, Seattle
| | - Jay Rubinstein
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Mary-Claire King
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| |
Collapse
|
9
|
Comprehensive Prediction Model, Including Genetic Testing, for the Outcomes of Cochlear Implantation. Ear Hear 2023; 44:223-231. [PMID: 35973050 DOI: 10.1097/aud.0000000000001269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Despite growing interest in the genetic contribution to cochlear implant (CI) outcomes, only a few studies with limited samples have examined the association of CI outcomes with genetic etiologies. We analyzed CI outcomes using known predictors and genetic testing results to obtain a comprehensive understanding of the impact of genetic etiologies. DESIGN We retrospectively reviewed the medical records and images of patients who underwent cochlear implantation and genetic testing at a single tertiary medical institution, between May 2008 and December 2020. After excluding those whose speech test results were unavailable, and those in whom the implant was removed due to complications, such as infection or device failure, 203 patients were included in this study. The participants were categorized into adult (≥19 years), child (2-18 years), and infant (<24 months) groups. Outcomes were measured based on categories of auditory perception, monosyllable, disyllable, and sentence scores. For the infant group, the Infant-Toddler Meaningful Auditory Integration Scale score was used. RESULTS Among the 203 participants, a causative genetic variant was identified in 117 (57.6%) individuals. The presence of a causative variant was significantly associated with better CI outcomes in the infant group (β = 0.23; 95% confidence interval, 0.01 to 0.47; p = 0.044), but not in the child and adult groups. In the genetically confirmed patients without cochlear malformation, genetic variants involving the spiral ganglion was a poor prognostic factor in the child group (β = -57.24; 95% confidence interval, -90.63 to -23.75; p = 0.004). CONCLUSIONS The presence of known genetic etiology of hearing loss was associated with better CI outcomes in the infant group, but not in the child and adult groups. A neural-type genetic variant was a poor prognostic factor in the genetically diagnosed child subgroup without cochlear malformation. Careful genetic counseling should be performed before cochlear implantation.
Collapse
|
10
|
Comparison of response properties of the electrically stimulated auditory nerve reported in human listeners and in animal models. Hear Res 2022; 426:108643. [PMID: 36343534 PMCID: PMC9986845 DOI: 10.1016/j.heares.2022.108643] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/29/2022] [Accepted: 10/20/2022] [Indexed: 11/04/2022]
Abstract
Cochlear implants (CIs) provide acoustic information to implanted patients by electrically stimulating nearby auditory nerve fibers (ANFs) which then transmit the information to higher-level neural structures for further processing and interpretation. Computational models that simulate ANF responses to CI stimuli enable the exploration of the mechanisms underlying CI performance beyond the capacity of in vivo experimentation alone. However, all ANF models developed to date utilize to some extent anatomical/morphometric data, biophysical properties and/or physiological data measured in non-human animal models. This review compares response properties of the electrically stimulated auditory nerve (AN) in human listeners and different mammalian models. Properties of AN responses to single pulse stimulation, paired-pulse stimulation, and pulse-train stimulation are presented. While some AN response properties are similar between human listeners and animal models (e.g., increased AN sensitivity to single pulse stimuli with long interphase gaps), there are some significant differences. For example, the AN of most animal models is typically more sensitive to cathodic stimulation while the AN of human listeners is generally more sensitive to anodic stimulation. Additionally, there are substantial differences in the speed of recovery from neural adaptation between animal models and human listeners. Therefore, results from animal models cannot be simply translated to human listeners. Recognizing the differences in responses of the AN to electrical stimulation between humans and other mammals is an important step for creating ANF models that are more applicable to various human CI patient populations.
Collapse
|
11
|
Defourny J. Considering gene therapy to protect from X-linked deafness DFNX2 and associated neurodevelopmental disorders. IBRAIN 2022; 8:431-441. [PMID: 37786584 PMCID: PMC10529175 DOI: 10.1002/ibra.12068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/10/2022] [Accepted: 09/13/2022] [Indexed: 10/04/2023]
Abstract
Mutations and deletions in the gene or upstream of the gene encoding the POU3F4 transcription factor cause X-linked progressive deafness DFNX2 and additional neurodevelopmental disorders in humans. Hearing loss can be purely sensorineural or mixed, that is, with both conductive and sensorineural components. Affected males show anatomical abnormalities of the inner ear, which are jointly defined as incomplete partition type III. Current approaches to improve hearing and speech skills of DFNX2 patients do not seem to be fully effective. Owing to inner ear malformations, cochlear implantation is surgically difficult and may predispose towards severe complications. Even in cases where implantation is safely performed, hearing and speech outcomes remain highly variable among patients. Mouse models for DFNX2 deafness revealed that sensorineural loss could arise from a dysfunction of spiral ligament fibrocytes in the lateral wall of the cochlea, which leads to reduced endocochlear potential. Highly positive endocochlear potential is critical for sensory hair cell mechanotransduction and hearing. In this context, here, we propose to develop a therapeutic approach in male Pou3f4 -/y mice based on an adeno-associated viral (AAV) vector-mediated gene transfer in cochlear spiral ligament fibrocytes. Among a broad range of AAV vectors, AAV7 was found to show a strong tropism for the spiral ligament. Thus, we suggest that an AAV7-mediated delivery of Pou3f4 complementary DNA in the spiral ligament of Pou3f4 -/y mice could represent an attractive strategy to prevent fibrocyte degeneration and to restore normal cochlear functions and properties, including a positive endocochlear potential, before hearing loss progresses to profound deafness.
Collapse
Affiliation(s)
- Jean Defourny
- GIGA‐Neurosciences, Unit of Cell and Tissue BiologyUniversity of Liège, C.H.U. B36LiègeBelgium
| |
Collapse
|
12
|
Comprehensive Etiologic Analyses in Pediatric Cochlear Implantees and the Clinical Implications. Biomedicines 2022; 10:biomedicines10081846. [PMID: 36009393 PMCID: PMC9405031 DOI: 10.3390/biomedicines10081846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Cochlear implantation is the treatment of choice for children with profound sensorineural hearing impairment (SNHI), yet the outcomes of cochlear implants (CI) vary significantly across individuals. To investigate the CI outcomes in pediatric patients with SNHI due to various etiologies, we prospectively recruited children who underwent CI surgery at two tertiary referral CI centers from 2010 to 2021. All patients underwent comprehensive history taking, next generation sequencing (NGS)-based genetic examinations, and imaging studies. The CI outcomes were evaluated using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores. Of the 160 pediatric cochlear implantees (76 females and 84 males) included in this study, comprehensive etiological work-up helped achieve clinical diagnoses in 83.1% (133/160) of the patients, with genetic factors being the leading cause (61.3%). Imaging studies identified certain findings in 31 additional patients (19.3%). Four patients (2.5%) were identified with congenital cytomegalovirus infection (cCMV), and 27 patients (16.9%) remained with unknown etiologies. Pathogenic variants in the four predominant non-syndromic SNHI genes (i.e., SLC26A4, GJB2, MYO15A, and OTOF) were associated with favorable CI outcomes (Chi-square test, p = 0.023), whereas cochlear nerve deficiency (CND) on imaging studies was associated with unfavorable CI outcomes (Chi-square test, p < 0.001). Our results demonstrated a clear correlation between the etiologies and CI outcomes, underscoring the importance of thorough etiological work-up preoperatively in pediatric CI candidates.
Collapse
|
13
|
Conversations in Cochlear Implantation: The Inner Ear Therapy of Today. Biomolecules 2022; 12:biom12050649. [PMID: 35625577 PMCID: PMC9138212 DOI: 10.3390/biom12050649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 02/01/2023] Open
Abstract
As biomolecular approaches for hearing restoration in profound sensorineural hearing loss evolve, they will be applied in conjunction with or instead of cochlear implants. An understanding of the current state-of-the-art of this technology, including its advantages, disadvantages, and its potential for delivering and interacting with biomolecular hearing restoration approaches, is helpful for designing modern hearing-restoration strategies. Cochlear implants (CI) have evolved over the last four decades to restore hearing more effectively, in more people, with diverse indications. This evolution has been driven by advances in technology, surgery, and healthcare delivery. Here, we offer a practical treatise on the state of cochlear implantation directed towards developing the next generation of inner ear therapeutics. We aim to capture and distill conversations ongoing in CI research, development, and clinical management. In this review, we discuss successes and physiological constraints of hearing with an implant, common surgical approaches and electrode arrays, new indications and outcome measures for implantation, and barriers to CI utilization. Additionally, we compare cochlear implantation with biomolecular and pharmacological approaches, consider strategies to combine these approaches, and identify unmet medical needs with cochlear implants. The strengths and weaknesses of modern implantation highlighted here can mark opportunities for continued progress or improvement in the design and delivery of the next generation of inner ear therapeutics.
Collapse
|
14
|
Seligman KL, Shearer AE, Frees K, Nishimura C, Kolbe D, Dunn C, Hansen MR, Gantz BJ, Smith RJH. Genetic Causes of Hearing Loss in a Large Cohort of Cochlear Implant Recipients. Otolaryngol Head Neck Surg 2022; 166:734-737. [PMID: 34154485 PMCID: PMC9128025 DOI: 10.1177/01945998211021308] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/11/2021] [Indexed: 12/24/2022]
Abstract
Understanding genetic causes of hearing loss can determine the pattern and course of a patient's hearing loss and may also predict outcomes after cochlear implantation. Our goal in this study was to evaluate genetic causes of hearing loss in a large cohort of adults and children with cochlear implants. We performed comprehensive genetic testing on all patients undergoing cochlear implantation. Of the 459 patients included in the study, 128 (28%) had positive genetic testing. In total, 44 genes were identified as causative. The top 5 genes implicated were GJB2 (20, 16%), TMPRSS3 (13, 10%), SLC26A4 (10, 8%), MYO7A (9, 7%), and MT-RNR1 (7, 5%). Pediatric patients had a higher diagnostic rate. This study lays the groundwork for future studies evaluating the relationship between genetic variation and cochlear implant performance.
Collapse
Affiliation(s)
- Kristen L. Seligman
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - A. Eliot Shearer
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Boston Children’s Hospital, Department of Otolaryngology & Communication Enhancement, Harvard Medical School, Boston, Massachusetts, USA
| | - Kathy Frees
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Carla Nishimura
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Diana Kolbe
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Camille Dunn
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Marlan R. Hansen
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Bruce J. Gantz
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Richard J. H. Smith
- Department of Otolaryngology–Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Interdepartmental PhD Program in Genetics, University of Iowa, Iowa City, Iowa, USA
- Department of Molecular Physiology & Biophysics, University of Iowa College of Medicine, Iowa City, Iowa, USA
| |
Collapse
|
15
|
Nishio SY, Moteki H, Miyagawa M, Yamasoba T, Kashio A, Iwasaki S, Takahashi M, Naito Y, Fujiwara K, Sugaya A, Takahashi H, Kitaoka K, Usami SI. Etiology of hearing loss affects auditory skill development and vocabulary development in pediatric cochlear implantation cases. Acta Otolaryngol 2022; 142:308-315. [PMID: 35481391 DOI: 10.1080/00016489.2022.2065027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Cochlear implantation (CI) is an effective treatment for severe-to-profound hearing loss patients and is currently used as the standard therapeutic option worldwide. However, the outcomes of CI vary among patients. AIMS/OBJECTIVES This study aimed to clarify the clinical features for each etiological group as well as the effects of etiology on CI outcomes. MATERIALS AND METHODS We collected clinical information for 308 pediatric cochlear implant cases, including the etiology, hearing thresholds, age at CI, early auditory skill development, total development, monosyllable perception, speech intelligibility and vocabulary development in school age, and compared them for each etiology group. RESULTS Among the 308 CI children registered for this survey, the most common etiology of hearing loss was genetic causes. The genetic etiology group showed the most favorable development after CI followed by the unknown etiology group, syndromic hearing loss group, congenital CMV infection group, inner ear malformation group, and cochlear nerve deficiency group. CONCLUSIONS AND SIGNIFICANCE Our results clearly indicated that the etiology of HL affects not only early auditory skill development, but also vocabulary development in school age. The results of the present study will aid in more appropriate CI outcome assessment and in more appropriate intervention or habilitation programs.
Collapse
Affiliation(s)
- Shin-ya Nishio
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
| | - Hideaki Moteki
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
| | - Maiko Miyagawa
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Akinori Kashio
- Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Iwasaki
- Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Minato-ku, Tokyo, Japan
| | - Masahiro Takahashi
- Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Minato-ku, Tokyo, Japan
| | - Yasushi Naito
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe-City, Hyogo, Japan
| | - Keizo Fujiwara
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe-City, Hyogo, Japan
| | - Akiko Sugaya
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmacy, Okayama, Japan
| | - Haruo Takahashi
- Department of Otolaryngology, Nagasaki University Faculty of Medicine, Nagasaki-shi, Nagasaki, Japan
| | - Kyoko Kitaoka
- Department of Otolaryngology, Nagasaki University Faculty of Medicine, Nagasaki-shi, Nagasaki, Japan
| | - Shin-ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
| |
Collapse
|
16
|
Usami SI, Nishio SY. The genetic etiology of hearing loss in Japan revealed by the social health insurance-based genetic testing of 10K patients. Hum Genet 2021; 141:665-681. [PMID: 34599366 PMCID: PMC9035015 DOI: 10.1007/s00439-021-02371-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022]
Abstract
Etiological studies have shown genetic disorders to be a major cause of sensorineural hearing loss, but there are a limited number of comprehensive etiological reports based on genetic analysis. In the present study, the same platform using a diagnostic DNA panel carrying 63 deafness genes and the same filtering algorithm were applied to 10,047 samples obtained from social health insurance-based genetic testing of hearing loss. The most remarkable result obtained in this comprehensive study was that the data first clarified the genetic epidemiology from congenital/early-onset deafness to late-onset hearing loss. The overall diagnostic rate was 38.8%, with the rate differing for each age group; 48.6% for the congenital/early-onset group (~5y.o.), 33.5% for the juvenile/young adult-onset group, and 18.0% for the 40+ y.o. group. Interestingly, each group showed a different kind of causative gene. With regard to the mutational spectra, there are certain recurrent variants that may be due to founder effects or hot spots. A series of haplotype studies have shown many recurrent variants are due to founder effects, which is compatible with human migration. It should be noted that, regardless of differences in the mutational spectrum, the clinical characteristics caused by particular genes can be considered universal. This comprehensive review clarified the detailed clinical characteristics (onset age, severity, progressiveness, etc.) of hearing loss caused by each gene, and will provide useful information for future clinical application, including genetic counseling and selection of appropriate interventions.
Collapse
Affiliation(s)
- Shin-Ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Shin-Ya Nishio
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| |
Collapse
|
17
|
Iwasa YI, Nishio SY, Yoshimura H, Sugaya A, Kataoka Y, Maeda Y, Kanda Y, Nagai K, Naito Y, Yamazaki H, Ikezono T, Matsuda H, Nakai M, Tona R, Sakurai Y, Motegi R, Takeda H, Kobayashi M, Kihara C, Ishino T, Morita SY, Iwasaki S, Takahashi M, Furutate S, Oka SI, Kubota T, Arai Y, Kobayashi Y, Kikuchi D, Shintani T, Ogasawara N, Honkura Y, Izumi S, Hyogo M, Ninoyu Y, Suematsu M, Nakayama J, Tsuchihashi N, Okami M, Sakata H, Yoshihashi H, Kobayashi T, Kumakawa K, Yoshida T, Esaki T, Usami SI. Detailed clinical features and genotype-phenotype correlation in an OTOF-related hearing loss cohort in Japan. Hum Genet 2021; 141:865-875. [PMID: 34536124 PMCID: PMC9034993 DOI: 10.1007/s00439-021-02351-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/23/2021] [Indexed: 11/26/2022]
Abstract
Mutations in the OTOF gene are a common cause of hereditary hearing loss and the main cause of auditory neuropathy spectrum disorder (ANSD). Although it is reported that most of the patients with OTOF mutations have stable, congenital or prelingual onset severe-to-profound hearing loss, some patients show atypical clinical phenotypes, and the genotype–phenotype correlation in patients with OTOF mutations is not yet fully understood. In this study, we aimed to reveal detailed clinical characteristics of OTOF-related hearing loss patients and the genotype–phenotype correlation. Detailed clinical information was available for 64 patients in our database who were diagnosed with OTOF-related hearing loss. As reported previously, most of the patients (90.6%) showed a “typical” phenotype; prelingual and severe-to-profound hearing loss. Forty-seven patients (73.4%) underwent cochlear implantation surgery and showed successful outcomes; approximately 85–90% of the patients showed a hearing level of 20–39 dB with cochlear implant and a Categories of Auditory Performance (CAP) scale level 6 or better. Although truncating mutations and p.Arg1939Gln were clearly related to severe phenotype, almost half of the patients with one or more non-truncating mutations showed mild-to-moderate hearing loss. Notably, patients with p.His513Arg, p.Ile1573Thr and p.Glu1910Lys showed “true” auditory neuropathy-like clinical characteristics. In this study, we have clarified genotype–phenotype correlation and efficacy of cochlear implantation for OTOF-related hearing loss patients in the biggest cohort studied to date. We believe that the clinical characteristics and genotype–phenotype correlation found in this study will support preoperative counseling and appropriate intervention for OTOF-related hearing loss patients.
Collapse
Affiliation(s)
- Yoh-Ichiro Iwasa
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ya Nishio
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto City, 390-8621, Japan
| | - Hidekane Yoshimura
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Akiko Sugaya
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuko Kataoka
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yukihide Maeda
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yukihiko Kanda
- Kanda ENT Clinic, Nagasaki Bell Hearing Center, Nagasaki, Japan
| | - Kyoko Nagai
- TAKASAKI Ear Nose and Throat Clinic, Takasaki, Japan
| | - Yasushi Naito
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroshi Yamazaki
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuo Ikezono
- Department of Otorhinolaryngology, Saitama School of Medicine, Moroyama, Japan
| | - Han Matsuda
- Department of Otorhinolaryngology, Saitama School of Medicine, Moroyama, Japan
| | | | - Risa Tona
- Shiga Medical Center for Children, Shiga, Japan
| | - Yuika Sakurai
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Remi Motegi
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hidehiko Takeda
- Department of Otorhinolaryngology, Toranomon Hospital, Tokyo, Japan
| | - Marina Kobayashi
- Department of Otorhinolaryngology, Toranomon Hospital, Tokyo, Japan
| | - Chiharu Kihara
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Ishino
- Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Shin-Ya Morita
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Iwasaki
- Department of Otorhinolaryngology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Masahiro Takahashi
- Department of Otorhinolaryngology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Sakiko Furutate
- Department of Otorhinolaryngology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Shin-Ichiro Oka
- Department of Otorhinolaryngology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Toshinori Kubota
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yasuhiro Arai
- Department of Otorhinolaryngology-Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Yumiko Kobayashi
- Department of Otolaryngology-Head and Neck Surgery, Iwate Medical University, Morioka, Japan
| | - Daisuke Kikuchi
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - Tomoko Shintani
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noriko Ogasawara
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yohei Honkura
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Shuji Izumi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Misako Hyogo
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuzuru Ninoyu
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mayumi Suematsu
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jun Nakayama
- Department of Otorhinolaryngology, Shiga University School of Medical Science, Otsu, Japan
| | - Nana Tsuchihashi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mayuri Okami
- Department of Otorhinolaryngology, Tokai University School of Medicine, Isehara, Japan
| | | | - Hiroshi Yoshihashi
- Department of Medical Genetics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Taisuke Kobayashi
- Department of Otolaryngology, Kochi University Medical School, Kochi, Japan
| | - Kozo Kumakawa
- Department of Otolaryngology, Kamio Memorial Hospital, Tokyo, Japan
| | - Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoko Esaki
- Department of Otolaryngology, Aichi Children's Health and Medical Center, Obu, Japan
| | - Shin-Ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto City, 390-8621, Japan.
| |
Collapse
|
18
|
Abstract
OBJECTIVE A small subset of children with congenital hearing loss have abnormal cochleovestibular nerves (i.e., absent, aplastic, or deficient cochlear nerves), with largely unknown etiology. Our objective was to investigate the underlying pathways and identify novel genetic variants responsible for cochleovestibular malformations and nerve abnormalities. It is our hypothesis that several cochleovestibular nerve abnormalities might share common causative pathways. DESIGN We used a family-based exome sequencing approach to study 12 children with known rare inner ear and/or cochleovestibular nerve malformations. RESULTS Our results highlight a diverse molecular etiology and suggest that genes important in the developing otic vesicle and cranial neural crest, e.g., MASP1, GREB1L, SIX1, TAF1, are likely to underlie inner ear and/or cochleovestibular nerve malformations. CONCLUSIONS We show that several cochleovestibular nerve malformations are neurocristopathies, which is consistent with the fact that cochleovestibular nerve development is based on otic placode-derived neurons in close association with neural crest-derived glia cells. In addition, we suggest potential genetic markers for more severely affected phenotypes, which may help prognosticate individual cochlear implantation outcomes. Developing better strategies for identifying which children with abnormal nerves will benefit from a cochlear implantation is crucial, as outcomes are usually far less robust and extremely variable in this population, and current neuroimaging and electrophysiologic parameters cannot accurately predict outcomes. Identification of a suitable treatment early will reduce the use of multiple interventions during the time-sensitive period for language development.
Collapse
|
19
|
Establishing Genotype-phenotype Correlation in USH2A-related Disorders to Personalize Audiological Surveillance and Rehabilitation. Otol Neurotol 2021; 41:431-437. [PMID: 32176120 DOI: 10.1097/mao.0000000000002588] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE USH2A-related disorders are characterised by genetic and phenotypic heterogeneity, and are associated with a spectrum of sensory deficits, ranging from deaf blindness to blindness with normal hearing. It has been previously proposed that the presence of specific USH2A alleles can be predictive of unaffected hearing. This study reports the clinical and genetic findings in a group of patients with USH2A-related disease and evaluates the validity of the allelic hierarchy model. PATIENTS AND INTERVENTION USH2A variants from 27 adults with syndromic and nonsyndromic USH2A-related disease were analyzed according to a previously reported model of allelic hierarchy. The analysis was replicated on genotype-phenotype correlation information from 197 individuals previously reported in 2 external datasets. MAIN OUTCOME MEASURE Genotype-phenotype correlations in USH2A-related disease. RESULTS A valid allelic hierarchy model was observed in 93% of individuals with nonsyndromic USH2A-retinopathy (n = 14/15) and in 100% of patients with classic Usher syndrome type IIa (n = 8/8). Furthermore, when two large external cohorts of cases were combined, the allelic hierarchy model was valid across 85.7% (n = 78/91) of individuals with nonsyndromic USH2A-retinopathy and 95% (n = 123/129) of individuals with classic Usher syndrome type II (p = 0.012, χ test). Notably, analysis of all three patient datasets revealed that USH2A protein truncating variants were reported most frequently in individuals with hearing loss. CONCLUSION Genetic testing results in individuals suspected to have an USH2A-related disorder have the potential to facilitate personalized audiological surveillance and rehabilitation pathways.
Collapse
|
20
|
Holzinger D, Hofer J, Dall M. Frühe Prädiktoren der Sprachentwicklung von Kindern mit permanenter Hörstörung. KINDHEIT UND ENTWICKLUNG 2021. [DOI: 10.1026/0942-5403/a000325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Sprachentwicklungsverläufe bei Kindern mit Hörstörungen zeigen eine hohe und überwiegend ungeklärte Varianz. Fragestellung und Methode: Unsere Übersichtsarbeit präsentiert aktuelle Evidenz zu frühen Prädiktoren der Sprachentwicklung. Ergebnisse und Diskussion: Trotz deutlicher positiver Trends erreicht nur jedes zweite Kind ein Sprachentwicklungsniveau im Normbereich. Der Literaturüberblick ergibt signifikante kindbezogene und familiäre Prädiktoren mit eher geringer Beeinflussbarkeit. Als hoch prädiktiv für sprachliche Ergebnisse und zudem der Intervention zugänglich erweisen sich die frühe Erkennung und technische Versorgung mit Hörgeräten oder -implantaten und Aufnahme in die Frühförderung, konsistente Hörtechnikverwendung und/oder früher Zugang zur Gebärdensprache. Zudem zeigt sich die Qualität der täglichen Eltern-Kind-Interaktion als hocheffektiv für die Sprachentwicklung. Schlussfolgerung: Es bestätigt sich die Wirksamkeit aktueller Best Practice früher Erkennung, Versorgung und familienzentrierter Frühförderung.
Collapse
Affiliation(s)
- Daniel Holzinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Linz
- Institut für Sprachwissenschaft, Karl-Franzens-Universität Graz
| | - Johannes Hofer
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Linz
- Abteilung für Pädiatrie I, Medizinische Universität Innsbruck
| | - Magdalena Dall
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz
| |
Collapse
|
21
|
Miyake K, Shirai K, Nishiyama N, Kawaguchi S, Ohta Y, Kawano A, Usami S, Kitano T, Tsukahara K. Cochlear implantation in a patient with a POU4F3 mutation. Clin Case Rep 2021; 9:298-303. [PMID: 33489177 PMCID: PMC7813023 DOI: 10.1002/ccr3.3520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/12/2020] [Accepted: 10/24/2020] [Indexed: 11/21/2022] Open
Abstract
Cochlear implants (CIs) are generally considered useful in the treatment of hereditary hearing loss with progressive deafness. Early CI can be beneficial for maintaining social activities in POU4F3 mutation patients.
Collapse
Affiliation(s)
- Keitaro Miyake
- Department of Otolaryngology, Head and Neck SurgeryTokyo Medical UniversityShinjuku‐kuJapan
| | - Kyoko Shirai
- Department of Otolaryngology, Head and Neck SurgeryTokyo Medical UniversityShinjuku‐kuJapan
| | - Nobuhiro Nishiyama
- Department of Clinical OncologyTokyo Medical University Ibaraki Medical CenterInashiki‐gunJapan
| | - Sachie Kawaguchi
- Department of OtorhinolaryngologyYokohama Asahi Chuo General HospitalYokohama‐shiJapan
| | - Yoko Ohta
- Department of Otolaryngology, Head and Neck SurgeryTokyo Medical UniversityShinjuku‐kuJapan
| | - Atsushi Kawano
- Department of Otolaryngology, Head and Neck SurgeryTokyo Medical UniversityShinjuku‐kuJapan
| | - Shin‐ichi Usami
- Department of Hearing Implant SciencesShinshu University School of MedicineMatsumoto‐shiJapan
| | - Tomohiro Kitano
- Department of OtorhinolaryngologyShinshu University School of MedicineMatsumoto‐shiJapan
| | - Kiyoaki Tsukahara
- Department of Otolaryngology, Head and Neck SurgeryTokyo Medical UniversityShinjuku‐kuJapan
| |
Collapse
|
22
|
Nisenbaum E, Prentiss S, Yan D, Nourbakhsh A, Smeal M, Holcomb M, Cejas I, Telischi F, Liu XZ. Screening Strategies for Deafness Genes and Functional Outcomes in Cochlear Implant Patients. Otol Neurotol 2021; 42:180-187. [PMID: 33885265 PMCID: PMC9237809 DOI: 10.1097/mao.0000000000002969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To review the current state of knowledge about the influence of specific genetic mutations that cause sensorineural hearing loss (SNHL) on cochlear implant (CI) functional outcomes, and how this knowledge may be integrated into clinical practice. A multistep and sequential population-based genetic algorithm suitable for the identification of congenital SNHL mutations before CI placement is also examined. DATA SOURCES, STUDY SELECTION A review was performed of the English literature from 2000 to 2019 using PubMed regarding the influence of specific mutations on CI outcomes and the use of next-generation sequencing for genetic screening of CI patients. CONCLUSION CI is an effective habilitation option for patients with severe-profound congenital SNHL. However, it is well known that CI outcomes show substantial inter-patient variation. Recent advances in genetic studies have improved our understanding of genotype-phenotype relationships for many of the mutations underlying congenital SNHL, and have explored how these relationships may account for some of the variance seen in CI performance outcomes. A sequential genetic screening strategy utilizing next-generation sequencing-based population-specific gene panels may allow for more efficient mutation identification before CI placement. Understanding the relationships between specific mutations and CI outcomes along with integrating routine comprehensive genetic testing into pre-CI evaluations will allow for more effective patient counseling and open the door for the development of mutation-specific treatment strategies.
Collapse
Affiliation(s)
- Eric Nisenbaum
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Sandra Prentiss
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Denise Yan
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Aida Nourbakhsh
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Molly Smeal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Meredith Holcomb
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Ivette Cejas
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Fred Telischi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
| | - Xue Zhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
- Dr. John T. Macdonald Foundation Department of Human Genetics, and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| |
Collapse
|
23
|
Brownstein Z, Gulsuner S, Walsh T, Martins FTA, Taiber S, Isakov O, Lee MK, Bordeynik-Cohen M, Birkan M, Chang W, Casadei S, Danial-Farran N, Abu-Rayyan A, Carlson R, Kamal L, Arnþórsson ÁÖ, Sokolov M, Gilony D, Lipschitz N, Frydman M, Davidov B, Macarov M, Sagi M, Vinkler C, Poran H, Sharony R, Samara N, Zvi N, Baris-Feldman H, Singer A, Handzel O, Hertzano R, Ali-Naffaa D, Ruhrman-Shahar N, Madgar O, Sofrin E, Peleg A, Khayat M, Shohat M, Basel-Salmon L, Pras E, Lev D, Wolf M, Steingrimsson E, Shomron N, Kelley MW, Kanaan M, Allon-Shalev S, King MC, Avraham KB. Spectrum of genes for inherited hearing loss in the Israeli Jewish population, including the novel human deafness gene ATOH1. Clin Genet 2020; 98:353-364. [PMID: 33111345 PMCID: PMC8045518 DOI: 10.1111/cge.13817] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 12/26/2022]
Abstract
Mutations in more than 150 genes are responsible for inherited hearing loss, with thousands of different, severe causal alleles that vary among populations. The Israeli Jewish population includes communities of diverse geographic origins, revealing a wide range of deafness-associated variants and enabling clinical characterization of the associated phenotypes. Our goal was to identify the genetic causes of inherited hearing loss in this population, and to determine relationships among genotype, phenotype, and ethnicity. Genomic DNA samples from informative relatives of 88 multiplex families, all of self-identified Jewish ancestry, with either non-syndromic or syndromic hearing loss, were sequenced for known and candidate deafness genes using the HEar-Seq gene panel. The genetic causes of hearing loss were identified for 60% of the families. One gene was encountered for the first time in human hearing loss: ATOH1 (Atonal), a basic helix-loop-helix transcription factor responsible for autosomal dominant progressive hearing loss in a five-generation family. Our results show that genomic sequencing with a gene panel dedicated to hearing loss is effective for genetic diagnoses in a diverse population. Comprehensive sequencing enables well-informed genetic counseling and clinical management by medical geneticists, otolaryngologists, audiologists, and speech therapists and can be integrated into newborn screening for deafness.
Collapse
Affiliation(s)
- Zippora Brownstein
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Suleyman Gulsuner
- Departments of Genome Sciences and Medicine, University of Washington, Seattle, WA, USA
| | - Tom Walsh
- Departments of Genome Sciences and Medicine, University of Washington, Seattle, WA, USA
| | - Fábio Tadeu Arrojo Martins
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Shahar Taiber
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Isakov
- Department of Cell and Developmental Biology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ming K. Lee
- Departments of Genome Sciences and Medicine, University of Washington, Seattle, WA, USA
| | - Mor Bordeynik-Cohen
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Maria Birkan
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Raphael Recanati Genetic Institute, Rabin Medical Center–Beilinson Hospital, Tel Aviv University Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Weise Chang
- Laboratory of Cochlear Development, National Institute on Deafness and Other Communications Disorders, NIH, Bethesda, MD, USA
| | - Silvia Casadei
- Departments of Genome Sciences and Medicine, University of Washington, Seattle, WA, USA
| | - Nada Danial-Farran
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Genetics Institute, Ha'Emek Medical Center, Afula, Israel
- Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Amal Abu-Rayyan
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Biological Sciences, Bethlehem University, Bethlehem, Palestine
| | - Ryan Carlson
- Departments of Genome Sciences and Medicine, University of Washington, Seattle, WA, USA
| | - Lara Kamal
- Department of Biological Sciences, Bethlehem University, Bethlehem, Palestine
| | - Ásgeir Örn Arnþórsson
- Department of Biochemistry and Molecular Biology, BioMedical Center, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Meirav Sokolov
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology - Head and Neck Surgery, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Dror Gilony
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology - Head and Neck Surgery, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Noga Lipschitz
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology - Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Moshe Frydman
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Bella Davidov
- Raphael Recanati Genetic Institute, Rabin Medical Center–Beilinson Hospital, Tel Aviv University Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Michal Macarov
- Department of Human Genetics and Metabolic Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Michal Sagi
- Department of Human Genetics and Metabolic Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Chana Vinkler
- Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
| | - Hana Poran
- Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Reuven Sharony
- Genetics Institute, Meir Medical Center, Kfar Saba and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Na’ama Zvi
- Department of Human Genetics and Metabolic Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Amihood Singer
- Community Genetics Department, Public Health Services, Ministry of Health, Ramat Gan, Israel
| | - Ophir Handzel
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronna Hertzano
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Doaa Ali-Naffaa
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Human Genetics Institute, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Noa Ruhrman-Shahar
- Raphael Recanati Genetic Institute, Rabin Medical Center–Beilinson Hospital, Tel Aviv University Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Ory Madgar
- Department of Otolaryngology - Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Efrat Sofrin
- Raphael Recanati Genetic Institute, Rabin Medical Center–Beilinson Hospital, Tel Aviv University Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Amir Peleg
- Human Genetics Institute, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Morad Khayat
- Genetics Institute, Ha'Emek Medical Center, Afula, Israel
| | - Mordechai Shohat
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Sheba Cancer Research Center, Sheba Medical Center, Tel Hashomer, Israel
- Institute of Medical Genetics, Maccabi HMO, Rehovot, Israel
| | - Lina Basel-Salmon
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Raphael Recanati Genetic Institute, Rabin Medical Center–Beilinson Hospital, Tel Aviv University Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Elon Pras
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Dorit Lev
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
| | - Michael Wolf
- Department of Otolaryngology - Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Eirikur Steingrimsson
- Department of Biochemistry and Molecular Biology, BioMedical Center, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Noam Shomron
- Department of Cell and Developmental Biology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Matthew W. Kelley
- Laboratory of Cochlear Development, National Institute on Deafness and Other Communications Disorders, NIH, Bethesda, MD, USA
| | - Moien Kanaan
- Department of Biological Sciences, Bethlehem University, Bethlehem, Palestine
| | - Stavit Allon-Shalev
- Genetics Institute, Ha'Emek Medical Center, Afula, Israel
- Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Mary-Claire King
- Departments of Genome Sciences and Medicine, University of Washington, Seattle, WA, USA
| | - Karen B. Avraham
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
24
|
Morgan M, Schott JW, Rossi A, Landgraf C, Warnecke A, Staecker H, Lesinski-Schiedat A, Schlegelberger B, Büning H, Auber B, Schambach A. Gene therapy as a possible option to treat hereditary hearing loss. MED GENET-BERLIN 2020. [DOI: 10.1515/medgen-2020-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The process of hearing involves a series of events. The energy of sound is captured by the outer ear and further transferred through the external auditory canal to the middle ear. In the middle ear, sound waves are converted into movements of the tympanic membrane and the ossicles, thereby amplifying the pressure so that it is sufficient to cause movement of the cochlear fluid. The traveling wave within the cochlea leads to depolarization of the inner ear hair cells that, in turn, release the neurotransmitter glutamate. Thereby, the spiral ganglion neurons are activated to transfer the signals via the auditory pathway to the primary auditory cortex. This complex combination of mechanosensory and physiological mechanisms involves many distinct types of cells, the function of which are impacted by numerous proteins, including those involved in ion channel activity, signal transduction and transcription. In the last 30 years, pathogenic variants in over 150 genes were found to be linked to hearing loss. Hearing loss affects over 460 million people world-wide, and current treatment approaches, such as hearing aids and cochlear implants, serve to improve hearing capacity but do not address the underlying genetic cause of hearing loss. Therefore, therapeutic strategies designed to correct the genetic defects causative for hearing loss offer the possibility to treat these patients. In this review, we will discuss genetic causes of hearing loss, novel gene therapeutic strategies to correct hearing loss due to gene defects and some of the preclinical studies in hearing loss animal models as well as the clinical translation of gene therapy approaches to treat hearing loss patients.
Collapse
Affiliation(s)
- Michael Morgan
- Institute of Experimental Hematology , Hannover Medical School , Hannover , Germany
- REBIRTH Research Center for Translational Regenerative Medicine , Hannover Medical School , Hannover , Germany
| | - Juliane W. Schott
- Institute of Experimental Hematology , Hannover Medical School , Hannover , Germany
- REBIRTH Research Center for Translational Regenerative Medicine , Hannover Medical School , Hannover , Germany
| | - Axel Rossi
- Institute of Experimental Hematology , Hannover Medical School , Hannover , Germany
- REBIRTH Research Center for Translational Regenerative Medicine , Hannover Medical School , Hannover , Germany
| | - Christian Landgraf
- Department of Human Genetics , Hannover Medical School , Hannover , Germany
| | - Athanasia Warnecke
- Department of Otolaryngology , Hannover Medical School , Hannover , Germany
- Hearing4all Cluster of Excellence , Hannover Medical School , Hannover , Germany
| | - Hinrich Staecker
- Department of Otolaryngology Head and Neck Surgery , University of Kansas School of Medicine , Kansas City , USA
| | - Anke Lesinski-Schiedat
- Department of Otolaryngology , Hannover Medical School , Hannover , Germany
- Hearing4all Cluster of Excellence , Hannover Medical School , Hannover , Germany
| | | | - Hildegard Büning
- Institute of Experimental Hematology , Hannover Medical School , Hannover , Germany
- REBIRTH Research Center for Translational Regenerative Medicine , Hannover Medical School , Hannover , Germany
- German Center for Infection Research (DZIF) , partner site Hannover-Braunschweig , Braunschweig , Germany
| | - Bernd Auber
- Department of Human Genetics , Hannover Medical School , Hannover , Germany
| | - Axel Schambach
- Institute of Experimental Hematology , Hannover Medical School , Carl-Neuberg-Str.1 , Hannover , Germany
- REBIRTH Research Center for Translational Regenerative Medicine , Hannover Medical School , Hannover , Germany
- Division of Hematology/Oncology, Boston Children’s Hospital , Harvard Medical School , Boston , MA , USA
| |
Collapse
|
25
|
Tekin AM, de Ceulaer G, Govaerts P, Bayazit Y, Wuyts W, Van de Heyning P, Topsakal V. A New Pathogenic Variant in the TRIOBP Associated with Profound Deafness Is Remediable with Cochlear Implantation. Audiol Neurootol 2020; 26:76-84. [PMID: 32877897 DOI: 10.1159/000508434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A rare type of nonsyndromic autosomal recessive hereditary hearing loss is caused by pathogenic mutations in the TRIOBP gene mostly involving exons 6 and 7. These mutations cause hearing loss originating from dysfunction of sensory inner ear hair cells. Of all the affected siblings, 2 brothers and 1 sister, part of an Afghan family, were referred to our clinic for diagnostic workup and candidacy selection for cochlear implantation (CI). METHODS Molecular analysis showed a homozygous c.1342C > T p. (Arg448*) pathogenic variant in exon 7 of the TRIOBP gene (reference sequence NM_001039141.2) in all 3 affected siblings. Clinical audiometry demonstrated profound sensorineural hearing loss in all 3 affected siblings (2 males and 1 female), and they were implanted unilaterally. RESULTS One month after activation, the pure-tone averages with the CI processor were between 30 and 23 dBHL. Ten months after the first activation of the implant, open-set speech audiometry test could be performed for the first time in the 2 younger CI recipients (S5 and S9), and they could identify up to a maximum 77% phonemes correctly. The oldest brother (S12) could not yet perform open-set speech audiometry at that moment. CONCLUSIONS Implant outcomes are better with normal inner ear anatomy in general. The earlier congenital patients are implanted, the better their outcomes. Here, we demonstrate both statements are true in a homozygous c.1342C > T p. (Arg448*) pathogenic variant in the TRIOBP gene in all 3 affected siblings.
Collapse
Affiliation(s)
- Ahmet M Tekin
- Department of Otolaryngology and Head and Neck Surgery, University of Medipol/Medipol University Hospital, Istanbul, Turkey
| | | | | | - Yıldırım Bayazit
- Department of Otolaryngology and Head and Neck Surgery, University of Medipol/Medipol University Hospital, Istanbul, Turkey
| | - Wim Wuyts
- Faculty of Medicine and Health Sciences, Center of Medical Genetics/University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otolaryngology and Head and Neck Surgery, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences/University of Antwerp, Antwerp, Belgium
| | - Vedat Topsakal
- Department of Otolaryngology and Head and Neck Surgery, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium, .,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences/University of Antwerp, Antwerp, Belgium,
| |
Collapse
|
26
|
Genomic analysis of inherited hearing loss in the Palestinian population. Proc Natl Acad Sci U S A 2020; 117:20070-20076. [PMID: 32747562 DOI: 10.1073/pnas.2009628117] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The genetic characterization of a common phenotype for an entire population reveals both the causes of that phenotype for that place and the power of family-based, population-wide genomic analysis for gene and mutation discovery. We characterized the genetics of hearing loss throughout the Palestinian population, enrolling 2,198 participants from 491 families from all parts of the West Bank and Gaza. In Palestinian families with no prior history of hearing loss, we estimate that 56% of hearing loss is genetic and 44% is not genetic. For the great majority (87%) of families with inherited hearing loss, panel-based genomic DNA sequencing, followed by segregation analysis of large kindreds and transcriptional analysis of participant RNA, enabled identification of the causal genes and mutations, including at distant noncoding sites. Genetic heterogeneity of hearing loss was striking with respect to both genes and alleles: The 337 solved families harbored 143 different mutations in 48 different genes. For one in four solved families, a transcription-altering mutation was the responsible allele. Many of these mutations were cryptic, either exonic alterations of splice enhancers or silencers or deeply intronic events. Experimentally calibrated in silico analysis of transcriptional effects yielded inferences of high confidence for effects on splicing even of mutations in genes not expressed in accessible tissue. Most (58%) of all hearing loss in the population was attributable to consanguinity. Given the ongoing decline in consanguineous marriage, inherited hearing loss will likely be much rarer in the next generation.
Collapse
|
27
|
Eshraghi AA, Polineni SP, Davies C, Shahal D, Mittal J, Al-Zaghal Z, Sinha R, Jindal U, Mittal R. Genotype-Phenotype Correlation for Predicting Cochlear Implant Outcome: Current Challenges and Opportunities. Front Genet 2020; 11:678. [PMID: 32765579 PMCID: PMC7381205 DOI: 10.3389/fgene.2020.00678] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/02/2020] [Indexed: 12/13/2022] Open
Abstract
The use and utility of cochlear implantation has rapidly increased in recent years as technological advances in the field have expanded both the efficacy and eligible patient population for implantation. This review aims to serve as a general overview of the most common hearing disorders that have favorable auditory outcomes with cochlear implants (CI). Hearing loss in children caused by congenital cytomegalovirus infection, syndromic conditions including Pendred Syndrome, and non-syndromic genetic conditions such as hearing impairment associated with GJB2 mutations have shown to be successfully managed by CI. Furthermore, cochlear implantation provides the auditory rehabilitation for the most common etiology of hearing loss in adults and age-related hearing loss (ARHL) or presbycusis. However, in some cases, cochlear implantation have been associated with some challenges. Regarding implantation in children, studies have shown that sometimes parents seem to have unrealistic expectations regarding the ability of CI to provide auditory rehabilitation and speech improvement. Given the evidence revealing the beneficial effects of early intervention via CI in individuals with hearing disorders especially hearing loss due to genetic etiology, early auditory and genetic screening efforts may yield better clinical outcomes. There is a need to better understand genotype-phenotype correlations and CI outcome, so that effective genetic counseling and successful treatment strategies can be developed at the appropriate time for hearing impaired individuals.
Collapse
Affiliation(s)
- Adrien A. Eshraghi
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
- Department of Neurological Surgery, Miller School of Medicine, Miami, FL, United States
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States
| | - Sai P. Polineni
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| | - Camron Davies
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| | - David Shahal
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| | - Jeenu Mittal
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| | - Zaid Al-Zaghal
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| | - Rahul Sinha
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| | - Urmi Jindal
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| | - Rahul Mittal
- Department of Otolaryngology, Miller School of Medicine, University of Miami Hearing Research Laboratory, Miami, FL, United States
| |
Collapse
|
28
|
Sucher CM, Eikelboom RH, Stegeman I, Jayakody DMP, Atlas MD. The effect of hearing loss configuration on cochlear implantation uptake rates: an Australian experience. Int J Audiol 2020; 59:828-834. [PMID: 32496880 DOI: 10.1080/14992027.2020.1768445] [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: 10/24/2022]
Abstract
Objective: Recent changes to cochlear implant (CI) candidacy criteria have led to the inclusion of candidates with greater levels of hearing in the contralateral and/or implanted ear. This study assessed the impact of various hearing loss configurations on CI uptake rates (those assessed as eligible for CI, who proceed to CI).Design: Retrospective cohort study.Study sample: Post-lingually deaf adult CI candidates (n = 619) seen at a Western Australian cochlear implant clinic.Results: An overall CI uptake rate of 44% was observed. Hearing loss configuration significantly impacted uptake rates. Uptake rates of 62% for symmetrical hearing loss, 48% for asymmetrical hearing loss (four-frequency average hearing loss (4FAHL) asymmetry ≤60 dB), 25% for highly asymmetrical hearing loss (4FAHL asymmetry >60 dB), 38% for hearing losses eligible for electric-acoustic stimulation, and 22% for individuals with single-sided hearing loss were observed. Hearing loss configuration and age were both significant factors in relation to CI uptake although the impact of age was limited.Conclusion: CI clinics who apply or are considering applying expanded CI candidacy criteria within their practice should be aware that candidates with greater levels of residual hearing in at least the contralateral ear are less likely to proceed to CI.
Collapse
Affiliation(s)
- Cathy M Sucher
- Ear Science Clinic, Ear Science Institute Australia, Subiaco East, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
| | - Robert H Eikelboom
- Ear Science Clinic, Ear Science Institute Australia, Subiaco East, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Inge Stegeman
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.,UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Dona M P Jayakody
- Ear Science Clinic, Ear Science Institute Australia, Subiaco East, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
| | - Marcus D Atlas
- Ear Science Clinic, Ear Science Institute Australia, Subiaco East, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
| |
Collapse
|
29
|
Zheng D, Liu X. Cochlear Implantation Outcomes in Patients With OTOF Mutations. Front Neurosci 2020; 14:447. [PMID: 32508568 PMCID: PMC7253664 DOI: 10.3389/fnins.2020.00447] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/09/2020] [Indexed: 01/26/2023] Open
Abstract
Auditory neuropathy is a special type of hearing loss caused by dysfunction of the synapse of the inner hair cells, the auditory nerve, and/or the auditory nerve itself. For patients with auditory neuropathy who have severe to profound hearing loss or failed auditory skills development with hearing-aids, cochlear implantation (CI) serves as the only possible effective treatment. It is accepted that the exact sites of lesion causing auditory neuropathy determine the CI performance. Mutations in the OTOF gene were the first identified and the most common cause of congenital auditory neuropathy. The site of lesion in patients with auditory neuropathy caused by biallelic OTOF mutations (OTOF-related auditory neuropathy) is presumed to be presynaptic, leaving auditory nerve function intact. Thus, OTOF-related auditory neuropathy is expected to have good CI performances. In this review, we describe the CI outcomes in patients with OTOF mutations. We will focus on whether biallelic OTOF mutations are ideal indications for CI in patients with auditory neuropathy. Also, the factors that may still influence the CI outcomes in patients with OTOF mutations are discussed.
Collapse
Affiliation(s)
- Dandan Zheng
- Department of Otorhinolaryngology, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiao Liu
- Department of Otorhinolaryngology, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
30
|
Lee SY, Shim YJ, Han JH, Song JJ, Koo JW, Oh SH, Lee S, Oh DY, Choi BY. The molecular etiology of deafness and auditory performance in the postlingually deafened cochlear implantees. Sci Rep 2020; 10:5768. [PMID: 32238869 PMCID: PMC7113281 DOI: 10.1038/s41598-020-62647-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/02/2020] [Indexed: 11/09/2022] Open
Abstract
Recent advances in molecular genetic testing (MGT) have improved identification of genetic aetiology of candidates for cochlear implantation (CI). However, whether genetic information increases CI outcome predictability in post-lingual deafness remains unclear. Therefore, we evaluated the outcomes of CI with respect to genetic aetiology and clinical predictors by comparing the data of study subjects; those with an identified genetic aetiology (GD group), and those without identifiable variants (GUD group). First, we identified the genetic aetiology in 21 of 40 subjects and also observed genetic etiologic heterogeneity. The GD group demonstrated significantly greater improvement in speech perception scores over a 1-year period than did the GUD group. Further, inverse correlation between deafness duration and the 1-year improvement in speech perception scores was tighter in the GD group than in the GUD group. The weak correlation between deafness duration and CI outcomes in the GUD group might suggest the pathophysiology underlying GUD already significantly involves the cortex, leading to lesser sensitivity to further cortex issues such as deafness duration. Under our MGT protocol, the correlation between deafness duration and CI outcomes were found to rely on the presence of identifiable genetic aetiology, strongly advocating early CI in individual with proven genetic aetiologies.
Collapse
Affiliation(s)
- Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ye Ji Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
| | - Jin-Hee Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Seungmin Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Doo-Yi Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| |
Collapse
|
31
|
Usami SI, Nishio SY, Moteki H, Miyagawa M, Yoshimura H. Cochlear Implantation From the Perspective of Genetic Background. Anat Rec (Hoboken) 2020; 303:563-593. [PMID: 32027099 PMCID: PMC7064903 DOI: 10.1002/ar.24360] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 12/13/2019] [Indexed: 12/18/2022]
Abstract
While cochlear implantation (CI) technology has greatly improved over the past 40 years, one aspect of CI that continues to pose difficulties is the variability of outcomes due to numerous factors involved in postimplantation performance. The electric acoustic stimulation (EAS) system has expanded indications for CI to include patients with residual hearing, and is currently becoming a standard therapy for these patients. Genetic disorders are known to be the most common cause of congenital/early-onset sensorineural hearing loss, and are also involved in a considerable proportion of cases of late-onset hearing loss. There has been a great deal of progress in the identification of deafness genes over the last two decades. Currently, more than 100 genes have been reported to be associated with non-syndromic hearing loss. Patients possessing a variety of deafness gene mutations have achieved satisfactory auditory performance after CI/EAS, suggesting that identification of the genetic background facilitates prediction of post-CI/EAS performance. When the intra-cochlear etiology is associated with a specific genetic background, there is a potential for good CI performance. Thus, it is essential to determine which region of the cochlea is affected by identifying the responsible genes. This review summarizes the genetic background of the patients receiving CI/EAS, and introduces detailed clinical data and CI/EAS outcomes in representative examples. Anat Rec, 303:563-593, 2020. © 2020 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.
Collapse
Affiliation(s)
- Shin-Ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ya Nishio
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hideaki Moteki
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Maiko Miyagawa
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hidekane Yoshimura
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
32
|
Cochlear Implantation Outcome in Children with DFNB1 locus Pathogenic Variants. J Clin Med 2020; 9:jcm9010228. [PMID: 31952308 PMCID: PMC7019930 DOI: 10.3390/jcm9010228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 11/30/2022] Open
Abstract
Almost 60% of children with profound prelingual hearing loss (HL) have a genetic determinant of deafness, most frequently two DFNB1 locus (GJB2/GJB6 genes) recessive pathogenic variants. Only few studies combine HL etiology with cochlear implantation (CI) outcome. Patients with profound prelingual HL who received a cochlear implant before 24 months of age and had completed DFNB1 genetic testing were enrolled in the study (n = 196). LittlEARS questionnaire scores were used to assess auditory development. Our data show that children with DFNB1-related HL (n = 149) had good outcome from the CI (6.85, 22.24, and 28 scores at 0, 5, and 9 months post-CI, respectively). A better auditory development was achieved in patients who receive cochlear implants before 12 months of age. Children without residual hearing presented a higher rate of auditory development than children with responses in hearing aids over a wide frequency range prior to CI, but both groups reached a similar level of auditory development after 9 months post-CI. Our data shed light upon the benefits of CI in the homogenous group of patients with HL due to DFNB1 locus pathogenic variants and clearly demonstrate that very early CI is the most effective treatment method in this group of patients.
Collapse
|
33
|
Büning H, Schambach A, Morgan M, Rossi A, Wichova H, Staecker H, Warnecke A, Lenarz T. Challenges and advances in translating gene therapy for hearing disorders. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2020. [DOI: 10.1080/23808993.2020.1707077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hildegard Büning
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research, Braunschweig, Germany
- REBIRTH Cluster of Excellence, Hannover Medical School, Hannover, Germany
| | - Axel Schambach
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
- REBIRTH Cluster of Excellence, Hannover Medical School, Hannover, Germany
- Division of Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael Morgan
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
- REBIRTH Cluster of Excellence, Hannover Medical School, Hannover, Germany
| | - Axel Rossi
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Helena Wichova
- Department of Otolaryngology Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, USA
| | - Hinrich Staecker
- Department of Otolaryngology Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, USA
| | - Athanasia Warnecke
- Department of Otolaryngology, Hannover Medical School, 30625 Hannover, Germany
- Hearing4all Cluster of Excellence, Hannover Medical School, Hannover, Germany
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, 30625 Hannover, Germany
- Hearing4all Cluster of Excellence, Hannover Medical School, Hannover, Germany
| |
Collapse
|
34
|
Role of Targeted Next Generation Sequencing in the Etiological Work-Up of Congenitally Deaf Children. Otol Neurotol 2019; 39:732-738. [PMID: 29889784 DOI: 10.1097/mao.0000000000001847] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The purpose of this study is to report the results of a comprehensive etiological work-up for congenitally deaf children including targeted next generation sequencing. STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS Fifty children with congenital, bilateral profound hearing loss (HL) (>90 dBnHL). INTERVENTIONS Etiological work-up included testing for pathogenic variants in GJB2, a phenotype driven genetic analysis, screening for congenital infections and imaging. When no etiology could be found, comprehensive genetic testing was performed using a HL gene panel including 45 syndromic and 96 non-syndromic HL genes. RESULTS Eleven patients carried bi-allelic pathogenic variants in GJB2. Phenotype driven genetic analysis identified two homozygous KCNQ1 patients (Jervell and Lange Nielsen syndrome) and one heterozygous CHD7 patient (CHARGE syndrome). One patient was diagnosed with achondroplasia and one had a clinical diagnosis of Waardenburg syndrome. A deafness gene panel evaluated 16 patients. In 12 out of 16, we identified a pathogenic (n = 12) or likely pathogenic (n = 2) variant and one variant of unknown significance (VUS). A definite diagnosis of non-syndromic or syndromic HL was made in 18 and seven patients, respectively. Non-genetic causes were congenital cytomegalovirus infection (n = 11), anatomic abnormalities (n = 2), neurological/metabolic/polymalformative conditions (n = 3), meningitis (n = 1), and auditory neuropathy (n = 1). CONCLUSIONS A definite genetic cause was found in 25 (50%) of congenital, bilaterally deaf children. Our data show that implementation of a gene panel improves the diagnostic yield for etiological work-up of congenital profound HL to 86%. Identification of the etiology of congenital HL may contribute to predicting outcomes of cochlear implantation.
Collapse
|
35
|
Shearer AE, Hansen MR. Auditory synaptopathy, auditory neuropathy, and cochlear implantation. Laryngoscope Investig Otolaryngol 2019; 4:429-440. [PMID: 31453354 PMCID: PMC6703118 DOI: 10.1002/lio2.288] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/17/2019] [Accepted: 06/13/2019] [Indexed: 02/03/2023] Open
Abstract
Cochlear implantation has become the standard-of-care for adults and children with severe to profound hearing loss. There is growing evidence that qualitative as well as quantitative deficits in the auditory nerve may affect cochlear implant (CI) outcomes. Auditory neuropathy spectrum disorder (ANSD) is characterized by dysfunctional transmission of sound from the cochlea to the brain due to defective synaptic function or neural conduction. In this review, we examine the precise mechanisms of genetic lesions causing ANSD and the effect of these lesions on CI outcomes. Reviewed data show that individuals with lesions that primarily affect the cochlear sensory system and the synapse, which are bypassed by the CI, have optimal CI outcomes. Individuals with lesions that affect the auditory nerve show poor performance with CIs, likely because neural transmission of the electrical signal from the CI is affected. We put forth a nuanced molecular classification of ANSD that has implications for preoperative counseling for patients with this disorder prior to cochlear implantation. We propose that description of ANSD patients should be based on the molecular site of lesion typically derived from genetic evaluation (synaptopathy vs. neuropathy) as this has implications for expected CI outcomes. Improvements in our understanding of genetic site of lesions and their effects on CI function should lead to better CI outcomes, not just for individuals with auditory neuropathy, but all individuals with hearing loss.
Collapse
Affiliation(s)
- Aiden Eliot Shearer
- Department of Otolaryngology-Head and Neck Surgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A
| | - Marlan R Hansen
- Department of Otolaryngology-Head and Neck Surgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A.,Department of Neurosurgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A
| |
Collapse
|
36
|
Dieleman E, Percy-Smith L, Caye-Thomasen P. Language outcome in children with congenital hearing impairment: The influence of etiology. Int J Pediatr Otorhinolaryngol 2019; 117:37-44. [PMID: 30579085 DOI: 10.1016/j.ijporl.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the possible association between the etiology of hearing impairment (HI) and language outcome in children with congenital HI after an early medical-technical intervention and three years of AVT. METHODS A retrospective, two-center study was conducted of 53 patients who were divided in four categories of etiology (degeneratio labyrinthi acustici (DLA) congenita hereditaria, DLA congenita non specificata, DLA congenita postinfectiosa and auditory neuropathy). Language outcome was assessed by examining receptive vocabulary (Peabody Picture Vocabulary Test, PPVT-4), receptive language (Reynell test) and productive language (the Danish 'Viborgmaterialet'). All tests were conducted 1, 2 and 3 years after the children received their hearing device. Test scores were calculated from the child's chronological age. Analysis of possible associations was performed using Fisher's exact test and McNemar's test was conducted to examine possible differences between each year of testing for every speech-language test. Subsequently, univariate analyses were performed to search for other possible covariates associated with language outcome. RESULTS No significant associations were found between the etiology of the HI and the language outcome of children with HI after 1 year of AVT (PPVT, p = 0,234; Reynell, p = 0,845; Viborgmaterialet, p = 0,667), neither after 2 years of AVT (PPVT, p = 0,228; Reynell, p = 0,172; Viborgmaterialet, p = 0,659) nor after 3 years of AVT (PPVT, p = 0,102; Reynell, p = 0,512 Viborgmaterialet, p = 0,580). Some significant associations were found between language outcome and the type of hearing device and between language outcome and additional disabilities, however no strong evidence was found. CONCLUSION Most children with congenital HI developed a comparable level of speech and language regardless of the etiology of their HI. This study highlights the interest of further research using objective assessments techniques in a larger and more homogeneous population. If the findings from this study will be confirmed in future studies, this will have a clinical and societal impact regarding the diagnostics of HI.
Collapse
Affiliation(s)
- Eveline Dieleman
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Lone Percy-Smith
- Patientforening Decibel, Rygårdsallé 43, 2900, Hellerup, Denmark
| | - Per Caye-Thomasen
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| |
Collapse
|
37
|
Liu WH, Chang PY, Chang SC, Lu JJ, Wu CM. Mutation screening in non-syndromic hearing loss patients with cochlear implantation by massive parallel sequencing in Taiwan. PLoS One 2019; 14:e0211261. [PMID: 30682115 PMCID: PMC6347456 DOI: 10.1371/journal.pone.0211261] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 01/10/2019] [Indexed: 01/05/2023] Open
Abstract
Objectives To explore the molecular epidemiology of rare deafness genes in Taiwanese sensorineural hearing impairment (SNHI) patients with cochlear implantation (CI) by performing massive parallel sequencing (MPS) and correlating genetic factors and CI outcomes. Methods We enrolled 41 Taiwanese non-syndromic deafness patients with CI that lacked known mutations in common deafness genes. All probands were screened by a targeted exon amplification method that used massively parallel sequencing to screen a customized panel that included 40 relatively rare non-syndromic deafness genes. Results Thirteen candidate variants in nine relatively rare deafness genes (MYO15A, TMC1, MYH14, MYO3A, ACTG1, COL11A2, DSPP, GRHL2, and WFS1) were identified in 24.4% (10/41) of the non-syndromic deafness probands with CI. According to the ACMG Standards and Guidelines, five variants in MYO15A and ACTG1 were classified as likely pathogenic variants. Two of three multi-generational pedigrees exhibiting deafness were analyzed for the segregation of the disorder with the possible disease-causing variants. Patients with variants detected in most of the identified variant-bearing genes showed relatively good CI outcomes. Conclusions We successfully identified candidate variants in partially deaf Taiwanese probands who lacked the known mutations in common deafness genes. Comparing the progress of hearing rehabilitation in CI patients with their apparent causative variants and the expression profiles of their altered genes allowed us to speculate on how alterations in specific gene sets may influence outcomes in hearing rehabilitation after CI.
Collapse
Affiliation(s)
- Wei-Hsiu Liu
- Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan
- Department of Otolaryngology—Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Pi-Yueh Chang
- Department of Medical Biotechnology and Laboratory Science, Chang-Gung University, Taoyuan, Taiwan
- Department of Medical Research, Chang-Gung Memorial Hospital and Graduate of Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Cheng Chang
- Department of Medical Biotechnology and Laboratory Science, Chang-Gung University, Taoyuan, Taiwan
- Department of Medical Research, Chang-Gung Memorial Hospital and Graduate of Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan
| | - Jang-Jih Lu
- Department of Medical Biotechnology and Laboratory Science, Chang-Gung University, Taoyuan, Taiwan
- Department of Medical Research, Chang-Gung Memorial Hospital and Graduate of Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan
- * E-mail: (CMW); (J-JL)
| | - Che-Ming Wu
- Department of Otolaryngology—Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan
- * E-mail: (CMW); (J-JL)
| |
Collapse
|
38
|
Moteki H, Nishio SY, Miyagawa M, Tsukada K, Noguchi Y, Usami SI. Feasibility of hearing preservation for residual hearing with longer cochlear implant electrodes. Acta Otolaryngol 2018; 138:1080-1085. [PMID: 30702034 DOI: 10.1080/00016489.2018.1508888] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Hearing preservation is thought to be achievable following atraumatic surgery with thin cochlear implant electrodes; therefore, the surgical approach and implant electrode design are crucial considerations. OBJECTIVE To assess the feasibility of hearing preservation with long electrodes for patients meeting the criteria for conventional cochlear implantation. METHODS One hundred and two patients (132 ears) who underwent cochlear implant surgery were analyzed. Inclusion criteria included measurable residual hearing in the low frequency before implantation and not meeting the criteria for electric acoustic stimulation (EAS). RESULTS Of the 18 patients with residual hearing in the low frequency enrolled, 17 subjects (94.4%) retained low frequency hearing. A younger age at surgery tended to contribute to better hearing preservation than that observed in older patients. There was no clear trend regarding the influence of insertion depth angle of the electrode on hearing preservation. CONCLUSION It is possible to achieve hearing preservation in the lower frequency by the use of longer electrodes. This study underscores the importance of atraumatic surgery, even for patients with only limited residual hearing, and longer electrodes should be adopted for EAS.
Collapse
Affiliation(s)
- Hideaki Moteki
- aDepartment of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
- bDepartment of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ya Nishio
- aDepartment of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
- bDepartment of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Maiko Miyagawa
- aDepartment of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Keita Tsukada
- aDepartment of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshihiro Noguchi
- bDepartment of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
- cDepartment of Otolaryngology, International University of Health and Welfare, Narita, Japan
| | - Shin-Ichi Usami
- aDepartment of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
- bDepartment of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
39
|
Rudman JR, Mei C, Bressler SE, Blanton SH, Liu XZ. Precision medicine in hearing loss. J Genet Genomics 2018; 45:99-109. [PMID: 29500086 DOI: 10.1016/j.jgg.2018.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 11/26/2022]
Abstract
Precision medicine (PM) proposes customized medical care based on a patient's unique genome, biomarkers, environment and behaviors. Hearing loss (HL) is the most common sensorineural disorder worldwide and is frequently caused by a single genetic mutation. With recent advances in PM tools such as genetic sequencing and data analysis, the field of HL is ideally positioned to adopt the strategies of PM. Here, we review current and future applications of PM in HL as they relate to the four core qualities of PM (P4): predictive, personalized, patient-centered, and participatory. We then introduce a strategy for effective incorporation of HL PM into the design of future research studies, electronic medical records, and clinical practice to improve diagnostics, prognostics, and, ultimately, individualized patient treatment. Finally, specific anticipated ethical and economic concerns in this growing era of genomics-based HL treatment are discussed. By integrating PM principles into translational HL research and clinical practice, hearing specialists are uniquely positioned to effectively treat the heterogeneous causes and manifestations of HL on an individualized basis.
Collapse
Affiliation(s)
- Jason R Rudman
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Christine Mei
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Sara E Bressler
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Susan H Blanton
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA; John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Xue-Zhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA; John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| |
Collapse
|
40
|
Lechowicz U, Pollak A, Frączak A, Rydzanicz M, Stawiński P, Lorens A, Skarżyński PH, Skarżyński H, Płoski R, Ołdak M. Application of next‑generation sequencing to identify mitochondrial mutations: Study on m.7511T>C in patients with hearing loss. Mol Med Rep 2017; 17:1782-1790. [PMID: 29257206 PMCID: PMC5780123 DOI: 10.3892/mmr.2017.8064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/24/2017] [Indexed: 11/23/2022] Open
Abstract
Interruptions in the activity of mitochondria induced by mutations in the mitochondrial genome (mtDNA) can be the source of numerous diseases including hearing loss (HL). One of the mitochondrial variants responsible for HL is the m.7511T>C mutation located in the mitochondrially encoded tRNA serine 1 (UCN) gene. Next-generation sequencing was used to search for the HL mutations in the whole mtDNA of 2 patients with maternal inheritance and real time-polymerase chain reaction was applied for population screening of the m.7511T>C mutation in a group of 1,644 patients with HL. Sequencing of the whole mtDNA in 2 probands revealed a homoplasmic m.7511T>C mutation. Inheritance of the m.7511T>C mutation has been confirmed in examined matrilineal relatives in both families. The mean age of HL onset was 14.1 years old with the mean degree of HL equaling 74.8 dB. A large-scale search for the m.7511T>C mutation among the patients with HL established the frequency of the m.7511T>C mutation at 0.12% among Polish patients with HL. In conclusion, this first report on central European patients harboring the m.7511T>C mutation reveals that the m.7511T>C may be important when diagnosing patients with maternally inherited HL.
Collapse
Affiliation(s)
- Urszula Lechowicz
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| | - Agnieszka Pollak
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| | - Agnieszka Frączak
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| | - Małgorzata Rydzanicz
- Department of Medical Genetics, Center for Biostructure, Medical University of Warsaw, 02‑106 Warsaw, Poland
| | - Piotr Stawiński
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| | - Artur Lorens
- Department of Implants and Auditory Perception, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| | - Piotr H Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| | - Henryk Skarżyński
- Oto‑Rhino‑Laryngology Surgery Clinic, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| | - Rafał Płoski
- Department of Medical Genetics, Center for Biostructure, Medical University of Warsaw, 02‑106 Warsaw, Poland
| | - Monika Ołdak
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, 02‑042 Warsaw, Poland
| |
Collapse
|
41
|
Parzefall T, Frohne A, Koenighofer M, Kirchnawy A, Streubel B, Schoefer C, Gstoettner W, Frei K, Lucas T. Identification of a rare COCH mutation by whole-exome sequencing : Implications for personalized therapeutic rehabilitation in an Austrian family with non-syndromic autosomal dominant late-onset hearing loss. Wien Klin Wochenschr 2017; 130:299-306. [PMID: 28733840 PMCID: PMC5966484 DOI: 10.1007/s00508-017-1230-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/26/2017] [Indexed: 12/24/2022]
Abstract
Background Non-syndromic autosomal dominant hearing impairment is characteristically postlingual in onset. Genetic diagnostics are essential for genetic counselling, disease prognosis and understanding of the molecular mechanisms of disease. To date, 36 causative genes have been identified, many in only individual families. Gene selection for genetic screening by traditional methods and genetic diagnosis in autosomal dominant patients has therefore been fraught with difficulty. Whole-exome sequencing provides a powerful tool to analyze all protein-coding genomic regions in parallel, thus allowing the comprehensive screening of all known genes and associated alterations. Methods In this study, a previously undiagnosed late-onset progressive autosomal dominant hearing loss in an Austrian family was investigated by means of whole-exome sequencing. Results were confirmed by Sanger sequencing. Results A previously described c.151C>T missense (p.Pro51Ser) mutation in the LCCL (limulus factor C, cochlin, late gestation lung protein Lgl1) domain of the cochlin gene (COCH) was identified as causative and segregated with disease in five members of the family. Molecular diagnostics led to the decision to perform cochlear implantation in an index patient who subsequently showed excellent postoperative auditory performance. The c.151C>T mutation was not found in 18 screened Austrian families with autosomal dominant hearing loss but was represented alongside other known pathogenic mutant COCH alleles in the Genome Aggregation Database (gnomAD) in European populations. A combined allele frequency of 0.000128 implies an orphan disease frequency for COCH-induced hearing loss of 1:3900 in Europe. Conclusions Exome sequencing successfully resolved the genetic diagnosis in a family suffering from autosomal dominant hearing impairment and allowed prediction of purported auditory outcome after cochlear implantation in an index patient. Personalized treatment approaches based on the molecular mechanisms of disease may become increasingly important in the future.
Collapse
Affiliation(s)
- Thomas Parzefall
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Alexandra Frohne
- Department for Cell and Developmental Biology, Orphan disease genetics group, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Martin Koenighofer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Andreas Kirchnawy
- Department for Cell and Developmental Biology, Orphan disease genetics group, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Berthold Streubel
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - Christian Schoefer
- Department for Cell and Developmental Biology, Orphan disease genetics group, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Gstoettner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Klemens Frei
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Trevor Lucas
- Department for Cell and Developmental Biology, Orphan disease genetics group, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
42
|
Nishio SY, Usami SI. Outcomes of cochlear implantation for the patients with specific genetic etiologies: a systematic literature review. Acta Otolaryngol 2017; 137:730-742. [PMID: 28498079 DOI: 10.1080/00016489.2016.1276303] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
CONCLUSION Most of the cases with gene mutations of intra-cochlear etiology showed relatively good CI outcomes. To progress toward more solid evidence-based CI intervention, a greater number of reports including CI outcomes for specific gene mutations are desired. BACKGROUND Cochlear implantation (CI) is the most important and effective treatment for patients with profound sensorineural hearing loss. However, the outcomes of CI vary among patients. One of the reasons of this heterogeneous outcome for cochlear implantation is thought to be the heterogeneous nature of hearing loss. Indeed, genetic factors, the most common etiology in severe-to-profound hearing loss, might be one of the key determinants of outcomes for CI and electric acoustic stimulation (EAS). Patients with genetic causes involving an 'intra-cochlear' etiology show good CI/EAS outcomes. REVIEW This review article aimed to summarize the reports on CI/EAS outcomes in patients with special genetic causes as well as to assist in future clinical decision-making. Most of the cases were suspected of an intra-cochlear etiology, such as those with GJB2, SLC26A4, and OTOF mutations, which showed relatively good CI outcomes. However, there have only been a limited number of reports on patients with other gene mutations.
Collapse
Affiliation(s)
- Shin-ya Nishio
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Shin-ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| |
Collapse
|
43
|
Kitano T, Miyagawa M, Nishio SY, Moteki H, Oda K, Ohyama K, Miyazaki H, Hidaka H, Nakamura KI, Murata T, Matsuoka R, Ohta Y, Nishiyama N, Kumakawa K, Furutate S, Iwasaki S, Yamada T, Ohta Y, Uehara N, Noguchi Y, Usami SI. POU4F3 mutation screening in Japanese hearing loss patients: Massively parallel DNA sequencing-based analysis identified novel variants associated with autosomal dominant hearing loss. PLoS One 2017; 12:e0177636. [PMID: 28545070 PMCID: PMC5435223 DOI: 10.1371/journal.pone.0177636] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 05/01/2017] [Indexed: 11/18/2022] Open
Abstract
A variant in a transcription factor gene, POU4F3, is responsible for autosomal dominant nonsyndromic hereditary hearing loss, DFNA15. To date, 14 variants, including a whole deletion of POU4F3, have been reported to cause HL in various ethnic groups. In the present study, genetic screening for POU4F3 variants was carried out for a large series of Japanese hearing loss (HL) patients to clarify the prevalence and clinical characteristics of DFNA15 in the Japanese population. Massively parallel DNA sequencing of 68 target candidate genes was utilized in 2,549 unrelated Japanese HL patients (probands) to identify genomic variations responsible for HL. The detailed clinical features in patients with POU4F3 variants were collected from medical charts and analyzed. Novel 12 POU4F3 likely pathogenic variants (six missense variants, three frameshift variants, and three nonsense variants) were successfully identified in 15 probands (2.5%) among 602 families exhibiting autosomal dominant HL, whereas no variants were detected in the other 1,947 probands with autosomal recessive or inheritance pattern unknown HL. To obtain the audiovestibular configuration of the patients harboring POU4F3 variants, we collected audiograms and vestibular symptoms of the probands and their affected family members. Audiovestibular phenotypes in a total of 24 individuals from the 15 families possessing variants were characterized by progressive HL, with a large variation in the onset age and severity with or without vestibular symptoms observed. Pure-tone audiograms indicated the most prevalent configuration as mid-frequency HL type followed by high-frequency HL type, with asymmetry observed in approximately 20% of affected individuals. Analysis of the relationship between age and pure-tone average suggested that individuals with truncating variants showed earlier onset and slower progression of HL than did those with non-truncating variants. The present study showed that variants in POU4F3 were a common cause of autosomal dominant HL.
Collapse
Affiliation(s)
- Tomohiro Kitano
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Maiko Miyagawa
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-ya Nishio
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hideaki Moteki
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kiyoshi Oda
- Department of Otorhinolaryngology, Tohoku Rosai Hospital, Sendai, Japan
| | - Kenji Ohyama
- Department of Otorhinolaryngology, Tohoku Rosai Hospital, Sendai, Japan
| | - Hiromitsu Miyazaki
- Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Hiroshi Hidaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Ken-ichi Nakamura
- Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Takaaki Murata
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Rina Matsuoka
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoko Ohta
- Department of Otorhinolaryngology Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Nobuhiro Nishiyama
- Department of Otorhinolaryngology Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kozo Kumakawa
- Department of Otorhinolaryngology, Toranomon Hospital, Tokyo, Japan
| | - Sakiko Furutate
- Department of Otorhinolaryngology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Satoshi Iwasaki
- Department of Otorhinolaryngology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Takechiyo Yamada
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Fukui, Fukui, Japan
| | - Yumi Ohta
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Natsumi Uehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University School of Medicine, Kobe, Japan
| | - Yoshihiro Noguchi
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
- * E-mail:
| |
Collapse
|
44
|
Moteki H, Nishio SY, Miyagawa M, Tsukada K, Iwasaki S, Usami SI. Long-term results of hearing preservation cochlear implant surgery in patients with residual low frequency hearing. Acta Otolaryngol 2017; 137:516-521. [PMID: 27852135 DOI: 10.1080/00016489.2016.1252061] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSION Differences were found between patients with stable hearing and those with progressive hearing loss in the lower frequencies with respect to the rate of progression in the contralateral ear. It is suggested that the electric acoustic stimulation (EAS) can provide improvement in hearing ability over the long-term if residual hearing might be lost to some extent. OBJECTIVE To evaluate the long-term threshold changes in the low frequency hearing of the implanted ear as compared with the non-implanted ear, and the hearing abilities with EAS along with the extent of residual hearing. METHODS Seventeen individuals were enrolled and received the EAS implant with a 24-mm FLEXeas electrode array. Hearing thresholds and speech perception were measured pre- and post-operatively for 1-5 years. Post-operative hearing preservation (HP) rates were calculated using the preservation numerical scale. RESULTS The average linear regression coefficient for the decline in hearing preservation score was -6.9 for the implanted ear and the patients were subsequently categorized into two groups: those with better than average, stable hearing; and those with worse than average, progressive hearing loss. EAS showed better results than electric stimulation alone, in spite of an absence of speech perception with acoustic stimulation.
Collapse
Affiliation(s)
- Hideaki Moteki
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-ya Nishio
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Maiko Miyagawa
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Keita Tsukada
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoshi Iwasaki
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Shin-ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
45
|
Shearer AE, Eppsteiner RW, Frees K, Tejani V, Sloan-Heggen CM, Brown C, Abbas P, Dunn C, Hansen MR, Gantz BJ, Smith RJH. Genetic variants in the peripheral auditory system significantly affect adult cochlear implant performance. Hear Res 2017; 348:138-142. [PMID: 28213135 DOI: 10.1016/j.heares.2017.02.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 01/12/2017] [Accepted: 02/13/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cochlear implantation is an effective habilitation modality for adults with significant hearing loss. However, post-implant performance is variable. A portion of this variance in outcome can be attributed to clinical factors. Recent physiological studies suggest that the health of the spiral ganglion also impacts post-operative cochlear implant outcomes. The goal of this study was to determine whether genetic factors affecting spiral ganglion neurons may be associated with cochlear implant performance. METHODS Adults with post-lingual deafness who underwent cochlear implantation at the University of Iowa were studied. Pre-implantation evaluation included comprehensive genetic testing for genetic diagnosis. A novel score of genetic variants affecting genes with functional effects in the spiral ganglion was calculated. A Z-scored average of up to three post-operative speech perception tests (CNC, HINT, and AzBio) was used to assess outcome. RESULTS Genetically determined spiral ganglion health affects cochlear implant outcomes, and when considered in conjunction with clinically determined etiology of deafness, accounts for 18.3% of the variance in postoperative speech recognition outcomes. Cochlear implant recipients with deleterious genetic variants that affect the cochlear sensory organ perform significantly better on tests of speech perception than recipients with deleterious genetic variants that affect the spiral ganglion. CONCLUSION Etiological diagnosis of deafness including genetic testing is the single largest predictor of postoperative speech outcomes in adult cochlear implant recipients. A detailed understanding of the genetic underpinning of hearing loss will better inform pre-implant counseling. The method presented here should serve as a guide for further research into the molecular physiology of the peripheral auditory system and cochlear implants.
Collapse
Affiliation(s)
- A Eliot Shearer
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Robert W Eppsteiner
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Kathy Frees
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Viral Tejani
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Christina M Sloan-Heggen
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Carolyn Brown
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Department of Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA
| | - Paul Abbas
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Department of Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA
| | - Camille Dunn
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Marlan R Hansen
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Bruce J Gantz
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Richard J H Smith
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Interdepartmental PhD Program in Genetics, University of Iowa, Iowa City, IA, USA; Department of Molecular Physiology & Biophysics, University of Iowa College of Medicine, Iowa City, IA, USA.
| |
Collapse
|
46
|
Korver AMH, Smith RJH, Van Camp G, Schleiss MR, Bitner-Glindzicz MAK, Lustig LR, Usami SI, Boudewyns AN. Congenital hearing loss. Nat Rev Dis Primers 2017; 3:16094. [PMID: 28079113 PMCID: PMC5675031 DOI: 10.1038/nrdp.2016.94] [Citation(s) in RCA: 268] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Congenital hearing loss (hearing loss that is present at birth) is one of the most prevalent chronic conditions in children. In the majority of developed countries, neonatal hearing screening programmes enable early detection; early intervention will prevent delays in speech and language development and has long-lasting beneficial effects on social and emotional development and quality of life. A diagnosis of hearing loss is usually followed by a search for an underlying aetiology. Congenital hearing loss might be attributed to environmental and prenatal factors, which prevail in low-income settings; congenital infections, particularly cytomegalovirus infection, are also a common risk factor for hearing loss. Genetic causes probably account for the majority of cases in developed countries; mutations can affect any component of the hearing pathway, in particular, inner ear homeostasis (endolymph production and maintenance) and mechano-electrical transduction (the conversion of a mechanical stimulus into electrochemical activity). Once the underlying cause of hearing loss is established, it might direct therapeutic decision making and guide prevention and (genetic) counselling. Management options include specific antimicrobial therapies, surgical treatment of craniofacial abnormalities and implantable or non-implantable hearing devices. An improved understanding of the pathophysiology and molecular mechanisms that underlie hearing loss and increased awareness of recent advances in genetic testing will promote the development of new treatment and screening strategies.
Collapse
Affiliation(s)
- Anna M H Korver
- Department of Pediatrics, St Antonius Hospital, PO BOX 2500, 3430 EM Nieuwegein, The Netherlands
| | - Richard J H Smith
- Molecular Otolaryngology and Renal Research Laboratories and the Genetics PhD Program, University of Iowa, Iowa City, Iowa, USA
| | - Guy Van Camp
- Department of Medical Genetics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Mark R Schleiss
- Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Maria A K Bitner-Glindzicz
- Genetics and Genomic Medicine Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Lawrence R Lustig
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, New York, USA
| | - Shin-Ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - An N Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
47
|
The Hearing Outcomes of Cochlear Implantation in Waardenburg Syndrome. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2854736. [PMID: 27376080 PMCID: PMC4916269 DOI: 10.1155/2016/2854736] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/27/2016] [Accepted: 05/18/2016] [Indexed: 01/22/2023]
Abstract
Objectives. This study aimed to determine the feasibility of cochlear implantation for sensorineural hearing loss in patients with Waardenburg syndrome. Method. A retrospective chart review was performed on patients who underwent cochlear implantation at the University of Tokyo Hospital. Clinical classification, genetic mutation, clinical course, preoperative hearing threshold, high-resolution computed tomography of the temporal bone, and postoperative hearing outcome were assessed. Result. Five children with Waardenburg syndrome underwent cochlear implantation. The average age at implantation was 2 years 11 months (ranging from 1 year 9 months to 6 years 3 months). Four patients had congenital profound hearing loss and one patient had progressive hearing loss. Two patients had an inner ear malformation of cochlear incomplete partition type 2. No surgical complication or difficulty was seen in any patient. All patients showed good hearing outcome postoperatively. Conclusion. Cochlear implantation could be a good treatment option for Waardenburg syndrome.
Collapse
|