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Xu K, Xiao Y, Luo J, Chao X, Wang R, Fan Z, Wang H, Xu L. Research progress on incomplete partition type 3 inner ear malformation. Eur Arch Otorhinolaryngol 2024; 281:3943-3948. [PMID: 38498189 PMCID: PMC11266284 DOI: 10.1007/s00405-024-08555-7] [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] [Received: 09/10/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE This review aims to provides a comprehensive overview of the latest research progress on IP-III inner ear malformation, focusing on its geneticbasis, imaging features, cochlear implantation, and outcome. METHODS Review the literature on clinical and genetic mechanisms associated with IP-III. RESULTS Mutations in the POU3F4 gene emerge as the principal pathogenic contributors to IP-III anomalies, primarily manifesting through inner ear potential irregularities leading to deafness. While cochlear implantation stands as the primary intervention for restoring hearing, the unique nature of the inner ear anomaly escalates the complexity of surgical procedures and postoperative results. Hence, meticulous preoperative assessment to ascertain surgical feasibility and postoperative verification of electrode placement are imperative. Additionally, gene therapy holds promise as a prospective treatment modality. CONCLUSIONS IP-III denotes X-linked recessive hereditary deafness, with cochlear implantation currently serving as the predominant therapeutic approach. Clinicians are tasked with preoperative assement and individualized postoperative rehabilitation.
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Affiliation(s)
- Kaifan Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
- Shandong Institute of Otorhinolaryngology, jinan, China
| | - Yun Xiao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Institute of Otorhinolaryngology, jinan, China
| | - Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
| | - Xiuhua Chao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
| | - Ruijie Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
| | - Zhaoming Fan
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Haibo Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China.
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China.
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Jung J, Lee SA, Kim UK, Moon IS, Gee HY, Choi JY. Genetic Characteristics and Audiological Performance After Cochlear Implantation in Patients With Incomplete Partition Type III. Clin Exp Otorhinolaryngol 2023; 16:403-406. [PMID: 37852606 DOI: 10.21053/ceo.2023.00864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/04/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Jinsei Jung
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
- Institute for Lee Won Sang Yonsei Ear Science, Seoul, Korea
| | - Se A Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Un-Kyung Kim
- Department of Biology, Kyungpook National University, Daegu, Korea
| | - In Seok Moon
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Heon Yung Gee
- Institute for Lee Won Sang Yonsei Ear Science, Seoul, Korea
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
- Institute for Lee Won Sang Yonsei Ear Science, Seoul, Korea
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Bernardinelli E, Huber F, Roesch S, Dossena S. Clinical and Molecular Aspects Associated with Defects in the Transcription Factor POU3F4: A Review. Biomedicines 2023; 11:1695. [PMID: 37371790 DOI: 10.3390/biomedicines11061695] [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: 04/20/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
X-linked deafness (DFNX) is estimated to account for up to 2% of cases of hereditary hearing loss and occurs in both syndromic and non-syndromic forms. POU3F4 is the gene most commonly associated with X-linked deafness (DFNX2, DFN3) and accounts for about 50% of the cases of X-linked non-syndromic hearing loss. This gene codes for a transcription factor of the POU family that plays a major role in the development of the middle and inner ear. The clinical features of POU3F4-related hearing loss include a pathognomonic malformation of the inner ear defined as incomplete partition of the cochlea type 3 (IP-III). Often, a perilymphatic gusher is observed upon stapedectomy during surgery, possibly as a consequence of an incomplete separation of the cochlea from the internal auditory canal. Here we present an overview of the pathogenic gene variants of POU3F4 reported in the literature and discuss the associated clinical features, including hearing loss combined with additional phenotypes such as cognitive and motor developmental delays. Research on the transcriptional targets of POU3F4 in the ear and brain is in its early stages and is expected to greatly advance our understanding of the pathophysiology of POU3F4-linked hearing loss.
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Affiliation(s)
- Emanuele Bernardinelli
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Florian Huber
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Sebastian Roesch
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Silvia Dossena
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria
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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.
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Affiliation(s)
- Jean Defourny
- GIGA‐Neurosciences, Unit of Cell and Tissue BiologyUniversity of Liège, C.H.U. B36LiègeBelgium
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Genetic Load of Alternations of Transcription Factor Genes in Non-Syndromic Deafness and the Associated Clinical Phenotypes: Experience from Two Tertiary Referral Centers. Biomedicines 2022; 10:biomedicines10092125. [PMID: 36140227 PMCID: PMC9495667 DOI: 10.3390/biomedicines10092125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/18/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022] Open
Abstract
Sensorineural hearing loss is one of the most common inherited sensory disorders. Functional classifications of deafness genes have shed light on genotype- and mechanism-based pharmacological approaches and on gene therapy strategies. In this study, we characterized the clinical phenotypes and genotypes of non-syndromic deafness caused by transcription factor (TF) gene variants, one of the functional classifications of genetic hearing loss. Of 1280 probands whose genomic DNA was subjected to molecular genetic testing, TF genes were responsible for hearing loss in 2.6%. Thirty-three pathogenic variants, including nine novel variants, accounting for non-syndromic deafness were clustered in only four TF genes (POU3F4, POU4F3, LMX1A, and EYA4), which is indicative of a narrow molecular etiologic spectrum of TF genes, and the functional redundancy of many other TF genes, in the context of non-syndromic deafness. The audiological and radiological characteristics associated with the four TF genes differed significantly, with a wide phenotypic spectrum. The results of this study reveal the genetic load of TF gene alterations among a cohort with non-syndromic hearing loss. Additionally, we have further refined the clinical profiles associated with TF gene variants as a basis for a personalized, genetically tailored approach to audiological rehabilitation.
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Almohammad M, Tasabehji T, Awad A, Hanafi I. Use of a Fascial Pad to Help Electrode Insertion During Cochlear Implantation in Incomplete Partition Type III. EAR, NOSE & THROAT JOURNAL 2022:1455613221111494. [PMID: 35801544 DOI: 10.1177/01455613221111494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cochlear implantation surgery in the rare cases of incomplete partition type III is constrained by intraoperative difficulties that result from the deformed cochlea. Our case study describes the use of a supporting fascia pad that served as a track to preserve the direction of the electrode during insertion into the cochlear lumen.
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Affiliation(s)
- Mohammad Almohammad
- Otorhinolaryngology Department, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Tala Tasabehji
- Otorhinolaryngology Department, Damascus Hospital, Damascus, Syria
| | - Abdulrahman Awad
- Otorhinolaryngology Department, Tishreen Military Hospital, Damascus, Syria
| | - Ibrahem Hanafi
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
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Brotto D, Sorrentino F, Cenedese R, Avato I, Bovo R, Trevisi P, Manara R. Genetics of Inner Ear Malformations: A Review. Audiol Res 2021; 11:524-536. [PMID: 34698066 PMCID: PMC8544219 DOI: 10.3390/audiolres11040047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022] Open
Abstract
Inner ear malformations are present in 20% of patients with sensorineural hearing loss. Although the first descriptions date to the 18th century, in recent years the knowledge about these conditions has experienced terrific improvement. Currently, most of these conditions have a rehabilitative option. Much less is known about the etiology of these anomalies. In particular, the evolution of genetics has provided new data about the possible relationship between inner ear malformations and genetic anomalies. In addition, in syndromic condition, the well-known presence of sensorineural hearing loss can now be attributed to the presence of an inner ear anomaly. In some cases, the presence of these abnormalities should be considered as a characteristic feature of the syndrome. The present paper aims to summarize the available knowledge about the possible relationships between inner ear malformations and genetic mutations.
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Affiliation(s)
- Davide Brotto
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
- Correspondence:
| | - Flavia Sorrentino
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Roberta Cenedese
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Irene Avato
- Department of Diagnostic, Paediatric, Clinical and Surgical Science, University of Pavia, 35128 Pavia, Italy;
| | - Roberto Bovo
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Patrizia Trevisi
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Renzo Manara
- Neuroradiology Unit, Department of Neurosciences, University of Padua, 35128 Padua, Italy;
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Tekin AM, Matulic M, Wuyts W, Assadi MZ, Mertens G, van Rompaey V, Li Y, van de Heyning P, Topsakal V. A New Pathogenic Variant in POU3F4 Causing Deafness Due to an Incomplete Partition of the Cochlea Paved the Way for Innovative Surgery. Genes (Basel) 2021; 12:genes12050613. [PMID: 33919129 PMCID: PMC8143104 DOI: 10.3390/genes12050613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 12/20/2022] Open
Abstract
Incomplete partition type III (IP-III) is a relatively rare inner ear malformation that has been associated with a POU3F4 gene mutation. The IP-III anomaly is mainly characterized by incomplete separation of the modiolus of the cochlea from the internal auditory canal. We describe a 71-year-old woman with profound sensorineural hearing loss diagnosed with an IP-III of the cochlea that underwent cochlear implantation. Via targeted sequencing with a non-syndromic gene panel, we identified a heterozygous c.934G > C p. (Ala31Pro) pathogenic variant in the POU3F4 gene that has not been reported previously. IP-III of the cochlea is challenging for cochlear implant surgery for two main reasons: liquor cerebrospinalis gusher and electrode misplacement. Surgically, it may be better to opt for a shorter array because it is less likely for misplacement with the electrode in a false route. Secondly, the surgeon has to consider the insertion angles of cochlear access very strictly to avoid misplacement along the inner ear canal. Genetic results in well describes genotype-phenotype correlations are a strong clinical tool and as in this case guided surgical planning and robotic execution.
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Affiliation(s)
- Ahmet M. Tekin
- Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.M.T.); (M.M.)
| | - Marco Matulic
- Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.M.T.); (M.M.)
| | - Wim Wuyts
- Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, 2650 Antwerp, Belgium;
| | | | - Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium; (G.M.); (V.v.R.); (P.v.d.H.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Vincent van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium; (G.M.); (V.v.R.); (P.v.d.H.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Yongxin Li
- Department of Otolaryngology, Head and Neck Surgery, Capital Medical University, Beijing 100730, China;
| | - Paul van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium; (G.M.); (V.v.R.); (P.v.d.H.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.M.T.); (M.M.)
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UZ Brussel, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Correspondence: ; Tel.: +32-24776882; Fax: +32-24776880
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