1
|
Kong D, Li W, Zhou P, Zhang Y, Dai C. A Novel Classification System and Surgical Strategies of First Branchial Cleft Anomalies. Laryngoscope 2024. [PMID: 38676459 DOI: 10.1002/lary.31477] [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: 12/06/2023] [Revised: 04/07/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To define a novel classification of first branchial cleft anomalies (FBCAs) based on the relationship between lesions and the facial nerve in terms of radiographic imaging findings and to introduce the corresponding surgical managements. METHODS The clinical data were retrospectively reviewed. Novel classification was proposed according to the head-neck MRI findings and surgical records. FBCAs limited in the cartilaginous segment of external auditory canal (EAC) or superficial parotid gland capsule were classified as type A. Lesions close to the FN and(or) involved into the parotid gland with no scar formation and no previous parotidectomy were classified as type B. FBCAs adhered to the FN and(or) invaded the parotid gland with scar formation due to previous surgery were classified as type C. Appropriate surgery approaches was also described, which was correlated with classification. RESULTS Fifty-one patients were included, and one patient suffered from bilateral lesions. Thirty-one, twelve, and nine lesions were classified as type A, type B, and type C FBCAs, respectively. One type A patient (1.92%) suffered from recurrence during follow-up. Temporary facial palsy (House-Brackmann II) was identified in 2 type C patients (3.85%) after surgery and recovered to normal within 2 months. One type B patient (1.92%) suffered from facial paralysis due to the FN injury and underwent facial nerve graft simultaneously. No patients with type C complained of hearing loss postoperatively. CONCLUSION This novel classification clearly illustrates definitely relationship between lesion and the facial nerve and appropriate surgical strategies were proposed based on the novel classification. LEVEL OF EVIDENCE 4 Laryngoscope, 2024.
Collapse
Affiliation(s)
- Dedi Kong
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Wei Li
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Pei Zhou
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Yibo Zhang
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Chunfu Dai
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| |
Collapse
|
2
|
He J, Mahmoudi A, Gu Y, Fu J, Yuan Q, Liu W. Case report: A novel mutation in the EYA1 gene in a child with branchiootic syndrome with secretory otitis media and bilateral vestibular hypofunction. Front Genet 2024; 14:1292085. [PMID: 38259619 PMCID: PMC10801012 DOI: 10.3389/fgene.2023.1292085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Branchiootic syndrome (BOS) is a rare, autosomal dominant syndrome characterized by malformations of the ear associated with hearing loss, second branchial arch anomalies, and the absence of renal anomalies. Herein, we report the case of an 8-year-old male patient with BOS. The proband also experiences mixed conductive and sensorineural hearing loss in the right ear, and severe-to-profound sensorineural hearing loss in the left ear. Preauricular pits, branchial fistulae, and cochlear hypoplasia were present bilaterally. Type III cup-shaped ear, and external auditory canal stenosis were detected in the right ear. Lateral semicircular canal-vestibule dysplasia was detected in the left ear. Moreover, the patient had unilateral secretory otitis media (SOM) in the right ear and bilateral vestibular hypofunction (VH), which has not been reported in previous studies. The patient's hearing on the right side was restored to nearly normal after myringotomy. Whole exome sequencing identified a novel frameshift mutation in EYA1 (NM_000503.6): c.1697_1698delinT [p.(Lys566IlefsTer73)] in the proband, which was defined a "pathogenic" mutation according to American College of Medical Genetics and Genomics guidelines. This is the first report of a child presenting with BOS, SOM and VH, which expands the known clinical manifestations of this syndrome. We also observed a novel EYA1 gene mutation in this patient with BOS, which enriches the mutation map and provides a reference for genetic diagnosis of this syndrome.
Collapse
Affiliation(s)
- Jun He
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ahmad Mahmoudi
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Yu Gu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jinfeng Fu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiulin Yuan
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Liu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| |
Collapse
|
3
|
Chen A, Ling J, Peng X, Liu X, Mao S, Chen Y, Qin M, Zhang S, Bai Y, Song J, Feng Z, Ma L, He D, Mei L, He C, Feng Y. A Novel EYA1 Mutation Causing Alternative RNA Splicing in a Chinese Family With Branchio-Oto Syndrome: Implications for Molecular Diagnosis and Clinical Application. Clin Exp Otorhinolaryngol 2023; 16:342-358. [PMID: 37817567 DOI: 10.21053/ceo.2023.00668] [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: 05/12/2023] [Accepted: 10/11/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVES Branchio-oto syndrome (BOS) primarily manifests as hearing loss, preauricular pits, and branchial defects. EYA1 is the most common pathogenic gene, and splicing mutations account for a substantial proportion of cases. However, few studies have addressed the structural changes in the protein caused by splicing mutations and potential pathogenic factors, and several studies have shown that middle-ear surgery has limited effectiveness in improving hearing in these patients. BOS has also been relatively infrequently reported in the Chinese population. This study explored the genetic etiology in the family of a proband with BOS and provided clinical treatment to improve the patient's hearing. METHODS We collected detailed clinical features and peripheral blood samples from the patients and unaffected individuals within the family. Pathogenic mutations were identified by whole-exome sequencing and cosegregation analysis and classified according to the American College of Medical Genetics and Genomics guidelines. Alternative splicing was verified through a minigene assay. The predicted three-dimensional protein structure and biochemical experiments were used to investigate the pathogenicity of the mutation. The proband underwent middle-ear surgery and was followed up at 1 month and 6 months postoperatively to monitor auditory improvement. RESULTS A novel heterozygous EYA1 splicing variant (c.1050+4 A>C) was identified and classified as pathogenic (PVS1(RNA), PM2, PP1). Skipping of exon 11 of the EYA1 pre-mRNA was confirmed using a minigene assay. This mutation may impair EYA1-SIX1 interactions, as shown by an immunoprecipitation assay. The EYA1-Mut protein exhibited cellular mislocalization and decreased protein expression in cytological experiments. Middle-ear surgery significantly improved hearing loss caused by bone-conduction abnormalities in the proband. CONCLUSION We reported a novel splicing variant of EYA1 in a Chinese family with BOS and revealed the potential molecular pathogenic mechanism. The significant hearing improvement observed in the proband after middle-ear surgery provides a reference for auditory rehabilitation in similar patients.
Collapse
Affiliation(s)
- Anhai Chen
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Ling
- Medical Functional Experiment Center, School of Basic Medicine, Central South University, Changsha, China
| | - Xin Peng
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Xianlin Liu
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Shuang Mao
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Yongjia Chen
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Mengyao Qin
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Shuai Zhang
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Yijiang Bai
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Song
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhili Feng
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China
- MOE Key Lab of Rare Pediatric Diseases and Institute of Otorhinolaryngology, Head and Neck Surgery, University of South China, Changsha, China
| | - Lu Ma
- MOE Key Lab of Rare Pediatric Diseases and Institute of Otorhinolaryngology, Head and Neck Surgery, University of South China, Changsha, China
- The Hengyang Key Laboratory of Cellular Stress Biology, Institute of Cytology and Genetics, Hengyang Medical School, University of South China, Hengyang, China
| | - Dinghua He
- Department of Otorhinolaryngology, The Affiliated Maternal and Child Health Hospital of Hunan Province, Hengyang Medical School, University of South China, Changsha, China
| | - Lingyun Mei
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Chufeng He
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Yong Feng
- Department of Otorhinolaryngology, Xiangya Hospital, Central South University, Changsha, China
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China
- MOE Key Lab of Rare Pediatric Diseases and Institute of Otorhinolaryngology, Head and Neck Surgery, University of South China, Changsha, China
- Department of Otorhinolaryngology, The Affiliated Maternal and Child Health Hospital of Hunan Province, Hengyang Medical School, University of South China, Changsha, China
| |
Collapse
|
4
|
Tang P, Li J, Li J, Yang J, Zhu J. Prenatal diagnosis and genetic analysis of a fetus with Branchio-oto-renal syndrome: A case report. Medicine (Baltimore) 2022; 101:e31172. [PMID: 36316881 PMCID: PMC9622624 DOI: 10.1097/md.0000000000031172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Branchio-oto-renal (BOR) syndrome is an autosomal-dominant disorder characterized by branchial arch anomalies, hearing loss, and kidney defects. Mutations in the human EYA1 gene have been reported associated with BOR syndrome. Here we identified that a novel variant, EYA1: NM_000503.4: c.827-1G > C (Intron 8, shear mutation) was associated with BOR in a fetus of a Chinese family. CASE PRESENTATION Prenatal ultrasound examination showed that both kidneys of the fetus were small and the echo of both kidneys was enhanced. The amount of amniotic fluid was normal, and no other structural abnormalities of the fetus were found. Fetal umbilical cord blood puncture was performed. No abnormality was found in karyotyping and chromosomal microarray analysis (CMA) results. Thus, we performed a trio-based whole exome sequencing (WES), and found that the fetus carried a novel homozygous variant, EYA1: NM_000503.4: c.827-1G > C (Intron 8, shear mutation), but the parents do not have this mutation. The variation sites of fetus and parents were verified by Sanger sequencing to clarify the source of pathogenic variation. CONCLUSION Combined with fetal imaging examination, the novel variation of EYA1: NM_000503.4: c.827-1G > C is the cause of fetal renal dysplasia. This case report indicates that the early use of appropriate technology can clarify the etiology of fetal disease and guide prognosis consultation.
Collapse
Affiliation(s)
- Ping Tang
- Fetal Medical Center, Jiaxing Maternity and Children Health Care Hospital/The Affiliated Women and Children’s Hospital of Jiaxing University, Jiaxing, Zhejiang, China
| | - Jiarui Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Li
- Department of Surgery, Jiaxing Maternity and Children Health Care Hospital/The Affiliated Women and Children’s Hospital of Jiaxing University, Jiaxing, Zhejiang, China
| | - Juan Yang
- Fetal Medical Center, Jiaxing Maternity and Children Health Care Hospital/The Affiliated Women and Children’s Hospital of Jiaxing University, Jiaxing, Zhejiang, China
| | - Jianjun Zhu
- Fetal Medical Center, Jiaxing Maternity and Children Health Care Hospital/The Affiliated Women and Children’s Hospital of Jiaxing University, Jiaxing, Zhejiang, China
- *Correspondence: Jianjun Zhu, Fetal Medical Center, Jiaxing Maternity and Children Health Care Hospital/The Affiliated Women and Children’s Hospital of Jiaxing University, Jiaxing, Zhejiang, China (e-mail: )
| |
Collapse
|
5
|
Biggs K, Crundwell G, Metcalfe C, Muzaffar J, Monksfield P, Bance M. Anatomical and audiological considerations in branchiootorenal syndrome: A systematic review. Laryngoscope Investig Otolaryngol 2022; 7:540-563. [PMID: 35434312 PMCID: PMC9008175 DOI: 10.1002/lio2.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Establish anatomical considerations, audiological outcomes, and optimal management in patients with branchiootic/branchiootorenal syndrome (BO/BOR). Methods Databases reviewed: Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. Clinical or radiological studies of patients with BOR syndrome describing either the audiological profile or anatomical changes were included. Articles in which BOR syndrome was associated with other syndromes, and those that were focused only on general and genetic aspects of BOR syndrome were excluded. Articles were assessed using Oxford Centre for Evidence‐Based Medicine (OCEBM) grading system and the Brazzelli risk of bias tool for nonrandomized studies. Results Searches identified 379 articles. Of these, 64 studies met the inclusion criteria, reporting outcomes in 482 patients from at least 95 families. In 308 patients, hearing loss was categorized as sensorineural (29%), conductive (20%), and mixed (51%). Hearing outcomes were variable in terms of onset, pattern, and severity; ranging from mild to profound deafness. One hundred sixty‐nine patients presented with inner ear anomalies, 145 had middle, and 151 had external ear abnormalities. In 44 studies, 58 ear operations were described. Mixed outcomes were reported in patients managed with hearing aids or middle ear surgery; however, successful cochlear implantation was described in all five cases. Conclusion The anatomical and audiological profiles of patients with BO/BOR are variable. A range of surgical procedures were described, however lacked objective outcome measures. Given the range of anatomical variants, management decisions should be made on an individual basis including full audiological and radiological assessment. Level of evidence NA.
Collapse
Affiliation(s)
- Kirsty Biggs
- Royal Stoke University Hospital Stoke on Trent UK
- Wolfson Institute of Population Health Queen Mary University of London London UK
| | - Gemma Crundwell
- Cambridge University Hospitals NHS Foundation Trust Addenbrooke’s Health Campus Cambridge UK
| | - Christopher Metcalfe
- Royal Stoke University Hospital Stoke on Trent UK
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - Jameel Muzaffar
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
- University of Cambridge Department of Clinical Neurosciences, Addenbrooke’s Health Campus Cambridge UK
| | - Peter Monksfield
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - Manohar Bance
- Cambridge University Hospitals NHS Foundation Trust Addenbrooke’s Health Campus Cambridge UK
- University of Cambridge Department of Clinical Neurosciences, Addenbrooke’s Health Campus Cambridge UK
| |
Collapse
|