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Ninoyu Y, Friedman RA. The genetic landscape of age-related hearing loss. Trends Genet 2024; 40:228-237. [PMID: 38161109 DOI: 10.1016/j.tig.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
Age-related hearing loss (ARHL) is a prevalent concern in the elderly population. Recent genome-wide and phenome-wide association studies (GWASs and PheWASs) have delved into the identification of causative variants and the understanding of pleiotropy, highlighting the polygenic intricacies of this complex condition. While recent large-scale GWASs have pinpointed significant SNPs and risk variants associated with ARHL, the detailed mechanisms, encompassing both genetic and epigenetic modifications, remain to be fully elucidated. This review presents the latest advances in association studies, integrating findings from both human studies and model organisms. By juxtaposing historical perspectives with contemporary genomics, we aim to catalyze innovative research and foster the development of novel therapeutic strategies for ARHL.
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Affiliation(s)
- Yuzuru Ninoyu
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA; Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Rick A Friedman
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA.
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Boussaty EC, Ninoyu Y, Andrade LR, Li Q, Takeya R, Sumimoto H, Ohyama T, Wahlin KJ, Manor U, Friedman RA. Altered Fhod3 expression involved in progressive high-frequency hearing loss via dysregulation of actin polymerization stoichiometry in the cuticular plate. PLoS Genet 2024; 20:e1011211. [PMID: 38498576 PMCID: PMC10977885 DOI: 10.1371/journal.pgen.1011211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 03/28/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
Age-related hearing loss (ARHL) is a common sensory impairment with complex underlying mechanisms. In our previous study, we performed a meta-analysis of genome-wide association studies (GWAS) in mice and identified a novel locus on chromosome 18 associated with ARHL specifically linked to a 32 kHz tone burst stimulus. Consequently, we investigated the role of Formin Homology 2 Domain Containing 3 (Fhod3), a newly discovered candidate gene for ARHL based on the GWAS results. We observed Fhod3 expression in auditory hair cells (HCs) primarily localized at the cuticular plate (CP). To understand the functional implications of Fhod3 in the cochlea, we generated Fhod3 overexpression mice (Pax2-Cre+/-; Fhod3Tg/+) (TG) and HC-specific conditional knockout mice (Atoh1-Cre+/-; Fhod3fl/fl) (KO). Audiological assessments in TG mice demonstrated progressive high-frequency hearing loss, characterized by predominant loss of outer hair cells, and a decreased phalloidin intensities of CP. Ultrastructural analysis revealed loss of the shortest row of stereocilia in the basal turn of the cochlea, and alterations in the cuticular plate surrounding stereocilia rootlets. Importantly, the hearing and HC phenotype in TG mice phenocopied that of the KO mice. These findings suggest that balanced expression of Fhod3 is critical for proper CP and stereocilia structure and function. Further investigation of Fhod3 related hearing impairment mechanisms may lend new insight towards the myriad mechanisms underlying ARHL, which in turn could facilitate the development of therapeutic strategies for ARHL.
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Affiliation(s)
- Ely Cheikh Boussaty
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Diego, La Jolla, California, United States of America
| | - Yuzuru Ninoyu
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Diego, La Jolla, California, United States of America
| | - Leonardo R. Andrade
- Waitt Advanced Biophotonics Center, Salk Institute for Biological Studies, La Jolla, California, United States of America
| | - Qingzhong Li
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Ryu Takeya
- Department of Pharmacology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hideki Sumimoto
- Department of Biochemistry, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Ohyama
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Karl J. Wahlin
- Shiley Eye Institute, University of California, San Diego, San Diego, California, United States of America
| | - Uri Manor
- Waitt Advanced Biophotonics Center, Salk Institute for Biological Studies, La Jolla, California, United States of America
- Department of Cell & Developmental Biology, School of Biological Sciences, University of California, San Diego, United States of America
| | - Rick A. Friedman
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Diego, La Jolla, California, United States of America
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Friedman RA. RESPONSE TO LETTER: "THE EFFECT OF IMMEDIATE MICROSURGICAL RESECTION OF VESTIBULAR SCHWANNOMA ON HEARING PRESERVATION". Otol Neurotol 2024; 45:336. [PMID: 38291795 DOI: 10.1097/mao.0000000000004131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Rick A Friedman
- Vice Chair, Department of OHNS Professor of Surgery and Neurosurgery Director of UCSD Acoustic Neuroma Center, UCSD Health/School of Medicine, La Jolla, CA
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Zhang L, Ostrander BT, Duhon B, Moshitaghi O, Lee J, Harris M, Hardesty DA, Prevedello DM, Schwartz MS, Dodson EE, Friedman RA, Adunka OF, Ren Y. Comparison of Postoperative Outcomes in Cystic Versus Solid Vestibular Schwannoma in a Multi-institutional Cohort. Otol Neurotol 2024; 45:92-99. [PMID: 38085765 PMCID: PMC10993235 DOI: 10.1097/mao.0000000000004062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE Cystic vestibular schwannomas (cVSs) have more variable and less favorable clinical outcomes after microsurgical resection compared with solid VS (sVS). This study compares the preoperative presentation and postoperative outcomes between cVS and sVS. STUDY DESIGN Retrospective cohort study. SETTING Two tertiary skull base referral centers. METHODS Consecutive adult patients who underwent VS resection from 2016 to 2021 were included. Univariate and multivariate analyses compared differences in baseline symptoms and postoperative outcomes between cVS and sVS. RESULTS There were a total of 315 patients (64% female; mean age, 54 yrs) and 46 (15%) were cystic. cVS were significantly larger than sVS (maximum diameter, 28 vs. 18 mm, p < 0.001) and had higher rates of dysphagia and dysphonia preoperatively (p < 0.02). cVSs were more likely to undergo translabyrinthine resection (76 vs. 50%, p = 0.001) and have a higher rate of subtotal resection (STR) compared with sVS (30 vs. 13%, p = 0.003). At latest follow-up, fewer cVS achieved good facial nerve (FN) outcome (House-Brackmann [HB] I/II) (80 vs. 90%, p = 0.048). Subanalysis of cVS and sVS matched in tumor size, and surgical approach did not show differences in the rate of STR or FN outcomes (HB I/II, 82 vs. 78%, p = 0.79). CONCLUSION In this large multi-institutional series, cVSs represent a distinct entity and are characterized by larger tumor size and higher incidence of atypical symptoms. Although cVSs were more likely to undergo STR and portend worse FN outcomes than sVSs, this may be due to their larger tumor size rather than the presence of the cystic component.
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Affiliation(s)
- Lisa Zhang
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Benjamin T. Ostrander
- Division of Otolaryngology—Head and Neck Surgery, Department of Otolaryngology, University of California, San Diego, La Jolla, California
| | - Bailey Duhon
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Omid Moshitaghi
- Division of Otolaryngology—Head and Neck Surgery, Department of Otolaryngology, University of California, San Diego, La Jolla, California
| | - Joshua Lee
- Division of Otolaryngology—Head and Neck Surgery, Department of Otolaryngology, University of California, San Diego, La Jolla, California
| | - Micah Harris
- Department of Otolaryngology, University of Pittsburgh
| | - Douglas A. Hardesty
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Daniel M. Prevedello
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Marc S. Schwartz
- Department of Neurosurgery, University of California, San Diego, La Jolla, California
| | - Edward E. Dodson
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Rick A. Friedman
- Division of Otolaryngology—Head and Neck Surgery, Department of Otolaryngology, University of California, San Diego, La Jolla, California
| | - Oliver F. Adunka
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Yin Ren
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Du EY, Assi SH, Moshtaghi O, Schwartz MS, Friedman RA, Dixon PR. Socioeconomic Disparities in the Pursuit of Care at a High-Volume Institution for Surgical Resection of Vestibular Schwannomas. Otol Neurotol 2023; 44:826-832. [PMID: 37550886 DOI: 10.1097/mao.0000000000003975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
OBJECTIVE Increased institutional surgical resection case volume for vestibular schwannomas (VSs) has been associated with improved patient outcomes, including reduced risk of prolonged hospital stay and readmission. Socioeconomic disparities in the pursuit of care at these high-volume institutions remain unknown. STUDY DESIGN Retrospective cohort epidemiological study. SETTING National Cancer Database, a hospital-based registry of over 1,500 facilities in the United States. PATIENTS Adult VS patients (age, >18 years) treated surgically. INTERVENTIONS High- versus low-volume facilities, defined using a facility case volume threshold of 25 cases per year. A risk-adjusted restricted cubic spline model was previously used to identify this risk threshold beyond which the incremental benefit of increasing case volume began to plateau. MAIN OUTCOME MEASURES Sociodemographic factors, including race, ethnicity, income, insurance status, and rurality. Multivariable analyses were adjusted for patient and tumor characteristics, including age, sex, Charlson-Deyo score, and tumor size. RESULTS A totoal of 10,048 patients were identified (median [interquartile range] age = 51 [41-60] years, 54% female, 87% Caucasian). Patients with Spanish/Hispanic ethnicity (OR = 0.71, 95% confidence interval [CI] = 0.52-0.96), income below median (OR = 0.63, 95% CI = 0.55-0.73]), and Medicare, Medicaid, or other government insurance versus private insurance (OR = 0.63, 95% CI = 0.53-0.74) had reduced odds of treatment at a high-volume facility. Further sensitivity analyses in which facility volume was operationalized continuously reinforced direction and significance of these associations. CONCLUSIONS Socioeconomic disparities exist in the propensity for VS patients to be treated at a high-volume facility. Further work is needed to understand the nature of these associations and whether interventions can be designed to mitigate them.
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Affiliation(s)
| | | | - Omid Moshtaghi
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, La Jolla, California
| | - Marc S Schwartz
- Department of Neurosurgery, University of California, San Diego, La Jolla, California
| | - Rick A Friedman
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, La Jolla, California
| | - Peter R Dixon
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, La Jolla, California
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Boussaty EC, Ninoyu Y, Andrade L, Li Q, Takeya R, Sumimoto H, Ohyama T, Wahlin KJ, Manor U, Friedman RA. Altered Fhod3 Expression Involved in Progressive High-Frequency Hearing Loss via Dysregulation of Actin Polymerization Stoichiometry in The Cuticular Plate. bioRxiv 2023:2023.07.20.549974. [PMID: 37546952 PMCID: PMC10401921 DOI: 10.1101/2023.07.20.549974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Age-related hearing loss (ARHL) is a common sensory impairment with comlex underlying mechanisms. In our previous study, we performed a meta-analysis of genome-wide association studies (GWAS) in mice and identified a novel locus on chromosome 18 associated with ARHL specifically linked to a 32 kHz tone burst stimulus. Consequently, we investigated the role of Formin Homology 2 Domain Containing 3 (Fhod3), a newly discovered candidate gene for ARHL based on the GWAS results. We observed Fhod3 expression in auditory hair cells (HCs) and primarily localized at the cuticular plate (CP). To understand the functional implications of Fhod3 in the cochlea, we generated Fhod3 overexpression mice (Pax2-Cre+/-; Fhod3Tg/+) (TG) and HC-specific conditional knockout mice (Atoh1-Cre+/-; Fhod3fl/fl) (KO). Audiological assessments in TG mice demonstrated progressive high-frequency hearing loss, characterized by predominant loss of outer HCs and decrease phalloidin intensities of CP. Ultrastructural analysis revealed shortened stereocilia in the basal turn cochlea. Importantly, the hearing and HC phenotype in TG mice were replicated in KO mice. These findings indicate that Fhod3 plays a critical role in regulating actin dynamics in CP and stereocilia. Further investigation of Fhod3-related hearing impairment mechanisms may facilitate the development of therapeutic strategies for ARHL in humans.
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Moshtaghi O, Dixon PR, Claussen AD, La Monte O, Tadano A, Gillette D, Tawfik K, Schwartz MS, Friedman RA. The Effect of Immediate Microsurgical Resection of Vestibular Schwannoma on Hearing Preservation. Otol Neurotol 2023; 44:600-604. [PMID: 37205868 DOI: 10.1097/mao.0000000000003893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Evaluate for differences in postoperative hearing in patients who undergo immediate versus delayed hearing preservation microsurgical resection of vestibular schwannomas (VS). STUDY DESIGN Retrospective single-institution cohort study spanning November 2017 to November 2021. SETTING Single-institution tertiary care hospital. PATIENTS Sporadic VS in patients with American Academy of Otolaryngology-Head and Neck Surgery hearing classification A or B, with tumor size less than or equal to 2 cm and undergoing hearing preservation microsurgical resection. INTERVENTIONS Delayed surgical intervention defined by time from first diagnostic MRI to date of surgery being greater than 3 months. MAIN OUTCOME MEASURES Preoperative and postoperative audiometric performance. RESULTS In total, 193 patients met inclusion criteria. Within the cohort, 70 (36%) proceeded with surgery within 3 months of diagnostic MRI with a mean observation time of 62 days, whereas 123 (63%) underwent surgery after 3 months with a mean observation time of 301 days. There was no difference in preoperative hearing between the two groups with word recognition score 99% in early intervention group and 100% in delayed intervention group ( p = 0.6). However, 64% of those who proceeded with immediate surgery had successful hearing preservation, compared to a 42% of those who had delayed intervention ( p < 0.01). In a multivariable logistic regression accounting for preoperative word recognition score, tumor size, and age at diagnosis, the odds of hearing preservation were lower in those who delayed surgery compared to immediate surgery (odds ratio, 0.31; 95% confidence interval, 0.15-0.61). CONCLUSIONS Patients who underwent microsurgical resection within 3 months of diagnosis demonstrated a hearing preservation advantage compared to those who did not. Findings of this study highlight the counseling challenges associated with the timing of surgical treatment of VS in patients presenting with good preoperative hearing and small tumors.
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Affiliation(s)
- Omid Moshtaghi
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
| | - Peter R Dixon
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
| | - Alexander D Claussen
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
| | - Olivia La Monte
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
| | - Ashley Tadano
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
| | - Dominique Gillette
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
| | - Kareem Tawfik
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
| | - Marc S Schwartz
- Department of Neurological Surgery, University of California-San Diego, San Diego, California
| | - Rick A Friedman
- Department of Otolaryngology Head and Neck Surgery, University of California-San Diego, San Diego, California
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Pham TB, Boussaty EC, Currais A, Maher P, Schubert DR, Manor U, Friedman RA. Attenuation of Age-Related Hearing Impairment in Senescence-Accelerated Mouse Prone 8 (SAMP8) Mice Treated with Fatty Acid Synthase Inhibitor CMS121. J Mol Neurosci 2023; 73:307-315. [PMID: 37097512 PMCID: PMC10200781 DOI: 10.1007/s12031-023-02119-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 04/17/2023] [Indexed: 04/26/2023]
Abstract
In the senescence-accelerated mouse prone 8 (SAMP8) mouse model, oxidative stress leads to premature senescence and age-related hearing impairment (ARHI). CMS121 inhibits oxytosis/ferroptosis by targeting fatty acid synthase. The aim of our study was to determine whether CMS121 is protective against ARHI in SAMP8 mice. Auditory brainstem responses (ABRs) were used to assess baseline hearing in sixteen 4-week-old female SAMP8 mice, which were divided into two cohorts. The control group was fed a vehicle diet, while the experimental group was fed a diet containing CMS121. ABRs were measured until 13 weeks of age. Cochlear immunohistochemistry was performed to analyze the number of paired ribbon-receptor synapses per inner hair cell (IHC). Descriptive statistics are provided with mean ± SEM. Two-sample t-tests were performed to compare hearing thresholds and paired synapse count across the two groups, with alpha = 0.05. Baseline hearing thresholds in the control group were statistically similar to those of the CMS121 group. At 13 weeks of age, the control group had significantly worse hearing thresholds at 12 kHz (56.5 vs. 39.8, p = 0.044) and 16 kHz (64.8 vs. 43.8, p = 0.040) compared to the CMS121 group. Immunohistochemistry showed a significantly lower synapse count per IHC in the control group (15.7) compared to the CMS121 group (18.4), p = 0.014. Our study shows a significant reduction in ABR threshold shifts and increased preservation of IHC ribbon synapses in the mid-range frequencies among mice treated with CMS121 compared to untreated mice.
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Affiliation(s)
- Tammy B Pham
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, 92037, La Jolla, CA, USA
| | - Ely Cheikh Boussaty
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, 92037, La Jolla, CA, USA
| | - Antonio Currais
- Cellular Neurobiology Laboratory, Salk Institute for Biological Studies, 92037, La Jolla, CA, USA
| | - Pamela Maher
- Cellular Neurobiology Laboratory, Salk Institute for Biological Studies, 92037, La Jolla, CA, USA
| | - David R Schubert
- Cellular Neurobiology Laboratory, Salk Institute for Biological Studies, 92037, La Jolla, CA, USA
| | - Uri Manor
- Waitt Advanced Biophotonics Center, Salk Institute for Biological Studies, 92037, La Jolla, CA, USA
| | - Rick A Friedman
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health, 92037, La Jolla, CA, USA.
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Brandel MG, Plonsker JH, Khan UA, Rennert RC, Friedman RA, Schwartz MS. Going the distance in acoustic neuroma resection: microsurgical outcomes at high-volume centers of excellence. J Neurooncol 2023; 163:105-114. [PMID: 37084124 DOI: 10.1007/s11060-023-04313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE High-volume hospitals are associated with improved surgical outcomes for acoustic neuromas (ANs). Due to the benign and slow-growing nature of ANs, many patients travel to geographically distant cities, states, or countries for their treatment. However, the impact of travel burden to high-volume centers, as well as its relative benefit are poorly understood. We compared post-operative outcomes between AN patients that underwent treatment at local, low-volume hospitals with those that traveled long distances to high-volume hospitals. METHODS The National Cancer Database was used to analyze AN patients that underwent surgery (2004-2015). Patients in the lowest quartile of travel distance and volume (Short-travel/Low-Volume: STLV) were compared to patients in the highest quartile of travel distance and volume (Long-travel/High-Volume: LTHV). Only STLV and LTHV cases were included for analysis. RESULTS Of 13,370 cases, 2,408 met inclusion criteria. STLV patients (n = 1,305) traveled a median of 6 miles (Interquartile range [IQR] 3-9) to low-volume centers (median 2, IQR 1-3 annual cases) and LTHV patients (n = 1,103) traveled a median of 143 miles [IQR 103-230, maximum 4,797] to high-volume centers (median 34, IQR 28-42 annual cases). LTHV patients had lower Charlson/Deyo scores (p = 0.001), mostly received care at academic centers (81.7% vs. 39.4%, p < 0.001), and were less likely to be minorities (7.0% vs. 24.2%, p < 0.001) or underinsured (4.2% vs. 13.8%, p < 0.001). There was no difference in average tumor size. On multivariable analysis, LTHV predicted increased likelihood of gross total resection (odds ratio [OR] 5.6, 95% confidence interval [CI] 3.8-8.4, p < 0.001), longer duration between diagnosis and surgery (OR 1.3, 95% CI 1.0-1.6, p = 0.040), decreased length of hospital stay (OR 0.5, 95% CI 0.4-0.7, p < 0.001), and greater overall survival (Hazard Ratio [HR] 0.6, 95% CI 0.4-0.95, p = 0.029). There was no significant difference in 30-day readmission on adjusted analysis. CONCLUSION Although traveling farther to high-volume centers was associated with greater time between diagnosis and treatment for AN patients, they experienced superior postoperative outcomes compared to patients who received treatment locally at low-volume centers. Enabling access and travel to high-volume centers may improve AN patient outcomes.
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Affiliation(s)
- Michael G Brandel
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Jillian H Plonsker
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Usman A Khan
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Robert C Rennert
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Rick A Friedman
- Department of Otolaryngology, University of California San Diego, San Diego, CA, USA
| | - Marc S Schwartz
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA.
- Acoustic Neuroma Center, 9300 Campus Point Drive Mail Code 7893, La Jolla, CA, 92037, USA.
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Dixon PR, Moshtaghi O, Khan U, Harris JP, Schwartz MS, Friedman RA. Association Between Facility Surgical Volume and Excess Time in the Hospital After Surgical Resection of Vestibular Schwannomas. JAMA Otolaryngol Head Neck Surg 2023; 149:352-358. [PMID: 36862385 PMCID: PMC9982737 DOI: 10.1001/jamaoto.2022.5243] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/02/2023] [Indexed: 03/03/2023]
Abstract
Importance High surgical vestibular schwannoma case volume in a medical institution may decrease the risk of adverse outcomes among patients undergoing vestibular schwannoma surgery. Objective To study the association between surgical vestibular schwannoma case volume and excess time in the hospital after vestibular schwannoma surgery. Design, Setting, and Participants This cohort study evaluated data from the National Cancer Database from January 1, 2004, through December 31, 2019, on Commission on Cancer-accredited facilities in the US. The hospital-based sample comprised adult patients aged 18 years or older with a vestibular schwannoma treated with surgery. Exposures Facility case volume, defined as the mean number of surgical vestibular schwannoma cases per year in the 2 years preceding the index case. Main Outcomes and Measures The primary outcome was a composite of prolonged hospital stay (>90th percentile) or 30-day readmission. Risk-adjusted restricted cubic splines were used to model the probability of the outcome according to facility volume. The inflection point (in cases per year) when the declining risk of excess time in the hospital began to plateau was selected as the threshold to define high- and low-volume facilities. Outcomes were compared among patients treated at high- and low-volume facilities, with mixed-effects logistic regression models adjusting for patient sociodemographic characteristics, comorbidities, tumor size, and clustering within facilities. Collected data were analyzed between June 24 and August 31, 2022. Results Among 11 524 eligible patients (mean [SD] age, 50.2 [12.8] years; 53.5% female; 46.5% male) who underwent surgical resection of vestibular schwannoma at 66 reporting facilities, the median length of stay was 4 (IQR, 3-5) days, and 655 patients (5.7%) were readmitted within 30 days. The median case volume was 16 (IQR, 9-26) cases per year. An adjusted restricted cubic spline model identified a downtrending probability of excess time in the hospital with increasing volume. The declining risk of excess time in the hospital began to plateau at a facility volume of 25 cases per year. Surgery at a facility with an annual case volume at or above this threshold was independently associated with a 42% reduction in the odds of excess time in the hospital compared with surgery at a low-volume center (odds ratio, 0.58; 95% CI, 0.44-0.77). Conclusions and Relevance This cohort study found that among adults undergoing vestibular schwannoma surgery, a higher facility case volume was associated with a reduced risk of prolonged hospital stay or 30-day readmission. A facility case volume of 25 cases per year may represent a risk-defining threshold.
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Affiliation(s)
- Peter R. Dixon
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
| | - Omid Moshtaghi
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
| | - Usman Khan
- Department of Neurological Surgery, University of California San Diego, San Diego
| | - Jeffrey P. Harris
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
| | - Marc S. Schwartz
- Department of Neurological Surgery, University of California San Diego, San Diego
| | - Rick A. Friedman
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
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Strickland BA, Rennert R, Zada G, Shahrestani S, Russin JJ, Friedman RA, Giannotta SL. Surgical Outcomes Following Vestibular Schwannoma Resection in Patients over the Age of Sixty-five. J Neurol Surg B Skull Base 2023; 84:129-135. [PMID: 36911086 PMCID: PMC9991522 DOI: 10.1055/a-1771-0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 01/24/2022] [Indexed: 10/19/2022] Open
Abstract
Objective Vestibular schwannoma (VS) are benign, often slow growing neoplasms. Some institutions opt for radiosurgery in symptomatic patients of advanced age versus surgical resection. The aim of the study is to analyze surgical outcomes of VS in patients over the age of 65 who were either not candidates for or refused radiosurgery. Methods This includes retrospective analysis of VS patients between 1988 and 2020. Demographics, tumor characteristics, surgical records, and clinical outcomes were recorded. Patient preference for surgery over radiosurgery was recorded in the event that patients were offered both. Facial nerve outcomes were quantified using House-Brackmann (HB) scores. Tumor growth was defined by increase in size of >2 mm. Results In total, 64 patients were included of average age 72.4 years (65-84 years). Average maximum tumor diameter was 29 mm (13-55 mm). Forty-five patients were offered surgery or GKRS, and chose surgery commonly due to radiation aversion (48.4%). Gross total resection was achieved in 39.1% ( n = 25), near total 32.8% ( n = 21), and subtotal 28.1% ( n = 18). Average hospitalization was 5 days [2-17] with 75% ( n = 48) discharged home. Postoperative HB scores were good (HB1-2) in 43.8%, moderate (HB3-4) in 32.8%, and poor (HB5-6) in 23.4%. HB scores improved to good in 51.6%, moderate in 31.3%, and remained poor in 17.1%, marking a rate of facial nerve improvement of 10.9%. Tumor control was achieved in 95.3% of cases at an average follow-up time of 37.8 months. Conclusion VS resection can be safely performed in patients over the age of 65. Advanced age should not preclude a symptomatic VS patient from being considered for surgical resection.
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Affiliation(s)
- Ben A Strickland
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Rob Rennert
- Department of Neuro Otology, University of California San Diego, San Diego, California, United States
| | - Gabriel Zada
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Shane Shahrestani
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Jonathan J Russin
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Rick A Friedman
- Department of Neuro Otology, University of California San Diego, San Diego, California, United States
| | - Steven L Giannotta
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
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Jiramongkolchai P, Schwartz MS, Friedman RA. Management of Neurofibromatosis Type 2-Associated Vestibular Schwannomas. Otolaryngol Clin North Am 2023; 56:533-541. [PMID: 36964092 DOI: 10.1016/j.otc.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Neurofibromatosis type 2 (NF2) is an autosomal dominant syndrome caused by a mutation in the NF2 suppressor gene and is characterized by the development of multiple benign tumors throughout the central nervous system. Bilateral vestibular schwannomas (VSs) are pathognomonic for NF2 and are associated with progressive hearing loss and eventual deafness in most patients. This review presents current management options for NF-2-associated VSs.
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Affiliation(s)
- Pawina Jiramongkolchai
- Division of Otolaryngology-Head and Neck Surgery, University of California San Diego School of Medicine, 200 West Arbor Drive, MC 8895, San Diego, CA 92103, USA
| | - Marc S Schwartz
- Department of Neurosurgery, University of California San Diego School of Medicine, 9300 Campus Point Drive, Mail Code 7893, La Jolla, CA 92037, USA
| | - Rick A Friedman
- Division of Otolaryngology-Head and Neck Surgery, University of California San Diego School of Medicine, 200 West Arbor Drive, MC 8895, San Diego, CA 92103, USA; Department of Neurosurgery, University of California San Diego School of Medicine, 9300 Campus Point Drive, Mail Code 7893, La Jolla, CA 92037, USA.
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13
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La Monte OA, Moshtaghi O, Tang E, Du EY, Swisher AR, Dixon PR, Nemati S, Djalilian HR, Schwartz MS, Friedman RA. Use of a Novel Clinical Decision-Making Tool in Vestibular Schwannoma Treatment. Otol Neurotol 2022; 43:e1174-e1179. [PMID: 36240736 DOI: 10.1097/mao.0000000000003719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the usefulness of a personalized tool and its effect on the decision-making process for those with vestibular schwannoma (VS). STUDY DESIGN Prospective study. SETTING Single institution, academic tertiary care lateral skull base surgery program. PATIENTS Patients diagnosed with VS. INTERVENTIONS A comprehensive clinical decision support (CDS) tool was constructed from a previously published retrospective patient-reported data obtained from members of the Acoustic Neuroma Association from January to March 2017. Demographic, tumor, and treatment modality data, including associated side effects, were collected for 775 patients and integrated in an interactive and personalized web-based tool. MAIN OUTCOME MEASURES Pre- and posttool questionnaires assessing the process of deciding treatment for VS using a decisional conflict scale (DCS) and satisfaction with decision (SWD) scale were compared. RESULTS A pilot study of 33 patients evaluated at a single institution tertiary care center with mean ± SD age of 63.9 ± 13.5 years and with average tumor size of 7.11 ± 4.75 mm were surveyed. CDS implementation resulted in a mean ± SD total DCS score decrease from 43.6 ± 15.5 to 37.6 ± 16.4 ( p < 0.01) and total SWD score increase from 82.8 ± 16.1 to 86.2 ± 14.4 ( p = 0.04), indicating a significant decrease in decisional conflict and increase in satisfaction. CONCLUSIONS Implementing a decision-making tool after diagnosis of VS reduced decisional conflict and improved satisfaction with decision. Patients considered the tool to be an aid to their medical knowledge, further improving their comfort and understanding of their treatment options. These findings provide a basis for developing predictive tools that will assist patients in making informed medical decisions in the future.
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Affiliation(s)
| | - Omid Moshtaghi
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, La Jolla
| | - Edison Tang
- School of Medicine, University of California, San Diego, La Jolla
| | - Eric Y Du
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, La Jolla
| | - Austin R Swisher
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, La Jolla
| | - Peter R Dixon
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, La Jolla
| | - Shamim Nemati
- School of Medicine, University of California, San Diego, La Jolla
| | - Hamid R Djalilian
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine
| | - Marc S Schwartz
- Department of Neurosurgery, University of California, San Diego, La Jolla, California
| | - Rick A Friedman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, La Jolla
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14
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Du EY, Ortega BK, Ninoyu Y, Williams RW, Cofer GP, Cook JJ, Hornburg KJ, Qi Y, Johnson GA, Friedman RA. Volumetric analysis of the aging auditory pathway using high resolution magnetic resonance histology. Front Aging Neurosci 2022; 14:1034073. [DOI: 10.3389/fnagi.2022.1034073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/27/2022] [Indexed: 11/12/2022] Open
Abstract
Numerous shown consequences of age-related hearing loss have been unveiled; however, the relationship of the cortical and subcortical structures of the auditory pathway with aging is not well known. Investigations into neural structure analysis remain sparse due to difficulties of doing so in animal models; however, recent technological advances have been able to achieve a resolution adequate to perform such studies even in the small mouse. We utilize 12 members of the BXD family of recombinant inbred mice and aged separate cohorts. Utilizing novel magnetic resonance histology imaging techniques, we imaged these mice and generated high spatial resolution three dimensional images which were then comprehensively labeled. We completed volumetric analysis of 12 separate regions of interest specific to the auditory pathway brainstem nuclei and cortical areas with focus on the effect of aging upon said structures. Our results showed significant interstrain variation in the age-related effect on structure volume supporting a genetic influence in this interaction. Through multivariable modeling, we observed heterogenous effects of aging between different structures. Six of the 12 regions of interests demonstrated a significant age-related effect. The auditory cortex and ventral cochlear nucleus were found to decrease in volume with age, while the medial division of the medial geniculate nucleus, lateral lemniscus and its nucleus, and the inferior colliculus increased in size with age. Additionally, no sex-based differences were noted, and we observed a negative relationship between auditory cortex volume and mouse weight. This study is one of the first to perform comprehensive magnetic resonance imaging and quantitative analysis in the mouse brain auditory pathway cytoarchitecture, offering both novel insights into the neuroanatomical basis of age-related changes in hearing as well as evidence toward a genetic influence in this interaction. High resonance magnetic resonance imaging provides a promising efficacious avenue in future mouse model hearing loss investigations.
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Du EY, Boussaty EC, La Monte OA, Dixon PR, Zhou TY, Friedman RA. Large-scale phenotyping and characterization of age-related hearing loss in outbred CFW mice. Hear Res 2022; 424:108605. [PMID: 36088865 DOI: 10.1016/j.heares.2022.108605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/27/2022] [Accepted: 09/03/2022] [Indexed: 11/18/2022]
Abstract
Age-related hearing loss (ARHL), or presbycusis, is one of the most prevalent conditions affecting the global population. A substantial fraction of patients with ARHL have no identifiable mutation despite over a hundred having been discovered, suggesting unidentified monogenic or polygenic causes. In this study, we investigated the hearing function of the aging outbred CFW mice through auditory brainstem response (ABR) thresholds. Through the characterization of 1,132 ABRs, we observed significant variation in both absolute thresholds and the effect of aging. We identify eight distinct patterns of hearing loss and were able to categorize nearly all data within these eight categories. Proportions within each category varied immensely between aging timepoints. We observe a small but consistent hearing deficit in female CFW mice. The resulting phenotypic data are a necessity for ARHL association mapping at a higher resolution than has previously been achieved and provides a new resource for studying ARHL.
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Affiliation(s)
- Eric Y Du
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Ely C Boussaty
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Olivia A La Monte
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA; University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - Peter R Dixon
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Thomas Y Zhou
- University of California, San Diego, La Jolla, CA, USA
| | - Rick A Friedman
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA.
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16
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Ren Y, Merna CM, Tawfik KO, Schwartz MS, Friedman RA. Auditory Brain Stem Response Predictors of Hearing Outcomes after Middle Fossa Resection of Vestibular Schwannomas. Skull Base Surg 2022; 83:496-504. [DOI: 10.1055/s-0040-1722718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
Abstract
Objectives To analyze the relationship between preoperative and intraoperative auditory brain stem response (ABR) characteristics and hearing outcomes in patients with vestibular schwannomas (VS) undergoing hearing preservation (HP) surgery via a middle cranial fossa (MCF) approach.
Design Prospective study.
Setting Academic tertiary skull base referral center.
Methods Pre- and postoperative pure-tone average (PTA) and word recognition score (WRS) were examined. Intraoperative ABR wave III latency, wave V latency, and amplitude were recorded. HP was defined as postoperative WRS ≥50%.
Participants Adult patients with VS and WRS ≥50% who underwent MCF tumor resection between November 2017 and September 2019.
Main Outcome Measures Postoperative hearing outcomes.
Results Sixty patients were included. Mean tumor size was 9.2 mm (range, 3–17). HP rates were 56.7% for the cohort and 69.7% for tumors <10 mm. A complete loss of wave V was associated with an 82.9% increase in postoperative PTA (p < 0.001) and 97.2% decrease in WRS (p < 0.001), whereas a diminished wave V was correlated with 62.7% increase in PTA (p < 0.001) and 55.7% decrease in WRS (p = 0.006). A diminished or absent wave V, but not increased wave III/V latency or decreased wave V amplitude, was correlated with a decline in postoperative hearing class (r = 0.735, p < 0.001). Receiver-operating characteristic analysis demonstrated that a stable wave V has the highest accuracy in predicting HP (sensitivity of 82.6%, specificity of 84.8%).
Conclusion Of the examined preoperative and intraoperative ABR characteristics, a stable wave V intraoperatively was the strongest predictor of HP after MCF resection of VS.
Level of Evidence Level III.
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Affiliation(s)
- Yin Ren
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, San Diego, California, United States
| | - Catherine M. Merna
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, United States
| | - Kareem O. Tawfik
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, San Diego, California, United States
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Marc S. Schwartz
- Division of Neurosurgery, Department of Surgery, University of California, San Diego, San Diego, California, United States
| | - Rick A. Friedman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego, San Diego, California, United States
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17
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Ramirez MA, Ninoyu Y, Miller C, Andrade LR, Edassery S, Bomba-Warczak E, Ortega B, Manor U, Rutherford MA, Friedman RA, Savas JN. Cochlear ribbon synapse maturation requires Nlgn1 and Nlgn3. iScience 2022; 25:104803. [PMID: 35992071 PMCID: PMC9386149 DOI: 10.1016/j.isci.2022.104803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/10/2022] [Accepted: 07/15/2022] [Indexed: 01/13/2023] Open
Abstract
Hearing depends on precise synaptic transmission between cochlear inner hair cells and spiral ganglion neurons through afferent ribbon synapses. Neuroligins (Nlgns) facilitate synapse maturation in the brain, but they have gone unstudied in the cochlea. We report Nlgn3 and Nlgn1 knockout (KO) cochleae have fewer ribbon synapses and have impaired hearing. Nlgn3 KO is more vulnerable to noise trauma with limited activity at high frequencies one day after noise. Furthermore, Nlgn3 KO cochleae have a 5-fold reduction in synapse number compared to wild type after two weeks of recovery. Double KO cochlear phenotypes are more prominent than the KOs, for example, 5-fold smaller synapses, 25% reduction in synapse density, and 30% less synaptic output. These observations indicate Nlgn3 and Nlgn1 are essential to cochlear ribbon synapse maturation and function.
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Affiliation(s)
- Miguel A. Ramirez
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yuzuru Ninoyu
- Division of Otolaryngology, Department of Surgery, University of California, San Diego, 9500 Gilman Drive, Mail Code 0666, La Jolla, CA 92093, USA
| | - Cayla Miller
- Waitt Advanced Biophotonics Core, Salk Institute for Biological Studies, 10010 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Leonardo R. Andrade
- Waitt Advanced Biophotonics Core, Salk Institute for Biological Studies, 10010 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Seby Edassery
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ewa Bomba-Warczak
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Briana Ortega
- Division of Otolaryngology, Department of Surgery, University of California, San Diego, 9500 Gilman Drive, Mail Code 0666, La Jolla, CA 92093, USA
| | - Uri Manor
- Waitt Advanced Biophotonics Core, Salk Institute for Biological Studies, 10010 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Mark A. Rutherford
- Department of Otolaryngology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Rick A. Friedman
- Division of Otolaryngology, Department of Surgery, University of California, San Diego, 9500 Gilman Drive, Mail Code 0666, La Jolla, CA 92093, USA
| | - Jeffrey N. Savas
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA,Corresponding author
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Harley RJ, Lee JH, Ostrander BT, Finegersh A, Pham TB, Tawfik KO, Ren Y, Faraji F, Friedman RA. Local Tumor Behavior Associated With Survival Among Patients With Paraganglioma of the Head and Neck. OTO Open 2022; 6:2473974X221086872. [PMID: 35571573 PMCID: PMC9096223 DOI: 10.1177/2473974x221086872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/27/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The purpose of this study was to evaluate the utility of
ICD-O-3–classified local tumor behavior as a
prognosticator of head and neck paraganglioma (HNP) outcomes. Study Design Retrospective cohort study. Setting National Cancer Database between 2004 and 2016. Methods This study included patients aged ≥18 years who were diagnosed with HNP.
Clinical outcomes and clinicopathologic features were compared with regard
to local tumor behavior. Results Our study included 525 patients, of which the majority had HNP classified as
locally invasive (45.9%) or borderline (37.9%). The most common anatomic
sites involved were the carotid body (33.7%), intracranial regions (29.0%),
or cranial nerves (25.5%). Carotid body tumors were exclusively locally
invasive, whereas intracranial and cranial nerve HNP were overwhelmingly
benign or borderline (94% and 91%, respectively). One-fourth of patients
underwent pathologic analysis of regional lymph nodes, of which the majority
were positive for metastasis (80.6%). Metastasis to distant organs was twice
as common in patients with locally invasive tumors vs benign (15% vs 7.1).
For benign disease, surgery with radiotherapy (adjusted hazard ratio [aHR],
40.45; P = .006) and active surveillance (aHR, 24.23;
P = .008) were associated with worse survival when
compared with surgery alone. For locally invasive tumors, greater age (aHR,
1.07; P < .0001) and positive surgical margins (aHR,
4.13; P = .010) were predictors of worse survival, while
combined surgery and radiotherapy were predictors of improved survival vs
surgery alone (aHR, 0.31; P = .027). Conclusion While criteria for tumor behavior could not be defined, our results suggest
that such a classification system could be used to enhance HNP risk
stratification and guide clinical management decisions.
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Affiliation(s)
- Randall J. Harley
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jason H. Lee
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Benjamin T. Ostrander
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Andrey Finegersh
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Tammy B. Pham
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Kareem O. Tawfik
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Yin Ren
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Farhoud Faraji
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Rick A. Friedman
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
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Ren Y, Mehranpour P, Moshtaghi O, Schwartz MS, Friedman RA. Opioid Prescribing Patterns After Skull Base Surgery for Vestibular Schwannoma. Otol Neurotol 2022; 43:e116-e121. [PMID: 34889846 DOI: 10.1097/mao.0000000000003349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Excessive opioid prescription is a source of prescription diversion and could contribute to chronic opioid abuse. This study describes the opioid prescribing patterns and risk factors for additional opioid prescription after surgical resection of vestibular schwannoma (VS). STUDY DESIGN Retrospective chart review. SETTING Single tertiary referral center. PATIENTS Adult VS patients undergoing surgical resection between May 2019 and March 2020. INTERVENTIONS Opioid use postoperatively and up to 60 days following surgery were characterized from medical records and by querying the state-wide Controlled Substance Utilization Review and Evaluation System. MAIN OUTCOME MEASURES The presence of additional opioid prescriptions within 60 days of surgery. RESULTS A total of 109 patients (mean age 50 yrs, 65.5% female) were prescribed an average of 138.2 ± 117.8 mg of morphine equivalents (MME). Twenty-two (20.9%) required additional prescriptions of 163.2 ± 103.2 MME. Age, gender, tumor size, or surgical approach (translabyrinthine, retrosigmoid, versus middle fossa) were not associated with additional prescriptions. Patients with additional prescriptions had higher body mass index (BMI 28.8 vs. 25.8 kg/m2, p = 0.015) and required more opioid medications during hospitalization (51.8 vs. 29.1 MME, p = 0.002). On multivariate logistic regression, higher BMI (odds ratio [OR] 1.32; p = 0.001), history of headaches (OR 11.9, p = 0.011), and history of opioid use (OR 29.3, p = 0.008) were associated with additional prescription. CONCLUSIONS Additional opioid prescriptions may be necessary in a portion of VS patients undergoing surgery. The choice of surgical approach is not associated with excess opioid requirements. Patients with higher BMI, history of headaches, or preoperative opioid use may require additional prescriptions.
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Affiliation(s)
- Yin Ren
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology Head and Neck Surgery, The Ohio State University, Columbus, Ohio
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery
| | | | - Omid Moshtaghi
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery
| | - Marc S Schwartz
- Department of Neurosurgery, University of California San Diego, La Jolla, California
| | - Rick A Friedman
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery
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20
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Ren Y, McDonald MA, Manning P, MacDonald BV, Schwartz MS, Friedman RA, Harris JP. Dispersed Bone Spicules as a Cause of Postoperative Headache after Retrosigmoid Vestibular Schwannoma Surgery: A Myth? J Neurol Surg B Skull Base 2021; 83:374-382. [PMID: 35903655 PMCID: PMC9324304 DOI: 10.1055/s-0041-1741112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/05/2021] [Indexed: 01/02/2023] Open
Abstract
Objectives Dispersion of bone dust in the posterior fossa during retrosigmoid craniectomy for vestibular schwannoma (VS) resection could be a source of meningeal irritation and lead to development of persistent postoperative headaches (POH). We aim to determine risk factors, including whether the presence of bone spicules that influence POH after retrosigmoid VS resection. Design Present study is a retrospective case series. Setting The study was conducted at a tertiary skull-base referral center. Participants Adult patients undergoing VS resection via a retrosigmoid approach between November 2017 and February 2020 were included for this study. Main Outcome Measures Development of POH lasting ≥ 3 months is the primary outcome of this study. Results Of 64 patients undergoing surgery, 49 had complete data (mean age, 49 years; 53% female). Mean follow-up time was 2.4 years. At latest follow up, 16 (33%) had no headaches, 14 (29%) experienced headaches lasting <3 months, 19 (39%) reported POH lasting ≥3 months. Twenty-seven (55%) patients had posterior fossa bone spicules detectable on postoperative computed tomography (CT). Age, gender, body mass index, length of stay, tumor diameter, size of craniectomy, the presence of bone spicules, or the amount of posterior petrous temporal bone removed from drilling did not differ significantly between patients with POH and those without. On multivariate logistic regression, patients with POH were less likely to have preoperative brainstem compression by the tumor (odds ratio [OR] = 0.21, p = 0.028) and more likely to have higher opioid requirements during hospitalization (OR = 1.023, p = 0.045). Conclusion The presence of bone spicules in the posterior fossa on postoperative CT did not contribute to headaches following retrosigmoid craniectomy approach for VS resection.
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Affiliation(s)
- Yin Ren
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States,Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, United States,Address for correspondence Yin Ren, MD, PhD Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology Head and Neck Surgery, The Ohio State University Wexner Medical Center915 Olentangy River Road, Suite 4000, Columbus, OH 43212United States
| | - Marin A. McDonald
- Department of Radiology, University of California San Diego, La Jolla, California, United States
| | - Paul Manning
- Department of Radiology, University of California San Diego, La Jolla, California, United States
| | - Bridget V. MacDonald
- Department of Otolaryngology Head and Neck Surgery, University of California Davis, Sacramento, California, United States
| | - Marc S. Schwartz
- Department of Neurosurgery, University of California San Diego, La Jolla, California, United States
| | - Rick A. Friedman
- Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, United States
| | - Jeffrey P. Harris
- Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, United States
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Tawfik KO, McDonald M, Ren Y, Moshtaghi O, Schwartz MS, Friedman RA. Cochlear T2 Signal May Predict Hearing Outcomes After Resection of Acoustic Neuroma. Otol Neurotol 2021; 42:1399-1407. [PMID: 34121085 DOI: 10.1097/mao.0000000000003228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Examine the impact of preoperative cochlear Fast Imaging Employing Steady-state Acquisition (FIESTA) and Constructive Interference in Steady State (CISS) signal intensity on hearing outcomes after middle cranial fossa (MCF) resection of acoustic neuroma (AN). METHODS Adult patients (≥18 years) who underwent MCF AN resection for hearing preservation (HP) between November 2017 and September 2019 were retrospectively reviewed. All patients had preoperative word recognition score (WRS) ≥50%. HP was defined as postoperative WRS ≥50%. A neuroradiologist blinded to patients' clinical and audiometric outcomes reviewed patients' preoperative magnetic resonance images. Ipsilateral-to-contralateral cochlear FIESTA/CISS signal intensity ratios were determined using hand-drawn regions of interest focused on the cochlear fluid. Preoperative and postoperative pure tone average (PTA) and WRS were reviewed. RESULTS Fifty-one patients were reviewed (60.8% female). Mean age was 47 years and mean tumor size 9.2 mm (±3.8). Hearing was preserved in 56.9% (n = 29). FIESTA/CISS signal ratios did not significantly differ between patients with and without HP. Lower FIESTA/CISS signal ratios correlated with greater declines in hearing (r = 0.322, p = 0.011 for PTA; and r = 0.384, p = 0.004 for WRS). On multivariate analysis accounting for tumor size and preoperative PTA/WRS, decreases in FIESTA/CISS signal ratios independently predicted greater declines in hearing by PTA (b = -100.9, p = 0.012) and WRS (b = 76.208), although the latter result was not statistically significant (p = 0.078). CONCLUSIONS Cochlear FIESTA/CISS signal intensity may be a predictor of postoperative hearing loss after MCF AN resection. In this cohort, degraded preoperative cochlear FIESTA/CISS signal strongly predicted postoperative hearing loss.Level of Evidence: IV.
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Affiliation(s)
| | - Marin McDonald
- University of California San Diego School of Medicine, La Jolla, California
| | - Yin Ren
- University of California San Diego School of Medicine, La Jolla, California
| | - Omid Moshtaghi
- University of California San Diego School of Medicine, La Jolla, California
| | - Marc S Schwartz
- University of California San Diego School of Medicine, La Jolla, California
| | - Rick A Friedman
- University of California San Diego School of Medicine, La Jolla, California
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22
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Khan UA, Plonsker JH, Friedman RA, Schwartz MS. Combined translabyrinthine, anterior petrosal approach for resection of collision vestibular schwannoma and petrous apex meningioma in neurofibromatosis type 2, with auditory brainstem implant placement. Neurosurgical Focus: Video 2021; 5:V17. [PMID: 36285231 PMCID: PMC9551634 DOI: 10.3171/2021.7.focvid21130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/23/2021] [Indexed: 11/17/2022]
Abstract
The natural history of neurofibromatosis type 2 (NF2) is profound bilateral hearing loss. The decision to pursue microsurgery may be more complicated in NF2 than with sporadic tumors. Schwannomas in NF2 often occur with other skull base tumors. Treatment should be tailored to preserve auditory perception for as long as possible. The authors present the case of a man with NF2 and a vestibular schwannoma who has poor hearing on the same side as a large petrous apex meningioma, both opposite to a well-hearing ear. This case highlights surgical decision-making and technical nuances during resection of collision tumors in NF2. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21130
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Affiliation(s)
| | | | - Rick A. Friedman
- Division of Head and Neck Surgery, University of California San Diego, California
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23
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Rennert RC, Brandel MG, Steinberg JA, Gonda DD, Friedman RA, Fukushima T, Day JD, Khalessi AA, Levy ML. Maturation of the anterior petrous apex: surgical relevance for performance of the middle fossa transpetrosal approach in pediatric patients. J Neurosurg 2021:1-7. [PMID: 34534955 DOI: 10.3171/2021.3.jns202648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 03/24/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The middle fossa transpetrosal approach to the petroclival and posterior cavernous sinus regions includes removal of the anterior petrous apex (APA), an area well studied in adults but not in children. To this end, the authors performed a morphometric analysis of the APA region during pediatric maturation. METHODS Measurements of the distance from the clivus to the internal auditory canal (IAC; C-IAC), the distance of the petrous segment of the internal carotid artery (petrous carotid; PC) to the mesial petrous bone (MPB; PC-MPB), the distance of the PC to the mesial petrous apex (MPA; PC-MPA), and the IAC depth from the middle fossa floor (IAC-D) were made on thin-cut CT scans from 60 patients (distributed across ages 0-3, 4-7, 8-11, 12-15, 16-18, and > 18 years). The APA volume was calculated as a cylinder using C-IAC (length) and PC-MPB (diameter). APA pneumatization was noted. Data were analyzed by laterality, sex, and age. RESULTS APA parameters did not differ by laterality or sex. APA pneumatization was seen on 20 of 60 scans (33.3%) in patients ≥ 4 years. The majority of the APA region growth occurred by ages 8-11 years, with PC-MPA and PC-MPB increasing 15.9% (from 9.4 to 10.9 mm, p = 0.08) and 23.5% (from 8.9 to 11.0 mm, p < 0.01) between ages 0-3 and 8-11 years, and C-IAC increasing 20.7% (from 13.0 to 15.7 mm, p < 0.01) between ages 0-3 and 4-7 years. APA volume increased 79.6% from ages 0-3 to 8-11 years (from 834.3 to 1499.2 mm3, p < 0.01). None of these parameters displayed further significant growth. Finally, IAC-D increased 51.1% (from 4.3 to 6.5 mm, p < 0.01) between ages 0-3 and adult, without significant differences between successive age groups. CONCLUSIONS APA development is largely complete by the ages of 8-11 years. Knowledge of APA growth patterns may aid approach selection and APA removal in pediatric patients.
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Affiliation(s)
- Robert C Rennert
- 1Department of Neurological Surgery, University of California, San Diego, La Jolla
| | - Michael G Brandel
- 1Department of Neurological Surgery, University of California, San Diego, La Jolla
| | - Jeffrey A Steinberg
- 1Department of Neurological Surgery, University of California, San Diego, La Jolla
| | - David D Gonda
- 2Department of Neurosciences and Pediatrics, University of California, San Diego, San Diego
| | - Rick A Friedman
- 3Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, University of California, San Diego, La Jolla, California
| | | | - John D Day
- 5Department of Neurosurgery, University of Arkansas, Little Rock, Arkansas
| | - Alexander A Khalessi
- 1Department of Neurological Surgery, University of California, San Diego, La Jolla
| | - Michael L Levy
- 2Department of Neurosciences and Pediatrics, University of California, San Diego, San Diego
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24
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Said M, Lee J, Moshtaghi O, Saliba J, Richardson AJW, Ngo V, Mehranpour P, Schwartz MS, Friedman RA. The Relationship Between the Functional Gait Assessment and Quality-of-Life Data in Patients Undergoing Vestibular Schwannoma Resection. Otol Neurotol 2021; 42:1074-1080. [PMID: 33741817 DOI: 10.1097/mao.0000000000003137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the relationship between the Functional Gait Assessment (FGA) and quality of life (QOL) measurements relating to balance before and after vestibular schwannoma (VS) resection and to assess the role of preoperative FGA in predicting postoperative QOL. STUDY DESIGN A prospective clinical study of adult patients undergoing VS resection between September 2018 and December 2019. FGA was administered 1 week before and after surgery. Dizziness Handicap Inventory (DHI) and Penn Acoustic Neuroma Quality of Life (PANQOL) were administered preoperatively and at 3 months postoperatively. SETTING Single tertiary center. PATIENTS Patients (age ≥ 18 years old) with VS undergoing microsurgical resection. Excluded were patient with previous surgery or radiation. INTERVENTION VS resection. MAIN OUTCOMES AND MEASURES Primary outcome: correlation between FGA and QOL surveys. Secondary outcome: correlation between preoperative measurements of balance and postoperative PANQOL. RESULTS One hundred thirty-eight patients were analyzed (mean age: 48 years old, 65.9% female). The translabyrinthine approach was most commonly performed. Under multivariate analysis, preoperative FGA significantly correlated with preoperative PANQOL balance score (p < 0.0001), preoperative PANQOL total score (p = 0.0002), and preoperative DHI (p < 0.0001). However, postoperative FGA did not significantly correlate with postoperative PANQOL balance or total scores (p = 0.446 and p = 0.4, respectively), or postoperative DHI (p = 0.3). Univariate analysis demonstrated that preoperative DHI and preoperative FGA were predictive of changes in postoperative PANQOL balance and total scores. However under multivariate analysis, preoperative FGA did not predict changes in postoperative PANQOL balance or total score (p = 0.24; p = 0.28, respectively). Preoperative DHI remained predictive of changes in postoperative PANQOL balance (p = 0.03) score but not of postoperative PANQOL total score (p = 0.37). CONCLUSIONS Although FGA and QOL data significantly correlated in the preoperative setting, our results did not suggest that preoperative FGA can be used to determine postoperative QOL. Additionally, the lack of correlation between FGA and QOL measurements in the acute postoperative setting suggests that further research is needed to determine contributors to postoperative QOL.
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Affiliation(s)
- Mena Said
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, USA
| | - Jason Lee
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, USA
| | - Omid Moshtaghi
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, USA
| | - Joe Saliba
- Division of Otolaryngology-Head and Neck Surgery, University of Montreal, Montreal, Canada
| | | | - Victoria Ngo
- University of California Davis Health, Sacramento, California, USA
| | - Pasha Mehranpour
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, USA
| | - Marc S Schwartz
- Division of Neurosurgery, Department of Surgery, University of California-San Diego, San Diego, California, USA
| | - Rick A Friedman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, USA
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25
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Lavinsky J, Kasperbauer G, Bento RF, Mendonça A, Wang J, Crow AL, Allayee H, Friedman RA. Noise Exposure and Distortion Product Otoacoustic Emission Suprathreshold Amplitudes: A Genome-Wide Association Study. Audiol Neurootol 2021; 26:445-453. [PMID: 34280920 DOI: 10.1159/000514143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 11/25/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although several candidate-gene association studies have been conducted to investigate noise-induced hearing loss (NIHL) in humans, most are underpowered, unreplicated, and account for only a fraction of the genetic risk. Mouse genome-wide association studies (GWASs) have revolutionized the field of genetics and have led to the discovery of hundreds of genes involved in complex traits. The hybrid mouse diversity panel (HMDP) is a collection of classic inbred and recombinant inbred strains whose genomes have been either genotyped at high resolution or sequenced. To further investigate the genetics of NIHL, we report the first GWAS based on distortion product otoacoustic emission (DPOAE) measurements and the HMDP. METHODS A total of 102 strains (n = 635) from the HMDP were evaluated based on DPOAE suprathreshold amplitudes before and after noise exposure. DPOAE amplitude variation was set at 60 and 70 dB SPL of the primary tones for each frequency separately (8, 11.3, 16, 22.6, and 32 kHz). These values provided an indirect assessment of outer hair cell integrity. Six-week-old mice were exposed for 2 h to 10 kHz octave-band noise at 108 dB SPL. To perform local expression quantitative trait locus (eQTL) analysis, gene expression microarray profiles were generated using cochlear RNA from 64 hybrid mouse strains (n = 3 arrays per strain). RESULTS Several new loci were identified and positional candidate-genes associated with NIHL were prioritized, especially after noise exposure (1 locus at baseline and 5 loci after exposure). A total of 35 candidate genes in these 6 loci were identified with at least 1 probe whose expression was regulated by a significant cis-eQTL in the cochlea. After careful analysis of the candidate genes based on cochlear gene expression, 2 candidate genes were prioritized: Eya1 (baseline) and Efr3a (post-exposure). DISCUSSION AND CONCLUSION For the first time, an association analysis with correction for population structure was used to map several loci for hearing traits in inbred strains of mice based on DPOAE suprathreshold amplitudes before and after noise exposure. Our results identified a number of novel loci and candidate genes for susceptibility to NIHL, especially the Eya1 and Efr3a genes. Our findings validate the power of the HMDP for detecting NIHL susceptibility genes.
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Affiliation(s)
- Joel Lavinsky
- Postgraduate Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilherme Kasperbauer
- Postgraduate Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo F Bento
- Department of Otolaryngology, University of São Paulo, La Jolla, California, USA
| | - Aline Mendonça
- Postgraduate Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juemei Wang
- Keck School of Medicine of USC, Los Angeles, California, USA
| | - Amanda L Crow
- Keck School of Medicine of USC, Los Angeles, California, USA
| | - Hooman Allayee
- Keck School of Medicine of USC, Los Angeles, California, USA
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26
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Tawfik KO, Khan UA, Friedman RA. Treatment of Small Vestibular Schwannomas. Curr Otorhinolaryngol Rep 2021. [DOI: 10.1007/s40136-020-00326-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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27
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Choi JS, Wu F, Park S, Friedman RA, Kari E, Volker CCJ. Factors Associated With Unilateral Hearing Loss and Impact on Communication in US Adults. Otolaryngol Head Neck Surg 2021; 165:868-875. [PMID: 33752481 DOI: 10.1177/0194599821995485] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the factors associated with unilateral hearing loss (UHL) and its impact on communication in US adults. STUDY DESIGN Cross-sectional study. SETTING Nationally representative sample of US adults. METHODS We analyzed data from the 2011-2012 and 2015-2016 National Health and Nutritional Examination Survey, in which participants aged 20 to 69 years completed an audiometric evaluation (n = 8138). UHL was defined as a speech frequency pure-tone average ≥25 dB in the worse hearing ear and <25 dB in the better hearing ear. Logistic regression was used to examine the association between UHL and relevant factors. RESULTS The prevalence of UHL was 8.1% (95% CI, 7.3%-9.0%) in US adults. Factors associated with UHL included older age, male sex, white race, lower level of education, diabetes, cardiovascular disease, and off-work noise exposure. Among adults with UHL, 40% (95% CI, 32%-48%) reported subjective trouble with hearing, a rate higher than the 12% (95% CI, 11%-14%) among normal-hearing adults. After adjusting for relevant factors, adults with UHL were more likely to report difficulties with following conversations with noise (odds ratio [OR], 1.7; 95% CI, 1.2-2.5) and frustration when talking to family and friends (OR, 3.0; 95% CI, 1.9-4.6). Higher levels of communication difficulties were observed with worsening level of UHL. CONCLUSIONS Adults with UHL report significant communication difficulties in comparison to normal-hearing adults. Further research is needed to understand the psychosocial impact of UHL on adults and ways to improve communication support for adults with UHL.
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Affiliation(s)
- Janet S Choi
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Franklin Wu
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Soyun Park
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Rick A Friedman
- Department of Otolaryngology-Head & Neck Surgery, University of California, San Diego, La Jolla, California, USA
| | - Elina Kari
- Department of Otolaryngology-Head & Neck Surgery, University of California, San Diego, La Jolla, California, USA
| | - Courtney C J Volker
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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28
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Momen-Heravi F, Friedman RA, Albeshri S, Sawle A, Kebschull M, Kuhn A, Papapanou PN. Cell Type-Specific Decomposition of Gingival Tissue Transcriptomes. J Dent Res 2021; 100:549-556. [PMID: 33419383 DOI: 10.1177/0022034520979614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Genome-wide transcriptomic analyses in whole tissues reflect the aggregate gene expression in heterogeneous cell populations comprising resident and migratory cells, and they are unable to identify cell type-specific information. We used a computational method (population-specific expression analysis [PSEA]) to decompose gene expression in gingival tissues into cell type-specific signatures for 8 cell types (epithelial cells, fibroblasts, endothelial cells, neutrophils, monocytes/macrophages, plasma cells, T cells, and B cells). We used a gene expression data set generated using microarrays from 120 persons (310 tissue samples; 241 periodontitis affected and 69 healthy). Decomposition of the whole-tissue transcriptomes identified differentially expressed genes in each of the cell types, which mapped to biologically relevant pathways, including dysregulation of Th17 cell differentiation, AGE-RAGE signaling, and epithelial-mesenchymal transition in epithelial cells. We validated selected PSEA-predicted, differentially expressed genes in purified gingival epithelial cells and B cells from an unrelated cohort (n = 15 persons), each of whom contributed with 1 periodontitis-affected and 1 healthy gingival tissue sample. Differential expression of these genes by quantitative reverse transcription polymerase chain reaction corroborated the PSEA predictions and pointed to dysregulation of biologically important pathways in periodontitis. Collectively, our results demonstrate the robustness of the PSEA in the decomposition of gingival tissue transcriptomes and its ability to identify differentially regulated transcripts in particular cellular constituents. These genes may serve as candidates for further investigation with respect to their roles in the pathogenesis of periodontitis.
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Affiliation(s)
- F Momen-Heravi
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, New York, NY, USA
| | - R A Friedman
- Biomedical Informatics Shared Resource, Herbert Irving Comprehensive Cancer Center and Department of Biomedical Informatics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - S Albeshri
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, New York, NY, USA
| | - A Sawle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - M Kebschull
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, New York, NY, USA.,School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - A Kuhn
- Institute of Life Technologies, School of Engineering, HES-SO University of Applied Sciences and Arts Western Switzerland, Sion, Switzerland
| | - P N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, New York, NY, USA
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29
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Cui L, Zheng J, Zhao Q, Chen JR, Liu H, Peng G, Wu Y, Chen C, He Q, Shi H, Yin S, Friedman RA, Chen Y, Guan MX. Mutations of MAP1B encoding a microtubule-associated phosphoprotein cause sensorineural hearing loss. JCI Insight 2020; 5:136046. [PMID: 33268592 PMCID: PMC7714412 DOI: 10.1172/jci.insight.136046] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 10/28/2020] [Indexed: 12/20/2022] Open
Abstract
The pathophysiology underlying spiral ganglion cell defect–induced deafness remains elusive. Using the whole exome sequencing approach, in combination with functional assays and a mouse disease model, we identified the potentially novel deafness-causative MAP1B gene encoding a highly conserved microtubule-associated protein. Three novel heterozygous MAP1B mutations (c.4198A>G, p.1400S>G; c.2768T>C, p.923I>T; c.5512T>C, p.1838F>L) were cosegregated with autosomal dominant inheritance of nonsyndromic sensorineural hearing loss in 3 unrelated Chinese families. Here, we show that MAP1B is highly expressed in the spiral ganglion neurons in the mouse cochlea. Using otic sensory neuron–like cells, generated by pluripotent stem cells from patients carrying the MAP1B mutation and control subject, we demonstrated that the p.1400S>G mutation caused the reduced levels and deficient phosphorylation of MAP1B, which are involved in the microtubule stability and dynamics. Strikingly, otic sensory neuron–like cells exhibited disturbed dynamics of microtubules, axonal elongation, and defects in electrophysiological properties. Dysfunctions of these derived otic sensory neuron–like cells were rescued by genetically correcting MAP1B mutation using CRISPR/Cas9 technology. Involvement of MAP1B in hearing was confirmed by audiometric evaluation of Map1b heterozygous KO mice. These mutant mice displayed late-onset progressive sensorineural hearing loss that was more pronounced in the high frequencies. The spiral ganglion neurons isolated from Map1b mutant mice exhibited the deficient phosphorylation and disturbed dynamics of microtubules. Map1b deficiency yielded defects in the morphology and electrophysiology of spiral ganglion neurons, but it did not affect the morphologies of cochlea in mice. Therefore, our data demonstrate that dysfunctions of spiral ganglion neurons induced by MAP1B deficiency caused hearing loss. Dysfunctions of spiral ganglion neurons caused by Map1b deficiency leads to sensorineural hearing loss.
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Affiliation(s)
- Limei Cui
- Division of Medical Genetics and Genomics, The Children's Hospital.,Institute of Genetics and.,Department of Human Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jing Zheng
- Division of Medical Genetics and Genomics, The Children's Hospital
| | - Qiong Zhao
- Division of Medical Genetics and Genomics, The Children's Hospital.,Institute of Genetics and.,Department of Human Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jia-Rong Chen
- Division of Medical Genetics and Genomics, The Children's Hospital.,Institute of Genetics and
| | | | - Guanghua Peng
- Deaprtment of Otorhinolaryngology, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yue Wu
- Division of Medical Genetics and Genomics, The Children's Hospital
| | - Chao Chen
- Division of Medical Genetics and Genomics, The Children's Hospital.,Institute of Genetics and
| | | | - Haosong Shi
- Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Shankai Yin
- Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Rick A Friedman
- Division of Otolaryngology, University of California at San Diego School of Medicine, La Jolla California, USA
| | - Ye Chen
- Division of Medical Genetics and Genomics, The Children's Hospital.,Institute of Genetics and.,Department of Human Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Min-Xin Guan
- Division of Medical Genetics and Genomics, The Children's Hospital.,Institute of Genetics and.,Department of Human Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Division of Otolaryngology, University of California at San Diego School of Medicine, La Jolla California, USA.,Zhejiang Provincial Key Laboratory of Genetic and Developmental Disorders, Hangzhou, Zhejiang, China.,Joint Institute of Genetics and Genomic Medicine between Zhejiang University and University of Toronto, Zhejiang University, Hangzhou, Zhejiang, China
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30
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Ren Y, MacDonald BV, Tawfik KO, Schwartz MS, Friedman RA. Clinical Predictors of Facial Nerve Outcomes After Surgical Resection of Vestibular Schwannoma. Otolaryngol Head Neck Surg 2020; 164:1085-1093. [PMID: 33048002 DOI: 10.1177/0194599820961389] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To identify clinical predictors of facial nerve (FN) outcomes after microsurgical resection of vestibular schwannoma (VS). STUDY DESIGN Prospective cohort study. SETTING Academic medical center. METHODS Consecutive patients undergoing VS resection from November 2017 to October 2019 were included. FN function was evaluated with the House-Brackmann (HB) scale and stratified into good (HB I-II) and poor (HB III-VI) function. Analyses included descriptive statistics, correlation, and logistic regression. RESULTS Of 256 patients who met criteria (mean age, 47.7 years; 62.5% female), 227 (88.7%) achieved good FN function postoperatively and 238 (93.0%) at latest follow-up (mean, 154.8 days). Operative approaches consisted of translabyrinthine (50.8%), retrosigmoid (25.0%), and middle fossa craniotomies (24.2%). Extent of resection was decided intraoperatively, and gross or near total resection was accomplished in 237 (92.6%) cases. Postoperative HB grade correlated with latest HB grade (0.615, P < .001). Factors associated with good postoperative FN function included small tumor size (≤15 mm; odds ratio [OR], 2.425; P = .042), gross or near total resection (OR, 3.170; P = .041), and ≥100-µV intraoperative FN electromyographic response to a 0.05-mA stimulus (OR, 22.242; P < .001). Factors associated with good FN function at latest follow-up included gross total resection (OR, 7.764; P = .003) and ≥100-µV FN electromyographic response (OR, 8.518; P < .001), accounting for surgical approach and tumor size. CONCLUSION Microsurgical resection of VS can be accomplished with excellent FN outcomes. Gross total resection and ≥100-µV intraoperative FN electromyographic response predicted excellent FN outcomes. Immediate postoperative FN function is a prognosticator of long-term FN function.
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Affiliation(s)
- Yin Ren
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California at San Diego, La Jolla, California, USA
| | - Bridget V MacDonald
- School of Medicine, University of California at San Diego, La Jolla, California, USA
| | - Kareem O Tawfik
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California at San Diego, La Jolla, California, USA.,Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Marc S Schwartz
- Department of Neurosurgery, University of California at San Diego, La Jolla, California, USA
| | - Rick A Friedman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California at San Diego, La Jolla, California, USA
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31
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Rennert RC, Levy DM, Plonsker J, Steinberg JA, Friedman RA, Crawford JR, Levy ML. Middle fossa approach for a pediatric facial nerve meningioma. J Neurosurg Pediatr 2020; 26:578-582. [PMID: 32858509 DOI: 10.3171/2020.5.peds2034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/19/2020] [Indexed: 11/06/2022]
Abstract
Pediatric cerebellopontine angle (CPA) meningiomas are extremely rare and are usually treated with a retrosigmoid surgical approach or radiation. The authors present the use of a middle fossa approach for the treatment of a symptomatic CPA meningioma in a 22-month-old female. The patient initially presented at 17 months with isolated progressive, long-standing right-sided facial weakness. MRI demonstrated a 5.0 × 5.0-mm right CPA lesion just superior to the cisternal segment of cranial nerve (CN) VII, which demonstrated growth on interval imaging. At 22 months of age she underwent a successful middle fossa craniotomy, including wide exposure of the porus acusticus, allowing for a gross-total resection with preservation of CNs VII and VIII. Pathological analysis revealed a WHO grade I meningioma. The patient remained neurologically stable on follow-up. The middle fossa approach can be used to safely access the CPA in properly selected pediatric patients.
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Affiliation(s)
| | | | | | | | - Rick A Friedman
- 2Surgery, Division of Otolaryngology, Head and Neck Surgery, and
| | - John R Crawford
- 3Neurosciences and Pediatrics, University of California, San Diego, California
| | - Michael L Levy
- 3Neurosciences and Pediatrics, University of California, San Diego, California
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Moshtaghi O, Saliba J, Gupta M, Mehranpour P, Tawfik KO, Ren Y, Schwartz MS, Friedman RA. Predicting Functional Outcomes and Length of Stay Following Acoustic Neuroma Resection. Laryngoscope 2020; 131:644-648. [PMID: 32757415 DOI: 10.1002/lary.28910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 06/04/2020] [Accepted: 06/06/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To examine whether simple mobility assessments can predict functional limitations and length of hospitalization after acoustic neuroma (AN) resection. STUDY DESIGN Prospective case series. METHODS A prospective clinical study of adult patients undergoing AN resection by either the translabyrinthine, retrosigmoid, or middle fossa approach was conducted at a tertiary center. Preoperative mobility assessments included the functional gait assessment (FGA) and the 10-m walk (10 MW). Postoperatively, the Activity Measure for Post-Acute Care (AMPAC, at 48 hours), FGA, and 10 MW (at 1 week) were obtained. Demographic and medical data were collected. RESULTS One hundred and thirty-eight patients were analyzed (mean age: 48.3 years, 68.8% female). Mean length of stay (LOS) was 3.1 days. The translabyrinthine approach was most commonly performed (48.6%). On regression analyses, preoperative FGA (P = 0.03) and 48-hour postoperative AM-PAC (P < 0.001) independently predicted LOS, even after accounting for age, gender, body mass index, and tumor size. On receiver operating characteristic analysis, a preoperative FGA cut score of 25.5 predicted a protracted hospital stay (>4 days) with a sensitivity of 77% and specificity of 50% (area under curve: 68.5). CONCLUSION This study demonstrated that preoperative mobility assessments can predict functional limitations and LOS after AN resection. These objective tools can be used by clinicians to manage expectations and guide preoperative counseling in patients considering surgery. LEVEL OF EVIDENCE 3 Laryngoscope, 131:644-648, 2021.
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Affiliation(s)
- Omid Moshtaghi
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Joe Saliba
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Mihir Gupta
- Division of Neurosurgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Pasha Mehranpour
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Kareem O Tawfik
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Yin Ren
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Marc S Schwartz
- Division of Neurosurgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Rick A Friedman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
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Kari E, Llaci L, Go JL, Naymik M, Knowles JA, Leal SM, Rangasamy S, Huentelman MJ, Friedman RA, Schrauwen I. A de novo SIX1 variant in a patient with a rare nonsyndromic cochleovestibular nerve abnormality, cochlear hypoplasia, and bilateral sensorineural hearing loss. Mol Genet Genomic Med 2019; 7:e995. [PMID: 31595699 PMCID: PMC6900394 DOI: 10.1002/mgg3.995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 01/06/2023] Open
Abstract
Background Childhood hearing impairment affects language and cognitive development. Profound congenital sensorineural hearing impairment can be due to an abnormal cochleovestibular nerve (CVN) and cochleovestibular malformations, however, the etiology of these conditions remains unclear. Methods We used a trio‐based exome sequencing approach to unravel the underlying molecular etiology of a child with a rare nonsyndromic CVN abnormality and cochlear hypoplasia. Clinical and imaging data were also reviewed. Results We identified a de novo missense variant [p(Asn174Tyr)] in the DNA‐binding Homeodomain of SIX1, a gene which previously has been associated with autosomal dominant hearing loss (ADHL) and branchio‐oto‐renal or Branchio‐otic syndrome, a condition not seen in this patient. Conclusions SIX1 has an important function in otic vesicle patterning during embryogenesis, and mice show several abnormalities to their inner ear including loss of inner ear innervation. Previous reports on patients with SIX1 variants lack imaging data and nonsyndromic AD cases were reported to have no inner ear malformations. In conclusion, we show that a de novo variant in SIX1 in a patient with sensorineural hearing loss leads to cochleovestibular malformations and abnormalities of the CVN, without any other abnormalities. Without proper interventions, severe to profound hearing loss is devastating to both education and social integration. Choosing the correct intervention can be challenging and a molecular diagnosis may adjust intervention and improve outcomes, especially for rare cases.
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Affiliation(s)
- Elina Kari
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Lorida Llaci
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - John L Go
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Marcus Naymik
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - James A Knowles
- Department of Cell Biology - MSC 5, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Suzanne M Leal
- Center for Statistical Genetics, Molecular and Human Genetics Department, Baylor College of Medicine, Houston, TX, USA
| | - Sampath Rangasamy
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Matthew J Huentelman
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Rick A Friedman
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Isabelle Schrauwen
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, AZ, USA.,Center for Statistical Genetics, Molecular and Human Genetics Department, Baylor College of Medicine, Houston, TX, USA
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Saliba J, Sakano H, Friedman RA, Harris JP. Tophaceous Gout of the Middle Ear: Case Reports and Review of the Literature. Audiol Neurootol 2019; 24:51-55. [PMID: 31167187 DOI: 10.1159/000500514] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022] Open
Abstract
Tophaceous gout of the middle ear is a rare occurrence that presents as a granular white-colored mass. It is frequently misdiagnosed as cholesteatoma or tympanosclerosis in patients who otherwise may not manifest any clinical or biochemical signs of gout. While uncommon, it can lead to clinically significant disease such as conductive hearing loss. The present report describes 2 cases of middle ear gouty tophi initially mistaken for another entity. Both patients underwent surgery, and the diagnosis of gout was revealed after final histopathological analysis. A review of the literature is also presented.
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Affiliation(s)
- Joe Saliba
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, University of California - San Diego, San Diego, California, USA
| | - Hitomi Sakano
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, University of California - San Diego, San Diego, California, USA.,Department of Otolaryngology, University of Rochester Medical Center, Rochester, New York, USA
| | - Rick A Friedman
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, University of California - San Diego, San Diego, California, USA
| | - Jeffrey P Harris
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, University of California - San Diego, San Diego, California, USA,
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Balasubramanian K, Weis M, Eyre DR, Martin J, Ortiz-Sanchez J, Duran I, Vangala S, Wang J, Friedman RA, Krakow D, Cohn DH. The α2 chain of type IX collagen is essential for type IX collagen biosynthesis. Am J Med Genet A 2019; 179:1672-1677. [PMID: 31161720 DOI: 10.1002/ajmg.a.61208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Karthika Balasubramanian
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, California
| | - MaryAnn Weis
- Department of Orthopaedic Surgery, University of Washington, Seattle, Washington
| | - David R Eyre
- Department of Orthopaedic Surgery, University of Washington, Seattle, Washington
| | - Jorge Martin
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California
| | - Jorge Ortiz-Sanchez
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, California
| | - Ivan Duran
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California
| | - Sitaram Vangala
- Department of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Juemei Wang
- Caruso Department of Otolaryngology, Keck School of Medicine at USC, University of Southern California, Los Angeles, California
| | - Rick A Friedman
- Caruso Department of Otolaryngology, Keck School of Medicine at USC, University of Southern California, Los Angeles, California
| | - Deborah Krakow
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California
| | - Daniel H Cohn
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, California.,Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California
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36
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Tawfik KO, Klepper K, Saliba J, Friedman RA. Advances in understanding of presbycusis. J Neurosci Res 2019; 98:1685-1697. [PMID: 30950547 DOI: 10.1002/jnr.24426] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 12/21/2022]
Abstract
The pathophysiology of age-related hearing loss (ARHL), or presbycusis, involves a complex interplay between environmental and genetic factors. The fundamental biomolecular mechanisms of ARHL have been well described, including the roles of membrane transport, reactive oxygen species, cochlear synaptopathy, vascular insults, hormones, and microRNA, to name a few. The genetic basis underlying these mechanisms remains under-investigated and poorly understood. The emergence of genome-wide association studies has allowed for the identification of specific groups of genes involved in ARHL. This review highlights recent advances in understanding of the pathogenesis of ARHL, the genetic basis underlying these processes and suggests future directions for research and potential therapeutic avenues.
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Affiliation(s)
- Kareem O Tawfik
- Division of Otolaryngology - Head & Neck Surgery, University of California San Diego School of Medicine, San Diego, California
| | - Kristin Klepper
- School of Medicine, University of California San Diego, La Jolla, California
| | - Joe Saliba
- Division of Otolaryngology - Head & Neck Surgery, University of California San Diego School of Medicine, San Diego, California
| | - Rick A Friedman
- Division of Otolaryngology - Head & Neck Surgery, University of California San Diego School of Medicine, San Diego, California
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37
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Strickland BA, Ravina K, Rennert RC, Jackanich A, Aaron K, Bakhsheshian J, Russin JJ, Friedman RA, Giannotta SL. Intentional Subtotal Resection of Vestibular Schwannoma: A Reexamination. J Neurol Surg B Skull Base 2019; 81:136-141. [PMID: 32206531 DOI: 10.1055/s-0039-1679898] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/15/2019] [Indexed: 10/27/2022] Open
Abstract
Background Treatment of vestibular schwannomas (VS) remains controversial. Historical surgical series prioritized gross total resections (GTR); however, near total resections (NTR) and intentional subtotal resections (STR) aiming at improving cranial nerve outcomes are becoming more popular. Objective The main purpose of this article is to assess the tumor control and facial nerve outcomes in VS patients treated with STR or NTR. Methods VS patients undergoing STR or NTR at our institution between 1984 and 2016 were retrospectively reviewed. Patient demographics, extent of tumor resection, facial nerve injury, tumor recurrence, and need for Gamma Knife radiosurgery were analyzed. Facial nerve outcomes were quantified using House-Brackmann (HB) scores. Tumor regrowth was defined by the San Francisco criteria. Results Four-hundred fifty-seven VS resections were performed in a 32-year period. Sixty cases met inclusion criteria. The mean (range) follow-up duration was 30.9 (12-103) months. The STR cohort ( n = 33) demonstrated regrowth in 12 patients (36.3%) at an average of 23.6 months. The NTR cohort ( n = 27) did not experience tumor recurrence. Risk of tumor recurrence was positively correlated with preoperative tumor size ( p = 0.002), size of residual tumor ( p < 0.001), and STR ( p < 0.001). Facial nerve outcomes of HB1-2 were observed in the majority of patients in both cohorts (74.1% NTR, 56% STR), though NTR was associated with a higher likelihood of facial nerve recovery ( p = 0.003). Conclusion GTR remains the gold standard as long as facial nerve outcomes remain acceptable. NTR achieved superior tumor control and higher likelihood of facial nerve recovery compared with STR.
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Affiliation(s)
- Ben A Strickland
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Kristine Ravina
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Robert C Rennert
- Department of Neurosurgery, University of California San Diego, San Diego, California, United States
| | - Anna Jackanich
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Ksenia Aaron
- Department of Otolaryngology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Joshua Bakhsheshian
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Jonathan J Russin
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Rick A Friedman
- Department of Otolaryngology, University of California San Diego, San Diego, California, United States
| | - Steven L Giannotta
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
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38
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Saliba J, Friedman RA, Cueva RA. Hearing Preservation in Vestibular Schwannoma Surgery. J Neurol Surg B Skull Base 2019; 80:149-155. [PMID: 30931222 DOI: 10.1055/s-0038-1677550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022] Open
Abstract
Modern imaging techniques allow early detection of small vestibular schwannomas (VSs) with minimal or no hearing impairment. While controversy surrounds the management of these tumors, given their benign nature and unpredictable natural history, microsurgical excision is the only modality that offers the opportunity to cure the tumor and preserve hearing. Hearing preservation in VS surgery may be accomplished via the middle fossa or retrosigmoid approaches. Appropriate patient selection and surgical approach is critical in achieving the best hearing outcomes. This article highlights the preoperative assessment, patient selection and prognostic factors, intraoperative monitoring of hearing, and surgical approaches to optimize hearing preservation during VS removal.
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Affiliation(s)
- Joe Saliba
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, California, United States
| | - Rick A Friedman
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, California, United States
| | - Roberto A Cueva
- Department of Otolaryngology - Head and Neck Surgery, Southern California Kaiser Permanente Medical Group, San Diego, California, United States
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Schrauwen I, Kari E, Mattox J, Llaci L, Smeeton J, Naymik M, Raible DW, Knowles JA, Crump JG, Huentelman MJ, Friedman RA. De novo variants in GREB1L are associated with non-syndromic inner ear malformations and deafness. Hum Genet 2018; 137:459-470. [PMID: 29955957 PMCID: PMC6082420 DOI: 10.1007/s00439-018-1898-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/19/2018] [Indexed: 11/24/2022]
Abstract
Congenital inner ear malformations affecting both the osseous and membranous labyrinth can have a devastating impact on hearing and language development. With the exception of an enlarged vestibular aqueduct, non-syndromic inner ear malformations are rare, and their underlying molecular biology has thus far remained understudied. To identify molecular factors that might be important in the developing inner ear, we adopted a family-based trio exome sequencing approach in young unrelated subjects with severe inner ear malformations. We identified two previously unreported de novo loss-of-function variants in GREB1L [c.4368G>T;p.(Glu1410fs) and c.982C>T;p.(Arg328*)] in two affected subjects with absent cochleae and eighth cranial nerve malformations. The cochlear aplasia in these affected subjects suggests that a developmental arrest or problem at a very early stage of inner ear development exists, e.g., during the otic pit formation. Craniofacial Greb1l RNA expression peaks in mice during this time frame (E8.5). It also peaks in the developing inner ear during E13-E16, after which it decreases in adulthood. The crucial function of Greb1l in craniofacial development is also evidenced in knockout mice, which develop severe craniofacial abnormalities. In addition, we show that Greb1l-/- zebrafish exhibit a loss of abnormal sensory epithelia innervation. An important role for Greb1l in sensory epithelia innervation development is supported by the eighth cranial nerve deficiencies seen in both affected subjects. In conclusion, we demonstrate that GREB1L is a key player in early inner ear and eighth cranial nerve development. Abnormalities in cochleovestibular anatomy can provide challenges for cochlear implantation. Combining a molecular diagnosis with imaging techniques might aid the development of individually tailored therapeutic interventions in the future.
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Affiliation(s)
- Isabelle Schrauwen
- Molecular and Human Genetics Department, Center for Statistical Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, 445 N 5th str, Phoenix, AZ, 85004, USA.
| | - Elina Kari
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of California, San Diego, ECOB-East Campus Office Building Room 3-013, 9444 Medical Center Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Jacob Mattox
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery, Keck University of Southern California School of Medicine, 1975 Zonal Ave., Los Angeles, CA, 90033, USA
| | - Lorida Llaci
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, 445 N 5th str, Phoenix, AZ, 85004, USA
| | - Joanna Smeeton
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California Keck School of Medicine, 1975 Zonal Ave., Los Angeles, CA, 90033, USA
| | - Marcus Naymik
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, 445 N 5th str, Phoenix, AZ, 85004, USA
| | - David W Raible
- Department of Biological Structure, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - James A Knowles
- Department of Cell Biology-MSC 5, SUNY Downstate Medical Center, 450 Clarkson Avenue, BSB 2-5, Brooklyn, NY, 11203, USA
| | - J Gage Crump
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California Keck School of Medicine, 1975 Zonal Ave., Los Angeles, CA, 90033, USA
| | - Matthew J Huentelman
- Neurogenomics Division and Center for Rare Childhood Disorders, Translational Genomics Research Institute, 445 N 5th str, Phoenix, AZ, 85004, USA
| | - Rick A Friedman
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of California, San Diego, ECOB-East Campus Office Building Room 3-013, 9444 Medical Center Drive, Mail Code 7220, La Jolla, CA, 92037, USA
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Babadjouni R, Wen T, Donoho DA, Buchanan IA, Cen SY, Friedman RA, Amar A, Russin JJ, Giannotta SL, Mack WJ, Attenello FJ. Increased Hospital Surgical Volume Reduces Rate of 30- and 90-Day Readmission After Acoustic Neuroma Surgery. Neurosurgery 2018; 84:726-732. [DOI: 10.1093/neuros/nyy187] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/17/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Robin Babadjouni
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Timothy Wen
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Daniel A Donoho
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Ian A Buchanan
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Steven Y Cen
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Rick A Friedman
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Arun Amar
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Jonathan J Russin
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Steven L Giannotta
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - William J Mack
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
| | - Frank J Attenello
- Department of Neurological Surgery, University of Southern California, Los Angeles, California
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Tu NC, Friedman RA. Age-related hearing loss: Unraveling the pieces. Laryngoscope Investig Otolaryngol 2018; 3:68-72. [PMID: 29721536 PMCID: PMC5915820 DOI: 10.1002/lio2.134] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/06/2017] [Accepted: 12/04/2017] [Indexed: 01/23/2023] Open
Abstract
Age-related hearing loss (ARHL) is the most common cause of hearing loss in the world. The development of ARHL in each individual is multifactorial, involving both intrinsic and extrinsic factors. This review highlights several of the key findings in the ARHL literature and discusses future directions. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Nathan C. Tu
- Tina and Rick Caruso Department of Otolaryngology–Head and Neck Surgery (N.C.T., R.A.F.)Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaU.S.A.
| | - Rick A. Friedman
- Tina and Rick Caruso Department of Otolaryngology–Head and Neck Surgery (N.C.T., R.A.F.)Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaU.S.A.
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Salehi P, Ge MX, Gundimeda U, Michelle Baum L, Lael Cantu H, Lavinsky J, Tao L, Myint A, Cruz C, Wang J, Nikolakopoulou AM, Abdala C, Kelley MW, Ohyama T, Coate TM, Friedman RA. Role of Neuropilin-1/Semaphorin-3A signaling in the functional and morphological integrity of the cochlea. PLoS Genet 2017; 13:e1007048. [PMID: 29059194 PMCID: PMC5695633 DOI: 10.1371/journal.pgen.1007048] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 11/02/2017] [Accepted: 09/28/2017] [Indexed: 11/18/2022] Open
Abstract
Neuropilin-1 (Nrp1) encodes the transmembrane cellular receptor neuropilin-1, which is associated with cardiovascular and neuronal development and was within the peak SNP interval on chromosome 8 in our prior GWAS study on age-related hearing loss (ARHL) in mice. In this study, we generated and characterized an inner ear-specific Nrp1 conditional knockout (CKO) mouse line because Nrp1 constitutive knockouts are embryonic lethal. In situ hybridization demonstrated weak Nrp1 mRNA expression late in embryonic cochlear development, but increased expression in early postnatal stages when cochlear hair cell innervation patterns have been shown to mature. At postnatal day 5, Nrp1 CKO mice showed disorganized outer spiral bundles and enlarged microvessels of the stria vascularis (SV) but normal spiral ganglion cell (SGN) density and presynaptic ribbon body counts; however, we observed enlarged SV microvessels, reduced SGN density, and a reduction of presynaptic ribbons in the outer hair cell region of 4-month-old Nrp1 CKO mice. In addition, we demonstrated elevated hearing thresholds of the 2-month-old and 4-month-old Nrp1 CKO mice at frequencies ranging from 4 to 32kHz when compared to 2-month-old mice. These data suggest that conditional loss of Nrp1 in the inner ear leads to progressive hearing loss in mice. We also demonstrated that mice with a truncated variant of Nrp1 show cochlear axon guidance defects and that exogenous semaphorin-3A, a known neuropilin-1 receptor agonist, repels SGN axons in vitro. These data suggest that Neuropilin-1/Semaphorin-3A signaling may also serve a role in neuronal pathfinding in the developing cochlea. In summary, our results here support a model whereby Neuropilin-1/Semaphorin-3A signaling is critical for the functional and morphological integrity of the cochlea and that Nrp1 may play a role in ARHL. Neuropilin-1 is a member of the neuropilin family acting as an essential cell surface receptor involved in semaphorin-dependent axon guidance and VEGF-dependent angiogenesis and lies within our previously identified ARHL GWAS interval. In this study, we investigated the role of Neuropilin-1/Semaphorin-3A signaling in the functional and morphological integrity of the cochlea, specifically the innervation and vascularization patterns. Detailed analyses of the cochleae of 4-month-old Nrp1 CKO mice showed abnormalities in ribbon synapses, innervation of the hair cells, and microvessels of the stria vascularis. We show also that Neuropilin-1/Semaphorin-3A signaling plays an important role in cochlear innervation.
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Affiliation(s)
- Pezhman Salehi
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio, United States of America
| | - Marshall X. Ge
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Usha Gundimeda
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Leah Michelle Baum
- Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Homero Lael Cantu
- Department of Biology, Georgetown University, Washington, D.C., United States of America
| | - Joel Lavinsky
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Graduate Program in Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Litao Tao
- Stem Cell Biology & Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Anthony Myint
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Charlene Cruz
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Juemei Wang
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Angeliki Maria Nikolakopoulou
- Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Carolina Abdala
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Matthew William Kelley
- National Institute on Deafness and Other Communication Disorders, Bethesda, Maryland, United States of America
| | - Takahiro Ohyama
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Thomas Matthew Coate
- Department of Biology, Georgetown University, Washington, D.C., United States of America
- * E-mail: (TMC); (RAF)
| | - Rick A. Friedman
- USC-Tina and Rick Caruso Department of Otolaryngology-Head & Neck Surgery, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- * E-mail: (TMC); (RAF)
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Kari E, Schrauwen I, Llaci L, Fisher LM, Go JL, Naymik M, Knowles JA, Huentelman MJ, Friedman RA. Compound heterozygous mutations in MASP1 in a deaf child with absent cochlear nerves. Neurol Genet 2017; 3:e153. [PMID: 28534045 PMCID: PMC5427666 DOI: 10.1212/nxg.0000000000000153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 03/27/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Elina Kari
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - Isabelle Schrauwen
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - Lorida Llaci
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - Laurel M Fisher
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - John L Go
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - Marcus Naymik
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - James A Knowles
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - Matthew J Huentelman
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
| | - Rick A Friedman
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery (E.K., L.M.F., J.L.G., J.A.K., R.A.F.), Keck University of Southern California School of Medicine, Los Angeles; and TGen (I.S., L.L., M.N., M.J.H.), Translational Genomics Research Institute, Phoenix, AZ
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Abstract
Objective. To conduct a clinical trial of intratympanic steroid injection for idiopathic sudden sensorineural hearing loss in subjects who failed oral steroid therapy. Study Design and Setting. Open-label methylprednisolone injection clinical trial in a tertiary neurotologic referral center. Twenty subjects (14 males; 6 females) received 4 injections within a 2-week period (4 days apart). Hearing, dizziness/p, and tinnitus were evaluated before and after treatment. Results. There were no serious unexpected adverse events and 2 types of expected adverse events (tympanic membrane perforation, nausea after injection). No increases in dizziness or tinnitus lasting longer than 24 hours were observed after injections. One of 20 (5%) improved to near-normal hearing. In addition, there was statistically significant improvement in 4-frequency pure-tone average and speech discrimination score at 1 month after treatment. Conclusion. Four intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids. Significance. A clinical trial of intratympanic injections for idiopathic sudden hearing loss was successfully completed and promising results were found.
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Affiliation(s)
- William H Slattery
- House Ear Institute, House Ear Clinic, Los Angeles, California 90057, USA.
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Myint A, White CH, Ohmen JD, Li X, Wang J, Lavinsky J, Salehi P, Crow AL, Ohyama T, Friedman RA. Large-scale phenotyping of noise-induced hearing loss in 100 strains of mice. Hear Res 2015; 332:113-120. [PMID: 26706709 DOI: 10.1016/j.heares.2015.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 12/06/2015] [Accepted: 12/07/2015] [Indexed: 01/13/2023]
Abstract
A cornerstone technique in the study of hearing is the Auditory Brainstem Response (ABR), an electrophysiologic technique that can be used as a quantitative measure of hearing function. Previous studies have published databases of baseline ABR thresholds for mouse strains, providing a valuable resource for the study of baseline hearing function and genetic mapping of hearing traits in mice. In this study, we further expand upon the existing literature by characterizing the baseline ABR characteristics of 100 inbred mouse strains, 47 of which are newly characterized for hearing function. We identify several distinct patterns of baseline hearing deficits and provide potential avenues for further investigation. Additionally, we characterize the sensitivity of the same 100 strains to noise exposure using permanent thresholds shifts, identifying several distinct patterns of noise-sensitivity. The resulting data provides a new resource for studying hearing loss and noise-sensitivity in mice.
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Affiliation(s)
- Anthony Myint
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA
| | - Cory H White
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA; Bioinformatics and Systems Biology Program, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0419, USA
| | - Jeffrey D Ohmen
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA; Department of Cell Biology and Genetics, House Research Institute, Los Angeles, CA 90057, USA
| | - Xin Li
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA; Department of Cell Biology and Genetics, House Research Institute, Los Angeles, CA 90057, USA
| | - Juemei Wang
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA; Department of Cell Biology and Genetics, House Research Institute, Los Angeles, CA 90057, USA
| | - Joel Lavinsky
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA
| | - Pezhman Salehi
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA
| | - Amanda L Crow
- Department of Preventive Medicine, Keck School of Medicine of USC, 2250 Alcazar St, Los Angeles, CA 90089-9073, USA
| | - Takahiro Ohyama
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA; Department of Cell Biology and Genetics, House Research Institute, Los Angeles, CA 90057, USA
| | - Rick A Friedman
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, 1501 San Pablo Street, Los Angeles, CA 90089-2821, USA; Department of Cell Biology and Genetics, House Research Institute, Los Angeles, CA 90057, USA.
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Hoa M, Friedman RA, Fisher LM, Derebery MJ. Prognostic implications of and audiometric evidence for hearing fluctuation in Meniere's disease. Laryngoscope 2015; 125 Suppl 12:S1-12. [PMID: 26343803 DOI: 10.1002/lary.25579] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS 1) To establish criteria for significant hearing fluctuation by assessing the range and occurrence of hearing fluctuations over the course of Meniere's disease; 2) to determine if audiometric evidence exists to support the notion that Meniere's disease is a pathophysiologic process involving the whole cochlea; and 3) to suggest prognostic implications for initial hearing fluctuation in patients with Meniere's disease. STUDY DESIGN Retrospective case series review. METHODS A total of 488 patients diagnosed by 1995 American Academy of Otolaryngology-Head and Neck Surgery Meniere's disease criteria for whom audiometric data were prospectively collected (2 cohorts: 341 and 146 patients initially seen between April 2002 to July 2003 and between January to December 2010, respectively). Based on several definitions for significant hearing fluctuation, change in hearing was categorized as "same," "worse," or "better" between any two consecutive evaluations. The relationship of initial hearing fluctuation to future hearing fluctuation and future hearing loss was evaluated. RESULTS Hearing fluctuation was evident in Meniere's disease patients with heterogeneous audiometric follow-up; and the characteristics of these hearing fluctuations, including the mean incidence, is described. Audiometric data suggests that there is a high congruence in Meniere's disease between changes in low- and high-frequency thresholds. Initial hearing fluctuation is associated with the occurrence of future and more frequent hearing fluctuations. CONCLUSION Understanding the range of hearing fluctuations establishes a basis for determining audiometric thresholds used in evaluating future therapeutic trials aimed at the prevention of hearing loss in Meniere's disease. This knowledge will also inform the counseling directed toward patients diagnosed with Meniere's disease.
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Affiliation(s)
- Michael Hoa
- Department of Otolaryngology-Head & Neck Surgery, Georgetown University Medical Center, Washington, DC.,the NIH/NIDCD Otolaryngology Surgeon-Scientist Development Program, Bethesda, Maryland
| | - Rick A Friedman
- the Department of Otolaryngology, Keck School of Medicine of the University of Southern California
| | - Laurel M Fisher
- the Department of Otolaryngology, Keck School of Medicine of the University of Southern California
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47
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Schrauwen I, Hasin-Brumshtein Y, Corneveaux JJ, Ohmen J, White C, Allen AN, Lusis AJ, Van Camp G, Huentelman MJ, Friedman RA. A comprehensive catalogue of the coding and non-coding transcripts of the human inner ear. Hear Res 2015; 333:266-274. [PMID: 26341477 DOI: 10.1016/j.heares.2015.08.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 08/12/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
Abstract
The mammalian inner ear consists of the cochlea and the vestibular labyrinth (utricle, saccule, and semicircular canals), which participate in both hearing and balance. Proper development and life-long function of these structures involves a highly complex coordinated system of spatial and temporal gene expression. The characterization of the inner ear transcriptome is likely important for the functional study of auditory and vestibular components, yet, primarily due to tissue unavailability, detailed expression catalogues of the human inner ear remain largely incomplete. We report here, for the first time, comprehensive transcriptome characterization of the adult human cochlea, ampulla, saccule and utricle of the vestibule obtained from patients without hearing abnormalities. Using RNA-Seq, we measured the expression of >50,000 predicted genes corresponding to approximately 200,000 transcripts, in the adult inner ear and compared it to 32 other human tissues. First, we identified genes preferentially expressed in the inner ear, and unique either to the vestibule or cochlea. Next, we examined expression levels of specific groups of potentially interesting RNAs, such as genes implicated in hearing loss, long non-coding RNAs, pseudogenes and transcripts subject to nonsense mediated decay (NMD). We uncover the spatial specificity of expression of these RNAs in the hearing/balance system, and reveal evidence of tissue specific NMD. Lastly, we investigated the non-syndromic deafness loci to which no gene has been mapped, and narrow the list of potential candidates for each locus. These data represent the first high-resolution transcriptome catalogue of the adult human inner ear. A comprehensive identification of coding and non-coding RNAs in the inner ear will enable pathways of auditory and vestibular function to be further defined in the study of hearing and balance. Expression data are freely accessible at https://www.tgen.org/home/research/research-divisions/neurogenomics/supplementary-data/inner-ear-transcriptome.aspx.
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Affiliation(s)
- Isabelle Schrauwen
- Department of Medical Genetics, University of Antwerp, 2610 Antwerp, Belgium.,Neurogenomics Division and The Dorrance Center for Rare Childhood Disorders, Translational Genomics Research Institute, 85004 Phoenix, AZ
| | - Yehudit Hasin-Brumshtein
- Department of Medicine/Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Jason J Corneveaux
- Neurogenomics Division and The Dorrance Center for Rare Childhood Disorders, Translational Genomics Research Institute, 85004 Phoenix, AZ
| | - Jeffrey Ohmen
- House Ear Institute, Los Angeles 90057, CA, United States
| | - Cory White
- House Ear Institute, Los Angeles 90057, CA, United States.,Keck School of Medicine, USC, Los Angeles, CA, United States
| | - April N Allen
- Neurogenomics Division and The Dorrance Center for Rare Childhood Disorders, Translational Genomics Research Institute, 85004 Phoenix, AZ
| | - Aldons J Lusis
- Department of Medicine/Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Guy Van Camp
- Department of Medical Genetics, University of Antwerp, 2610 Antwerp, Belgium
| | - Matthew J Huentelman
- Neurogenomics Division and The Dorrance Center for Rare Childhood Disorders, Translational Genomics Research Institute, 85004 Phoenix, AZ
| | - Rick A Friedman
- Keck School of Medicine, USC, Los Angeles, CA, United States
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Kode A, Mosialou I, Manavalan SJ, Rathinam CV, Friedman RA, Teruya-Feldstein J, Bhagat G, Berman E, Kousteni S. FoxO1-dependent induction of acute myeloid leukemia by osteoblasts in mice. Leukemia 2015; 30:1-13. [PMID: 26108693 PMCID: PMC4691220 DOI: 10.1038/leu.2015.161] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/29/2015] [Accepted: 06/11/2015] [Indexed: 01/08/2023]
Abstract
Osteoblasts, the bone forming cells, affect self-renewal and expansion of hematopoietic stem cells (HSCs), as well as homing of healthy hematopoietic cells and tumor cells into the bone marrow. Constitutive activation of β-catenin in osteoblasts is sufficient to alter the differentiation potential of myeloid and lymphoid progenitors and to initiate the development of acute myeloid leukemia (AML) in mice. We show here that Notch1 is the receptor mediating the leukemogenic properties of osteoblast-activated β-catenin in HSCs. Moreover, using cell-specific gene inactivation mouse models, we show that FoxO1 expression in osteoblasts is required for and mediates the leukemogenic properties of β-catenin. At the molecular level, FoxO1 interacts with β-catenin in osteoblasts to induce expression of the Notch ligand, Jagged-1. Subsequent activation of Notch signaling in long-term repopulating HSC progenitors induces the leukemogenic transformation of HSCs and ultimately leads to the development of AML. These findings identify FoxO1 expressed in osteoblasts as a factor affecting hematopoiesis and provide a molecular mechanism whereby the FoxO1/activated β-catenin interaction results in AML. These observations support the notion that the bone marrow niche is an instigator of leukemia and raise the prospect that FoxO1 oncogenic properties may occur in other tissues.
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Affiliation(s)
- A Kode
- Department of Physiology and Cellular Biophysics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - I Mosialou
- Department of Physiology and Cellular Biophysics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - S J Manavalan
- Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - C V Rathinam
- Department of Genetics and Development, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - R A Friedman
- Biomedical Informatics Shared Resource, Department of Biomedical Informatics, Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - J Teruya-Feldstein
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - G Bhagat
- Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Department of Pathology, Institute for Cancer Genetics Irving Cancer Research Center, Columbia University, New York, NY, USA
| | - E Berman
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S Kousteni
- Department of Physiology and Cellular Biophysics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Lavinsky J, Crow AL, Pan C, Wang J, Aaron KA, Ho MK, Li Q, Salehide P, Myint A, Monges-Hernadez M, Eskin E, Allayee H, Lusis AJ, Friedman RA. Genome-wide association study identifies nox3 as a critical gene for susceptibility to noise-induced hearing loss. PLoS Genet 2015; 11:e1005094. [PMID: 25880434 PMCID: PMC4399881 DOI: 10.1371/journal.pgen.1005094] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 02/23/2015] [Indexed: 01/09/2023] Open
Abstract
In the United States, roughly 10% of the population is exposed daily to hazardous levels of noise in the workplace. Twin studies estimate heritability for noise-induced hearing loss (NIHL) of approximately 36%, and strain specific variation in sensitivity has been demonstrated in mice. Based upon the difficulties inherent to the study of NIHL in humans, we have turned to the study of this complex trait in mice. We exposed 5 week-old mice from the Hybrid Mouse Diversity Panel (HMDP) to a 10 kHz octave band noise at 108 dB for 2 hours and assessed the permanent threshold shift 2 weeks post exposure using frequency specific stimuli. These data were then used in a genome-wide association study (GWAS) using the Efficient Mixed Model Analysis (EMMA) to control for population structure. In this manuscript we describe our GWAS, with an emphasis on a significant peak for susceptibility to NIHL on chromosome 17 within a haplotype block containing NADPH oxidase-3 (Nox3). Our peak was detected after an 8 kHz tone burst stimulus. Nox3 mutants and heterozygotes were then tested to validate our GWAS. The mutants and heterozygotes demonstrated a greater susceptibility to NIHL specifically at 8 kHz both on measures of distortion product otoacoustic emissions (DPOAE) and on auditory brainstem response (ABR). We demonstrate that this sensitivity resides within the synaptic ribbons of the cochlea in the mutant animals specifically at 8 kHz. Our work is the first GWAS for NIHL in mice and elucidates the power of our approach to identify tonotopic genetic susceptibility to NIHL. Noise-induced hearing loss (NIHL) is the most common work-related disease in the world and the second cause of hearing loss. Although several candidate gene association studies for NIHL in humans have been conducted, each are underpowered, un-replicated, and account for only a fraction of the genetic risk. Buoyed by the prospects and successes of human association studies, several groups have proposed mouse genome-wide association studies. The environment can be carefully controlled, facilitating the study of complex traits like NIHL. In this manuscript, we describe, for the first time, an association analysis with correction for population structure for the mapping of several loci for susceptibility to NIHL in inbred strains of mice. We identify Nox3 as the associated gene for susceptibility to NIHL that the genetic susceptibility is frequency specific and that it occurs at the level of the cochlear synaptic ribbon.
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Affiliation(s)
- Joel Lavinsky
- Graduate Program in Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Amanda L. Crow
- Department of Preventive Medicine and Institute for Genetic Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Calvin Pan
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Juemei Wang
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Ksenia A. Aaron
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Maria K. Ho
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Qingzhong Li
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Pehzman Salehide
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Anthony Myint
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Maya Monges-Hernadez
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Eleazar Eskin
- Department of Computer Science, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Hooman Allayee
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Aldons J. Lusis
- Department of Preventive Medicine and Institute for Genetic Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Rick A. Friedman
- Department of Otolaryngology, Zilkha Neurogenetic Institute, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- * E-mail:
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Ho MKL, Hasin Y, Lusis AJ, Friedman RA. RNA-Seq Analysis of Allele-Specific Expression in the Mouse Cochlea. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814541629a281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Age-related hearing impairment or presbycusis is one of the most common sensory abnormalities in the world. Mouse models have been widely used in studies of hearing loss to separate genetic and environmental influences. We will describe novel cis- and trans-regulation and dominance patterns in gene expression levels from cochlea of mice. Methods: Next-generation sequencing (RNA-Seq) data has been acquired from cochlea of three F1 mouse hybrid strains (n = 4) from parental strains C57BL/6J, DBA/2J, C3H/HeJ. Results: An analysis of allele-specific expression will be reported and novel transcripts, isoforms, cis and trans-regulation, long non-coding RNAs, and dominance patterns will be discussed in relation to known genes. Conclusions: This will help to elucidate mechanisms and better understand the genetic backdrop of age related hearing impairment.
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