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Xu K, Xiao Y, Luo J, Chao X, Wang R, Fan Z, Wang H, Xu L. Research progress on incomplete partition type 3 inner ear malformation. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08555-7. [PMID: 38498189 DOI: 10.1007/s00405-024-08555-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE This review aims to provides a comprehensive overview of the latest research progress on IP-III inner ear malformation, focusing on its geneticbasis, imaging features, cochlear implantation, and outcome. METHODS Review the literature on clinical and genetic mechanisms associated with IP-III. RESULTS Mutations in the POU3F4 gene emerge as the principal pathogenic contributors to IP-III anomalies, primarily manifesting through inner ear potential irregularities leading to deafness. While cochlear implantation stands as the primary intervention for restoring hearing, the unique nature of the inner ear anomaly escalates the complexity of surgical procedures and postoperative results. Hence, meticulous preoperative assessment to ascertain surgical feasibility and postoperative verification of electrode placement are imperative. Additionally, gene therapy holds promise as a prospective treatment modality. CONCLUSIONS IP-III denotes X-linked recessive hereditary deafness, with cochlear implantation currently serving as the predominant therapeutic approach. Clinicians are tasked with preoperative assement and individualized postoperative rehabilitation.
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Affiliation(s)
- Kaifan Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
- Shandong Institute of Otorhinolaryngology, jinan, China
| | - Yun Xiao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Institute of Otorhinolaryngology, jinan, China
| | - Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
| | - Xiuhua Chao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
| | - Ruijie Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China
| | - Zhaoming Fan
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Haibo Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China.
- Department of Auditory Implantology, Second People's Hospital of Shandong Province, jinan, China.
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Robson CD, Lewis M, D'Arco F. Non-Syndromic Sensorineural Hearing Loss in Children. Neuroimaging Clin N Am 2023; 33:531-542. [PMID: 37741656 DOI: 10.1016/j.nic.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Pediatric hearing loss is common with significant consequences in terms of language, communication, social and emotional development, and academic advancement. Radiological imaging provides useful information regarding hearing loss etiology, prognosis, therapeutic options, and potential surgical pitfalls. This review provides an overview of temporal bone imaging protocols, an outline of the classification of inner ear anomalies associated with sensorineural hearing loss and illustrates some of the more frequently encountered and/or important causes of non-syndromic hearing loss.
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Affiliation(s)
- Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, USA.
| | - Martin Lewis
- Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK
| | - Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK
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Dasgupta S, Hong J, Morris R, Iqbal J, Lennox-Bowley A, Saniasiaya J. X-Linked Gusher Disease DFNX2 in Children, a Rare Inner Ear Dysplasia with Mixed Hearing and Vestibular Loss. Audiol Res 2023; 13:600-614. [PMID: 37622928 PMCID: PMC10451158 DOI: 10.3390/audiolres13040052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
Conductive hearing losses are typically present in disorders of the external/middle ear. However, there is a rare group of inner ear conditions called third windows that can also generate a conductive hearing loss. This is due to an abnormal connection between the middle and the inner ear or between the inner ear and the cranial cavity. X-linked gusher disorder is an extremely rare congenital inner ear dysplastic syndrome with an abnormal connection due to a characteristic incomplete cochlear partition type III and an incomplete internal auditory meatus fundus. The disorder is inherited in an X-linked fashion due to the mutation of the POU3F4 gene. We present two siblings diagnosed with the condition and their long-term follow-ups. They both presented audiovestibular symptoms and showed progressive mixed losses and bilateral vestibular weakness. They were treated with cochlear implant, digital amplification and with vestibular rehabilitation. Significant others around them were involved in their journey with the medical team, and in both, a very favourable outcome was achieved. This is the first time that we have reported evolving audiovestibular function with vestibular quantification in X-linked gusher disorder and emphasize on the multidisciplinary holistic approach to manage these children effectively.
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Affiliation(s)
- Soumit Dasgupta
- Alder Hey Children’s Hospital NHS Foundation Trust, Eaton Road, Liverpool L14 5AB, UK
- Faculty of Health and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (J.H.); (R.M.)
| | - James Hong
- Faculty of Health and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (J.H.); (R.M.)
| | - Rhyanna Morris
- Faculty of Health and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK; (J.H.); (R.M.)
| | - Javed Iqbal
- East Lancashire Hospitals NHS Trust, Burnley BB10 2PQ, UK;
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Bernardinelli E, Huber F, Roesch S, Dossena S. Clinical and Molecular Aspects Associated with Defects in the Transcription Factor POU3F4: A Review. Biomedicines 2023; 11:1695. [PMID: 37371790 DOI: 10.3390/biomedicines11061695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
X-linked deafness (DFNX) is estimated to account for up to 2% of cases of hereditary hearing loss and occurs in both syndromic and non-syndromic forms. POU3F4 is the gene most commonly associated with X-linked deafness (DFNX2, DFN3) and accounts for about 50% of the cases of X-linked non-syndromic hearing loss. This gene codes for a transcription factor of the POU family that plays a major role in the development of the middle and inner ear. The clinical features of POU3F4-related hearing loss include a pathognomonic malformation of the inner ear defined as incomplete partition of the cochlea type 3 (IP-III). Often, a perilymphatic gusher is observed upon stapedectomy during surgery, possibly as a consequence of an incomplete separation of the cochlea from the internal auditory canal. Here we present an overview of the pathogenic gene variants of POU3F4 reported in the literature and discuss the associated clinical features, including hearing loss combined with additional phenotypes such as cognitive and motor developmental delays. Research on the transcriptional targets of POU3F4 in the ear and brain is in its early stages and is expected to greatly advance our understanding of the pathophysiology of POU3F4-linked hearing loss.
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Affiliation(s)
- Emanuele Bernardinelli
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Florian Huber
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Sebastian Roesch
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Silvia Dossena
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria
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Sun L, Lin Z, Wang X, Shen J, Li Y, Huang Y, Yang J. Molecular etiology study of hearing loss in 13 Chinese Han families. Front Neurol 2022; 13:1048218. [PMID: 36504663 PMCID: PMC9728030 DOI: 10.3389/fneur.2022.1048218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/24/2022] [Indexed: 11/24/2022] Open
Abstract
Hearing loss affecting about 2/1000 newborns is the most common congenital disease. Genetic defects caused approximately 70% of patients who have non-syndromic hearing loss. We recruited 13 Chinese Han deafness families who tested negative for GJB2, SLC26A4, and mitochondrial 12S rRNA. The probands of each family were performed whole-exome sequencing (WES) or targeted next-generation sequencing (NGS) for known deafness genes to study for pathogenic causes. We found four novel mutations of CDH23, one novel mutation of MYO15A, one novel mutation of TMC1, one novel mutation of PAX3, and one novel mutation of ADGRV1, one novel CNV of ADGRV1, and one novel CNV of STRC. Hearing loss is a highly hereditary and heterogeneous disease. The results in the limited samples of this study show that Usher and Waardenburg syndrome-related genes account for a major proportion are strongly associated with Chinese Han hearing loss patients negative for GJB2, SLC26A4, and mitochondrial 12S rRNA, followed by STRC resulting in mild to moderate deafness.
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Affiliation(s)
- Lianhua Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China,*Correspondence: Jun Yang
| | - Zhengyu Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Xiaowen Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jiali Shen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yue Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yuyu Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jun Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China,Lianhua Sun
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Defourny J. Considering gene therapy to protect from X-linked deafness DFNX2 and associated neurodevelopmental disorders. IBRAIN 2022; 8:431-441. [PMID: 37786584 PMCID: PMC10529175 DOI: 10.1002/ibra.12068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/10/2022] [Accepted: 09/13/2022] [Indexed: 10/04/2023]
Abstract
Mutations and deletions in the gene or upstream of the gene encoding the POU3F4 transcription factor cause X-linked progressive deafness DFNX2 and additional neurodevelopmental disorders in humans. Hearing loss can be purely sensorineural or mixed, that is, with both conductive and sensorineural components. Affected males show anatomical abnormalities of the inner ear, which are jointly defined as incomplete partition type III. Current approaches to improve hearing and speech skills of DFNX2 patients do not seem to be fully effective. Owing to inner ear malformations, cochlear implantation is surgically difficult and may predispose towards severe complications. Even in cases where implantation is safely performed, hearing and speech outcomes remain highly variable among patients. Mouse models for DFNX2 deafness revealed that sensorineural loss could arise from a dysfunction of spiral ligament fibrocytes in the lateral wall of the cochlea, which leads to reduced endocochlear potential. Highly positive endocochlear potential is critical for sensory hair cell mechanotransduction and hearing. In this context, here, we propose to develop a therapeutic approach in male Pou3f4 -/y mice based on an adeno-associated viral (AAV) vector-mediated gene transfer in cochlear spiral ligament fibrocytes. Among a broad range of AAV vectors, AAV7 was found to show a strong tropism for the spiral ligament. Thus, we suggest that an AAV7-mediated delivery of Pou3f4 complementary DNA in the spiral ligament of Pou3f4 -/y mice could represent an attractive strategy to prevent fibrocyte degeneration and to restore normal cochlear functions and properties, including a positive endocochlear potential, before hearing loss progresses to profound deafness.
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Affiliation(s)
- Jean Defourny
- GIGA‐Neurosciences, Unit of Cell and Tissue BiologyUniversity of Liège, C.H.U. B36LiègeBelgium
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7
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Karamert R, Tutar H, Altinyay Ş, Düzlü M, Yildiz M, Akdulum İ, Uğur MB, Çolak M, Cebeci S, Şahin MM, Orçan E, Bayazit YA. Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills. ORL J Otorhinolaryngol Relat Spec 2021; 84:211-218. [PMID: 34500448 DOI: 10.1159/000517562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 05/30/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. METHODS In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. RESULTS In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). CONCLUSION It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3.
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Affiliation(s)
- Recep Karamert
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hakan Tutar
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Şenay Altinyay
- Department of Audiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mehmet Düzlü
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Merve Yildiz
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - İsmail Akdulum
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mehmet Birol Uğur
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mustafa Çolak
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Süleyman Cebeci
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Muammer Melih Şahin
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Elçin Orçan
- Department of Audiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Al-Busaidi RS, Habib SJ, Al-Lawati AM, Tahhan KMW, Al-Saidi YA. Incomplete Partition Type III: Computed Tomography Features and Cochlear Implantation Complications. Oman Med J 2021; 36:e286. [PMID: 34405054 PMCID: PMC8363663 DOI: 10.5001/omj.2021.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 05/03/2020] [Indexed: 11/17/2022] Open
Abstract
In this case report, we review a male child who presented with severe bilateral hearing loss. Preoperative high-resolution computed tomography (HRCT) evaluation facilitated the initial diagnosis of the disease, which revealed typical findings of cochlear incomplete partition type III anomaly (IP-III), surgical planning, and cochlear implant selection to avoid possible complications. The child underwent cochlear implantation, which resulted in gushing and misplacement of the electrodes into the internal auditory canal (IAC) as postoperative complications. Postoperative imaging was used to determine the position of the implant and to assess the complications. The child’s postoperative X-ray revealed misplacement of the cochlear implant, the extent of which was further assessed by a HRCT scan for preplanning the revision surgery and electrode selection. Following the revision surgery, a further HRCT scan confirmed proper implantation and ruled out any further complications.
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Surgical Outcomes With Cochlear Implantation in Patients With Enlarged Cochlear Aperture: A Systematic Review. Otol Neurotol 2021; 42:638-645. [PMID: 33492060 DOI: 10.1097/mao.0000000000003021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Evaluate surgical outcomes in patients with enlarged cochlear aperture (ECA) after cochlear implantation. DATABASES REVIEWED PubMed, EMBASE, and Scopus. METHODS A systematic review was performed using standardized methodology. Studies were included if they included subjects with ECA who underwent cochlear implantation. Exclusion criteria included non-English articles, abstracts, letters/commentaries, case reports, and reviews. Bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. RESULTS Out of 1,688 identified articles, 7 articles representing 23 subjects with ECA were included. Publication rates increased between the period of study from 2009 to 2018. Four studies were level 4 evidence and three studies were level 3 evidence. In total, 20 subjects underwent cochlear implantation. Cerebrospinal fluid gushers were encountered in the majority of cases that reported complications (16/17, 94.1%); one patient developed postoperative meningitis, and another experienced postimplantation facial nerve stimulation. No study provided measurements on cochlear aperture size or defined size criteria used to identify ECA. Four studies recognized X-linked deafness to be associated with ECA, and the most common mutation was in POU3F4 gene. CONCLUSION An association exists between ECA and cerebrospinal fluid gusher, underscoring the importance of reviewing preoperative imaging. Size criteria are not well defined, and there is a paucity of data with respect to normative measurements. Many cases of ECA may give a genetic link. Although level of evidence of current studies remains modest, ECA reports have increased and will likely continue to expand with advancements in imaging and genetic testing.
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Warnecke A, Giesemann A. Embryology, Malformations, and Rare Diseases of the Cochlea. Laryngorhinootologie 2021; 100:S1-S43. [PMID: 34352899 PMCID: PMC8354575 DOI: 10.1055/a-1349-3824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Despite the low overall prevalence of individual rare diseases, cochlear
dysfunction leading to hearing loss represents a symptom in a large
proportion. The aim of this work was to provide a clear overview of rare
cochlear diseases, taking into account the embryonic development of the
cochlea and the systematic presentation of the different disorders. Although
rapid biotechnological and bioinformatic advances may facilitate the
diagnosis of a rare disease, an interdisciplinary exchange is often required
to raise the suspicion of a rare disease. It is important to recognize that
the phenotype of rare inner ear diseases can vary greatly not only in
non-syndromic but also in syndromic hearing disorders. Finally, it becomes
clear that the phenotype of the individual rare diseases cannot be
determined exclusively by classical genetics even in monogenetic
disorders.
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Affiliation(s)
- Athanasia Warnecke
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 Hannover.,Deutsche Forschungsgemeinschaft Exzellenzcluster"Hearing4all" - EXC 2177/1 - Project ID 390895286
| | - Anja Giesemann
- Institut für Neuroradiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 Hannover
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Tekin AM, Matulic M, Wuyts W, Assadi MZ, Mertens G, van Rompaey V, Li Y, van de Heyning P, Topsakal V. A New Pathogenic Variant in POU3F4 Causing Deafness Due to an Incomplete Partition of the Cochlea Paved the Way for Innovative Surgery. Genes (Basel) 2021; 12:genes12050613. [PMID: 33919129 PMCID: PMC8143104 DOI: 10.3390/genes12050613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 12/20/2022] Open
Abstract
Incomplete partition type III (IP-III) is a relatively rare inner ear malformation that has been associated with a POU3F4 gene mutation. The IP-III anomaly is mainly characterized by incomplete separation of the modiolus of the cochlea from the internal auditory canal. We describe a 71-year-old woman with profound sensorineural hearing loss diagnosed with an IP-III of the cochlea that underwent cochlear implantation. Via targeted sequencing with a non-syndromic gene panel, we identified a heterozygous c.934G > C p. (Ala31Pro) pathogenic variant in the POU3F4 gene that has not been reported previously. IP-III of the cochlea is challenging for cochlear implant surgery for two main reasons: liquor cerebrospinalis gusher and electrode misplacement. Surgically, it may be better to opt for a shorter array because it is less likely for misplacement with the electrode in a false route. Secondly, the surgeon has to consider the insertion angles of cochlear access very strictly to avoid misplacement along the inner ear canal. Genetic results in well describes genotype-phenotype correlations are a strong clinical tool and as in this case guided surgical planning and robotic execution.
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Affiliation(s)
- Ahmet M. Tekin
- Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.M.T.); (M.M.)
| | - Marco Matulic
- Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.M.T.); (M.M.)
| | - Wim Wuyts
- Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, 2650 Antwerp, Belgium;
| | | | - Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium; (G.M.); (V.v.R.); (P.v.d.H.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Vincent van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium; (G.M.); (V.v.R.); (P.v.d.H.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Yongxin Li
- Department of Otolaryngology, Head and Neck Surgery, Capital Medical University, Beijing 100730, China;
| | - Paul van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium; (G.M.); (V.v.R.); (P.v.d.H.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.M.T.); (M.M.)
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UZ Brussel, Brussels Health Campus, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Correspondence: ; Tel.: +32-24776882; Fax: +32-24776880
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Novel Variants in Hearing Loss Genes and Associations With Audiometric Thresholds in a Multi-ethnic Cohort of US Patients With Cochlear Implants. Otol Neurotol 2021; 41:978-985. [PMID: 32658404 DOI: 10.1097/mao.0000000000002671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVES To investigate novel variants in hearing loss genes and clinical factors affecting audiometric outcomes of cochlear implant (CI) patients. BACKGROUND Approximately 50% of hearing loss has a genetic etiology, with certain genetic variants more prevalent in specific ethnic groups. Different variants and some clinical variables including inner ear malformations result in different prognoses or clinical outcomes after CI. METHODS Medical and genetic testing records of pediatric CI patients were reviewed for clinical variables. Minor allele frequencies of variants were obtained from Genome Aggregation Database (gnomAD) and variants were classified for pathogenicity. Standard statistical testing was done using Fisher's exact, Wilcoxon, and Spearman correlation tests. RESULTS Eighteen CI patients with genetic test results had pathogenic variants, including six patients with syndromic hearing loss and six patients with known GJB2 variants. Novel pathogenic variants were noted in CHD7, ADGRV1, and ARID1B, with variants in the latter two genes identified in Hispanic patients. Overall, carriage of genetic variants was associated with better pre-CI audiometric thresholds at 2000 Hz (p = 0.048). On the other hand, post-CI thresholds were significantly worse in patients with inner ear malformations, particularly in patients with atretic cochlear nerve canals. CONCLUSION Four novel pathogenic variants were identified, which contributes to knowledge of allelic spectrum for hearing loss especially in Hispanic patients. In this cohort, carriage of pathogenic variants particularly of GJB2 variants was associated with better pre-CI audiometric thresholds, while patients with inner ear malformations had worse post-CI audiometric thresholds.
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Xiao C, Liu S, Wang H, Ding Y, Chen Y, Liu H. Genetic etiology study of four Chinese families with two nonsyndromic deaf children in succession by targeted next-generation sequencing. Mol Genet Genomic Med 2021; 9:e1634. [PMID: 33638616 PMCID: PMC8123758 DOI: 10.1002/mgg3.1634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 12/09/2020] [Accepted: 02/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Genetic components contribute significantly to the cause of hearing loss. Nonsyndromic hearing loss has been shown to have high genetic heterogeneity. For families who had given birth to two nonsyndromic deaf children in succession, it seems that their deafness was highly related to genetics. OBJECTIVES This study aimed to disclose the genetic causes of the subjects from the four Chinese families with two nonsyndromic deaf children in succession who failed to find the genetic etiology of the hearing loss by common deafness genetic screening (GJB2, GJB3, SLC26A4, and MT-RNR1, including 20 hot variants in 4 genes). METHODS Targeted next-generation sequencing (NGS) of 127 known deafness genes was performed in probands of four families, followed by a series of comprehensive analyses of all family members combined with a literature review of related genes. RESULTS We identified pathogenic variants in three families including c.919-2A>G/c.1985G>A in SLC26A4; c.109G>A (p.V37I) in GJB2; and m.7505T>C in MT-TS1. Sanger sequencing confirmed that these variants segregated with the hearing impairment of each family. We also identified c.331C>T/c.625-5C>T/c.5717G>A in CDH23; c.138T>C in POU3F4 in two families, in which the pathogenicity in clinical was likely pathogenic or unknown. CONCLUSIONS Using the NGS detection technology, we found the genetic etiology of the HL in part of deaf families. Our study provided a useful piece of information for the variant spectrum of hearing loss in Chinese families with two deaf children in succession.
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Affiliation(s)
- Caixia Xiao
- Tianjin Women and Children Healthcare CenterTianjinChina
| | - Shuang Liu
- Tianjin Women and Children Healthcare CenterTianjinChina
| | - Hongyue Wang
- Tianjin Women and Children Healthcare CenterTianjinChina
| | - Yibing Ding
- Tianjin Women and Children Healthcare CenterTianjinChina
| | - Yaqiu Chen
- Tianjin Women and Children Healthcare CenterTianjinChina
| | - Haiyan Liu
- Tianjin Women and Children Healthcare CenterTianjinChina
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Varadarajan VV, Dayton OL, De Jesus RO, Antonelli PJ. Prevalence of occult cochlear basal turn patency. Acta Otolaryngol 2020; 140:889-892. [PMID: 32804558 DOI: 10.1080/00016489.2020.1800815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Perilymph gusher (PLG) is a rare complication of otologic surgery attributed to a communication between the cochlea and the internal auditory canal (IAC). Subtle patency between the cochlear basal turn and IAC has recently been identified on computed tomography (CT) as a risk factor, specifically when the defect is > 0.75 mm. OBJECTIVES Investigate the prevalence of radiographic cochlear basal turn patency. MATERIALS AND METHODS Patients with CT of the temporal bones and inner ears interpreted as "normal" were included. An otologist and a radiologist independently reviewed CTs to measure radiographic dehiscence in an oblique plane along the interface of the cochlea and IAC. Known PLGs were excluded. RESULTS Two hundred and ten ears were included (88 conductive or mixed hearing loss, 62 sensorineural hearing loss, 41 audiometrically normal ears). 71 ears (33.8%) were radiographically patent. Mean defect width was 0.41 mm (0.15-0.7 mm). Defect width was not associated with type of hearing loss, age, or gender. No defects were wider than 0.75 mm. CONCLUSIONS Radiographic patency of the cochlear basal turn may be present in patients with hearing loss and normal hearing, but patency > 0.75 mm (i.e. risk for PLG) is rare.
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Affiliation(s)
| | - Orrin L. Dayton
- Department of Radiology, University of Florida, Gainesville, FL, USA
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15
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Ashman PE, Jyung RW. Perilymphatic Fistula Manifesting as a Pseudomeningocele-Like Presentation Following Stapedectomy. EAR, NOSE & THROAT JOURNAL 2020; 101:NP232-NP234. [PMID: 33035130 DOI: 10.1177/0145561320965200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Peter E Ashman
- Department of Otolaryngology-Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Robert W Jyung
- Department of Otolaryngology-Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, NJ, USA
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16
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Association Between Incomplete Partition Type III and Abnormal Hypothalamic Morphology: Further Imaging Evidence. J Comput Assist Tomogr 2020; 44:704-707. [PMID: 32842072 DOI: 10.1097/rct.0000000000001050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Incomplete partition III (IP-III), characterized by congenital mixed or sensorineural hearing loss, is a rare genetic disease transmitted through X-linked mode of inheritance. Inner ear findings of IP-III have been well described and allow an immediate diagnosis to be made. Recently, an association between IP-III and distinct hypothalamic malformations has been reported in some of the patients with IP-III. The purpose of this study was to investigate the morphologic abnormalities of the hypothalamus in IP-III. MATERIALS AND METHODS Magnetic resonance imaging studies of 8 subjects, including 1 set of brothers, who were diagnosed with IP-III based on their clinical and inner ear imaging findings, were analyzed. RESULTS Of the 8 subjects, 7 demonstrated some degree of morphologic abnormality of the hypothalamus. Of these, 2 showed asymmetrical thickening, 1 showed symmetrical thickening, and 4 showed mass-like enlargement of the hypothalamus. Six of 7 subjects with hypothalamic abnormalities showed asymmetry in caudal extension of the abnormalities, which was more discernible on coronal oblique T2-weighted images. Clinically, none of the subjects had endocrinologic or neurologic symptoms. CONCLUSIONS This retrospective analysis presents further magnetic resonance imaging evidence on the association between the rare IP-III malformations and the presence of hypothalamic morphologic abnormalities.
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Nada A, Agunbiade SA, Whitehead MT, Cousins JP, Ahsan H, Mahdi E. Cross-Sectional Imaging Evaluation of Congenital Temporal Bone Anomalies: What Each Radiologist Should Know. Curr Probl Diagn Radiol 2020; 50:716-724. [PMID: 32951949 DOI: 10.1067/j.cpradiol.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/09/2020] [Accepted: 08/21/2020] [Indexed: 11/22/2022]
Abstract
Hearing loss in pediatric age group is associated with many congenital temporal bone disorders. Aberrant development of various ear structures leads into either conductive or sensorineural hearing loss. Knowledge of the embryology and anatomical details of various compartments of the ear help better understanding of such disorders. In general, abnormalities of external and middle ears result in conductive hearing loss. Whereas abnormalities of inner ear structures lead into sensorineural hearing loss. These abnormalities could occur as isolated or part of syndromes. Temporal bone disorders are a significant cause of morbidity and developmental delays in children. Imaging evaluation of children presented with hearing loss is paramount in early diagnosis and proper management planning. Our aim is to briefly discuss embryology and anatomy of the pediatric petrous temporal bones. The characteristic imaging features of commonly encountered congenital temporal bone disorders and their associated syndromes will be discussed.
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Affiliation(s)
- A Nada
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO.
| | - S A Agunbiade
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
| | - M T Whitehead
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC; George Washington University Hospital, Washington, DC
| | - J P Cousins
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
| | - H Ahsan
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
| | - E Mahdi
- Diagnostic Radiology Resident, Department of Radiology, University of Missouri Health care. One Hospital Drive, Columbia, MO
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Dasgupta S, Ratnayake S, Crunkhorn R, Iqbal J, Strachan L, Avula S. Audiovestibular Quantification in Rare Third Window Disorders in Children. Front Neurol 2020; 11:954. [PMID: 33041966 PMCID: PMC7526203 DOI: 10.3389/fneur.2020.00954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/23/2020] [Indexed: 12/19/2022] Open
Abstract
Third window disorders are structural abnormalities in the bony otic capsule that establish a connection between the middle/inner ear or the inner ear/cranial cavity. Investigated extensively in adults, they have hardly been studied in children. This study is a retrospective study of children (aged 5-17 years) diagnosed with rare third window disorders (third window disorders reported rarely or not reported in children) in a tertiary pediatric vestibular unit in the United Kingdom. It aimed to investigate audiovestibular function in these children. Final diagnosis was achieved by high resolution CT scan of the temporal bones. Of 920 children attending for audiovestibular assessment over a 42 month period, rare third windows were observed in 8 (<1%). These included posterior semicircular canal dehiscence (n = 3, 0.3%), posterior semicircular canal thinning (n = 2, 0.2%), X linked gusher (n = 2, 0.2%), and a combination of dilated internal auditory meatus/irregular cochlear partition/deficient facial nerve canal (n = 1, 0.1%). The majority of them (87.5%) demonstrated a mixed/conductive hearing loss with an air-bone gap in the presence of normal tympanometry (100%). Transient otoacoustic emissions were absent with a simultaneous cochlear pathology in 50% of the cohort. Features of disequilibrium were observed in 75% and about a third showed deranged vestibular function tests. Video head impulse test abnormalities were detected in 50% localizing to the side of the lesion. Cervical vestibular evoked myogenic potential test abnormalities were observed in all children in the cohort undergoing the test where low thresholds and high amplitudes classically found in third window disorders localized to the side of the defects in 28.5%. In the series, 71.4% also demonstrated absent responses/amplitude asymmetry, some of which did not localize to the ipsilesional side. Two children presented with typical third window symptoms. This study observes 2 new rare pediatric third window phenotypes and the presence of a cochlear hearing loss in these disorders. It emphasizes that these disorders should be considered as an etiology of hearing loss/disequilibrium in children. It also suggests that pediatric third window disorders may not present with classical third window features and are variable in their presentations/audiovestibular functions.
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Affiliation(s)
- Soumit Dasgupta
- Department of Paediatric Audiology and Audiovestibular Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Sudhira Ratnayake
- Department of Paediatric Audiology and Audiovestibular Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Rosa Crunkhorn
- Department of Paediatric Audiology and Audiovestibular Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Javed Iqbal
- Department of Paediatric Audiology and Audiovestibular Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Laura Strachan
- Department of Paediatric Audiology and Audiovestibular Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Shivaram Avula
- Department of Paediatric Radiology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
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Petrina NE, Marakhonov AV, Zinchenko RA. [Presentation of a rare case of hereditary hearing loss with X-linked recessive inheritance associated with the POU3F4 gene]. Vestn Otorinolaringol 2020; 85:65-69. [PMID: 32885640 DOI: 10.17116/otorino20208504165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Congenital hearing loss is one of the most frequent inherited human pathologies, occurring in 1-2 out of 1000 newborns. X-linked hearing loss occurs in 1-5% of all congenital hearing impairments. The proband (a man) and his affected brother have profound prelingual non-syndromic neurosensory hearing loss. Their parents are healthy. The aim of the study was to determine the cause of hearing loss in a given family and to assess the population frequency of the revealed pathogenic genetic variant. NGS analysis identified a pathogenic variant c.907C>T (p.Pro303Ser) in the POU3F4 gene mapped to the Xq21.1 locus. This is the second case of X-linked hearing loss (DFNX2, OMIM 304400) in Europe, caused by the c.907C>T variant in the POU3F4 gene. DFNX2-hearing loss is manifested with abnormalities of the inner ear, predisposing to the "gusher effect" - otoliquorrhea during stapedoplasty. The brother was diagnosed with a c.907C>T variant in the POU3F4 gene in the hemizygous state while in their mother - in the heterozygous state. Their father had no variant c.907C>T. Molecular genetic analysis showed that the genetic variant c.907C>T was not detected in the control sample of healthy female from the Nogai population, which suggests its low frequency in the population.
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Affiliation(s)
- N E Petrina
- Research Center for Medical Genetics, Moscow, Russia
| | | | - R A Zinchenko
- Research Center for Medical Genetics, Moscow, Russia.,N.A. Semashko National Research Institute of Public Health, Moscow, Russia
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Prat Matifoll JA, Wilson M, Goetti R, Birman C, Bennett B, Peadon E, Prats-Uribe A, Prelog K. A Case Series of X-Linked Deafness-2 with Sensorineural Hearing Loss, Stapes Fixation, and Perilymphatic Gusher: MR Imaging and Clinical Features of Hypothalamic Malformations. AJNR Am J Neuroradiol 2020; 41:1087-1093. [PMID: 32409310 DOI: 10.3174/ajnr.a6541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/20/2020] [Indexed: 11/07/2022]
Abstract
X-linked deafness-2 (DFNX2) is an X-linked recessive disorder characterized by profound sensorineural hearing loss and a pathognomonic temporal bone deformity. Because hypothalamic malformations associated with DFNX2 have been rarely described, we aimed to further describe these lesions and compare them with features of a nonaffected population. All patients diagnosed with DFNX2 between 2006 and 2019 were included and compared with age-matched patients with normal MR imaging findings and without hypothalamic dysfunction. MR imaging features differing between groups were selected to help identify DFNX2. Sensitivity and specificity were calculated for these features. Agreement among 3 radiologists was quantified using the index κ. Information on the presence or absence of gelastic seizures, precocious puberty, or delayed puberty was also gathered. We selected distinctive MR imaging features of hypothalamic malformations in DFNX2. The feature selected on axial T2 images was the folded appearance of the ventromedial hypothalamus (sensitivity, 100%; specificity, 95.8%) characterized by an abnormal internal/external cleft (sensitivity, 100%; specificity, 95.7%). On coronal T2, the first distinctive feature was a concave morphology of the medial eminence (sensitivity, 100%; specificity, 97.1%), the second feature was at least 1 hypothalamic-septum angle ≥90° (sensitivity, 90%; specificity, 72.5%), and the third feature was a forebrain-hypothalamic craniocaudal length of ≥6 mm (sensitivity, 70%; specificity, 79.7%). Clinical features were also distinctive because 9 patients with DFNX2 did not present with gelastic seizures or precocious puberty. One patient had delayed puberty. The κ index and intraclass correlation coefficient ranged between 0.78 and 0.95. Imaging and clinical features of the hypothalamus suggest that there is a hypothalamic malformation associated with DFNX2. Early assessment for pubertal delay is proposed.
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Affiliation(s)
| | | | - R Goetti
- Radiology Department (R.G.), University of Sydney, Children's Hospital at Westmead (Sydney), Westmead, New South Wales, Australia
| | | | | | - E Peadon
- Deafness Centre (E.P.); Children's Hospital at Westmead (Sydney), Westmead, New South Wales, Australia
| | - A Prats-Uribe
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (A.P.-U.), Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, Oxford, UK
| | - K Prelog
- From the Departments of Radiology (J.-A.P.M., K.P.)
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21
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Hong R, Du Q, Pan Y. New Imaging Findings of Incomplete Partition Type III Inner Ear Malformation and Literature Review. AJNR Am J Neuroradiol 2020; 41:1076-1080. [PMID: 32467182 DOI: 10.3174/ajnr.a6576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 04/04/2020] [Indexed: 11/07/2022]
Abstract
Incomplete partition type III, also referred to as X-linked deafness, is a rare genetic inner ear malformation. Its characteristic CT findings, including bulbous dilation of the internal auditory canal and absence of the modiolus with the interscalar septa present, have been well-recognized. In this series of 19 cases, we report the abnormalities of the vestibule and semicircular canals and provide a comprehensive description of their CT and MR imaging findings. The inner ear malformations in incomplete partition type III were bilateral and basically symmetric, with involvement of the internal auditory canal, nerve canals in the fundus, cochlea, vestibule, semicircular canals, vestibular aqueduct, otic capsule, round window, oval window, and stapes. An irregular vestibule with a cystic appearance is also a distinctive imaging feature, which could be seen in about 90% of our patients, with a cystic appearance of the semicircular canals present in nearly half of the cases.
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Affiliation(s)
- R Hong
- From the Departments of Radiology (R.H., Y.P.)
| | - Q Du
- Otolaryngology-Head and Neck Surgery (Q.D.), Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Y Pan
- From the Departments of Radiology (R.H., Y.P.)
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Irregular Contour of Inner Ear Structures and Hypomineralized Areas at Otic Capsule: Are They Other Additional Imaging Findings of Incomplete Partition-III? J Comput Assist Tomogr 2020; 44:386-388. [PMID: 32168082 DOI: 10.1097/rct.0000000000000991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Incomplete partition III (IP-III) characterized by congenital mixed or sensorineural hearing loss is a rare genetic disease transmitted through X-linked inheritance. Incomplete partition III can be easily achieved based on pathognomonic computed tomography findings. The aims of this study were to investigate the otic capsule abnormalities in IP-III and to report irregular contour of membranous labyrinth and hypomineralized areas at otic capsule, which have not previously been described. MATERIALS AND METHODS The otic capsule features of 10 subjects (8 affected patients, 1 of whom is a female; 2 carrier mothers), who were diagnosed on clinical and typical radiologic findings, were analyzed. RESULTS All patients had typical IP-III as described in the literature. Seven of 10 patients had irregular contour. Seven of 10 patients demonstrated hypomineralized areas, which were very hypodense to normally develop otic capsule areas. One affected patients and 2 carrier mothers had a normal-looking membranous labyrinth contour and normal mineralization at otic capsule. CONCLUSIONS We report for the first time the irregular contour of inner ear structures and hypodense otic capsule areas in patients with IP-III. We think that though speculative, abnormal development of the inner endosteal layer results in irregular contour of inner ear structures. Hypomineralized areas at otic capsule could be explained by abnormal development of middle enchondral layer due to reduced or absent vascular supply from middle ear mucosa during fetal life. These findings may be accepted as additional criteria of IP-III.
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Abstract
BACKGROUND Incomplete partition type III (IP III) is defined by a missing lamina cribrosa between the cochlea and the internal auditory canal (IAC). Cochlear implantation (CI) may result in an insertion of the electrode array into the IAC. The aim of this study is to evaluate CI surgery protocols, long-term audiological outcome, mapping and electrophysiological data after CI in IP III patients. MATERIALS AND METHODS Nine IP III patients were implanted with perimodiolar electrode arrays between 1999 and 2014; eight of them were included in this study. We evaluated mapping data, stapedius reflexes, electrode impedances and ECAP thresholds. We matched them with 3 CI patients each with normal cochlear morphology regarding sex, age, side, implant type and surgical date. Speech discrimination was evaluated with the Oldenburger sentence test for adults, Göttingen audiometric speech test for children and the Freiburger monosyllabic word test. RESULTS 3 years after CI IP III patients showed a significant increase in pulse width, calculated electric load and electrode impedances in basal electrodes. Intraoperative electrically-evoked stapedius reflexes could be measured in all patients. Speech recognition scores were lower than average scores for matched patients, but without statistical significance. CONCLUSIONS The significant increase of pulse width, electric load and electrode impedances of basal electrodes over time seem to be characteristic for IP III patients probably occurring due to fibrosis and neurodegeneration of the cochlear nerve. The long term audiological results are stable. Intraoperative imaging and stapedius reflexes are highly recommended to control the right position of the electrode array.
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Abstract
OBJECTIVES Perilymphatic gusher (PLG) is an uncommon complication of stapedectomy and cochlear implant placement. Computerized tomography (CT) may reveal congenital dysplasia responsible for PLG but may also be (incorrectly) interpreted as normal. The aim of this study was to review CT findings in patients with PLG reported to have normal temporal bones. PATIENTS Patients in which a PLG was encountered and preoperative CT imaging had been interpreted as normal. INTERVENTION Collaborative review of temporal bone computed tomography by neurotologist and neuroradiologist. MAIN OUTCOME MEASURE Identification of undetected inner ear anomalies that may predispose to PLG. RESULTS Unanticipated PLG was encountered during stapes surgery in two patients and cochlear implantation in one. A focal bony dehiscence between the basal turn of the cochlea and internal auditory canal (IAC) was identified on a few oblique reformatted images in all patients. CONCLUSIONS High resolution CT with oblique image reformatting is essential to identify focal communication between the IAC and basal turn of the cochlea in ears with PLG.
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Varadarajan VV, Dayton OL, De Jesus RO, Sarntinoranont M, Antonelli PJ. Cochlear basal turn patency in unrecognized perilymph gushers. Int J Pediatr Otorhinolaryngol 2019; 126:109601. [PMID: 31369970 DOI: 10.1016/j.ijporl.2019.109601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/23/2019] [Accepted: 07/23/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Perilymph gusher (PLG), an uncommon complication of otologic surgery, has been attributed to communication between the cochlea and the internal auditory canal (IAC). Subtle osseous defects may be missed on routine review of computed tomography (CT). This study aimed to quantify cochlear basal turn patency not seen on axial CT in patients with PLG and compare those against patients without intraoperative PLG. METHODS Ears that underwent cochlear implantation or stapedotomy with preoperative helical CT that was interpreted as "normal" at a tertiary referral center. An otologist and a radiologist independently and in a blinded fashion measured the dimensions of cochlear basal turn patency on CT images in oblique plane and parasagittal planes along the interface of the cochlea and IAC fundus. RESULTS Sixty-one ears were reviewed, including 3 with surgically confirmed PLGs and 12 with apparent dehiscence without a PLG. Mean defect width with PLG was 0.83 mm (range 0.75-0.9 mm) and without PLG was 0.43 mm (range 0.3-0.65 mm, p = 0.011). A greater proportion of PLGs occurred in ears with defects (3 of 15) than in ears without (0 of 46, p = 0.013). Using a cutoff of 0.75 mm, a greater proportion of PLGs occurred with defect width >0.75 mm (3 of 3) than in defects <0.75 mm (0 of 12, p = 0.022). CONCLUSIONS CT dehiscence between the IAC and cochlear basal turn, particularly with a width > 0.75 mm, should be considered a risk for PLG with stapedotomy or cochlear implantation.
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Affiliation(s)
| | - Orrin L Dayton
- Department of Radiology, University of Florida, Gainesville, FL, USA
| | | | - Malisa Sarntinoranont
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA
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Alballaa A, Aschendorff A, Arndt S, Hildenbrand T, Becker C, Hassepass F, Laszig R, Beck R, Speck I, Wesarg T, Ketterer MC. [Incomplete partition type III revisited-long-term results following cochlear implant. German version]. HNO 2019; 67:760-768. [PMID: 31485697 DOI: 10.1007/s00106-019-00733-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Incomplete partition type III (IP III) is defined by a missing lamina cribrosa between the cochlea and the internal auditory canal (IAC). Cochlear implantation (CI) may result in an insertion of the electrode array into the IAC. The aim of this study is to evaluate CI surgery protocols, long-term audiological outcome, mapping and electrophysiological data after CI in IP III patients. MATERIALS AND METHODS Nine IP III patients were implanted with perimodiolar electrode arrays between 1999 and 2014; eight of them were included in this study. We evaluated mapping data, stapedius reflexes, electrode impedances and ECAP thresholds. We matched them with 3 CI patients each with normal cochlear morphology regarding sex, age, side, implant type and surgical date. Speech discrimination was evaluated with the Oldenburger sentence test for adults, Göttingen audiometric speech test for children and the Freiburger monosyllabic word test. RESULTS 3 years after CI IP III patients showed a significant increase in pulse width, calculated electric load and electrode impedances in basal electrodes. Intraoperative electrically-evoked stapedius reflexes could be measured in all patients. Speech recognition scores were lower than average scores for matched patients, but without statistical significance. CONCLUSIONS The significant increase of pulse width, electric load and electrode impedances of basal electrodes over time seem to be characteristic for IP III patients probably occurring due to fibrosis and neurodegeneration of the cochlear nerve. The long term audiological results are stable. Intraoperative imaging and stapedius reflexes are highly recommended to control the right position of the electrode array.
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Affiliation(s)
- A Alballaa
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
- Department of Otolaryngology, King Abdulaziz University Hospital, King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Aschendorff
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - S Arndt
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - T Hildenbrand
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - C Becker
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - F Hassepass
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - R Laszig
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - R Beck
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - I Speck
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - T Wesarg
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - M C Ketterer
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland.
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Brotto D, Uberti A, Manara R. From Mondini to the latest inner ear malformations’ classifications: an historical and critical review. HEARING, BALANCE AND COMMUNICATION 2019. [DOI: 10.1080/21695717.2019.1663041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Davide Brotto
- Neurosciences Department, ENT Unit, Università Degli Studi di Padova, Padova, Italy
| | - Andrea Uberti
- Neurosciences Department, ENT Unit, Università Degli Studi di Padova, Padova, Italy
| | - Renzo Manara
- Neurosciences Department, ENT Unit, Università Degli Studi di Padova, Padova, Italy
- Department of Neuroradiology, Università Degli Studi di Padova, Padova, Italy
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28
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Buck L, Bailey KC, Carron JD. A Case of Childhood Hearing Loss. JAMA Otolaryngol Head Neck Surg 2019; 145:864-865. [DOI: 10.1001/jamaoto.2019.1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lauren Buck
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson
| | - Kandice C. Bailey
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson
| | - Jeffery D. Carron
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson
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Quirk B, Youssef A, Ganau M, D'Arco F. Radiological diagnosis of the inner ear malformations in children with sensorineural hearing loss. BJR Open 2019; 1:20180050. [PMID: 33178934 PMCID: PMC7592472 DOI: 10.1259/bjro.20180050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 11/24/2022] Open
Abstract
Malformations in either the inner ear, vestibulocochlear nerve (VIIIth) or auditory cortex of the brain can lead to congenital sensorineural hearing loss (SNHL). In most cases the underlying disorders involve the membranous labyrinth at a microscopic level and therefore radiological examinations are entirely normal. In a significant proportion however (up to 20%), there are abnormalities visualized in the inner ear and/or the VIIIth nerve; the type of abnormality is relevant for the surgical planning of a cochlear implant. Imaging and the accurate radiological identification of the affected inner ear structures therefore plays an integral role in the clinical evaluation of sensorineural hearing loss. In this pictorial review, we describe the main malformations of the inner ear in view of recent classifications and briefly explore the surgical implications.
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Affiliation(s)
- Bernadine Quirk
- Great Ormond Street Hospital for Children NHS Foundation Trust
| | - Adam Youssef
- Great Ormond Street Hospital for Children NHS Foundation Trust
| | - Mario Ganau
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust
| | - Felice D'Arco
- Great Ormond Street Hospital for Children NHS Foundation Trust
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30
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McFadden MD, Wilmoth JG, Mancuso AA, Antonelli PJ. Preoperative Computed Tomography May Fail to Detect Patients at Risk for Perilymph Gusher. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/014556130508401212] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Michael D. McFadden
- Department of Otolaryngology–Head and Neck Surgery, University of Florida College of Medicine, Gainesville
| | - Jason G. Wilmoth
- Department of Otolaryngology–Head and Neck Surgery, University of Florida College of Medicine, Gainesville
| | - Anthony A. Mancuso
- Department of Otolaryngology–Head and Neck Surgery, University of Florida College of Medicine, Gainesville
- Department of Radiology, University of Florida College of Medicine, Gainesville
| | - Patrick J. Antonelli
- Department of Otolaryngology–Head and Neck Surgery, University of Florida College of Medicine, Gainesville
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Abstract
Temporal bone high-resolution computed tomography (HRCT) and magnetic resonance (MR) imaging are valuable tools in the evaluation of pediatric hearing loss. Computed tomography is important in the evaluation of pediatric conductive hearing loss and is the imaging modality of choice for evaluation of osseous abnormalities. MR imaging is the modality of choice for evaluation of sensorineural hearing loss. A broad spectrum of imaging findings can be seen with hearing loss in children. HRCT and MR imaging provide complementary information and are often used in conjunction in the preoperative evaluation of pediatric candidates for cochlear implantation.
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Su Y, Gao X, Huang SS, Mao JN, Huang BQ, Zhao JD, Kang DY, Zhang X, Dai P. Clinical and molecular characterization of POU3F4 mutations in multiple DFNX2 Chinese families. BMC MEDICAL GENETICS 2018; 19:157. [PMID: 30176854 PMCID: PMC6122742 DOI: 10.1186/s12881-018-0630-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/21/2018] [Indexed: 02/07/2023]
Abstract
Background Many X-linked non-syndromic hearing loss (HL) cases are caused by various mutations in the POU domain class 3 transcription factor 4 (POU3F4) gene. This study aimed to identify allelic variants of this gene in two Chinese families displaying X-linked inheritance deafness-2 (DFNX2) and one sporadic case with indefinite inheritance pattern. Methods Direct DNA sequencing of the POU3F4 gene was performed in these families and in 100 Chinese individuals with normal hearing. Results There are characteristic imaging findings in DFNX2 Chinese families with POU3F4 mutations. The temporal bone computed tomography (CT) images of patients with DFNX2 are characterized by a thickened stapes footplate, hypoplasia of the cochlear base, absence of the bony modiolus, and dilated internal acoustic meatus (IAM) as well as by abnormally wide communication between the IAM and the basal turn of the cochlea. We identified three causative mutations in POU3F4 for three probands and their extended families. In family 1468, we observed a novel deletion mutation, c.973delT, which is predicted to result in a p.Trp325Gly amino acid frameshift. In family 2741, the mutation c.927delCTC was identified, which is predicted to result in the deletion of serine at position 310. In both families, the mutations were located in the POU homeodomain and are predicted to truncate the C-terminus of the POU domain. In the third family, a novel de novo transversion mutation (c.669 T > A) was identified in a 5-year-old boy that resulted in a nonsense mutation (p.Tyr223*). The mutation created a new stop codon and is predicted to result in a truncated POU3F4 protein. Conclusions Based on characteristic radiological findings and clinical features, POU3F4 gene mutation analysis will increase the success rate of stapes operations and cochlear implantations, and improve molecular diagnosis, genetic counseling, and knowledge of the molecular epidemiology of HL among patients with DFNX2.
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Affiliation(s)
- Yu Su
- Department of Otorhinolaryngology, Head and Neck Surgery, PLA General Hospital, Beijing, 100853, People's Republic of China.,Department of Otorhinolaryngology, Hainan Branch of PLA General Hospital, Sanya, 572000, People's Republic of China
| | - Xue Gao
- Department of Otorhinolaryngology, Head and Neck Surgery, PLA General Hospital, Beijing, 100853, People's Republic of China.,Department of Otolaryngology, The General Hospital of the PLA Rocket Force, 16# Xi Wai Da Jie, Beijing, 100088, People's Republic of China
| | - Sha-Sha Huang
- Department of Otorhinolaryngology, Head and Neck Surgery, PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Jing-Ning Mao
- Department of Medical Imaging, PLA 307 Hospital, Beijing, 100074, People's Republic of China
| | - Bang-Qing Huang
- Department of Otorhinolaryngology, Hainan Branch of PLA General Hospital, Sanya, 572000, People's Republic of China
| | - Jian-Dong Zhao
- Department of Otorhinolaryngology, Head and Neck Surgery, PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Dong-Yang Kang
- Department of Otorhinolaryngology, Head and Neck Surgery, PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Xin Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Pu Dai
- Department of Otorhinolaryngology, Head and Neck Surgery, PLA General Hospital, Beijing, 100853, People's Republic of China.
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Corvino V, Apisa P, Malesci R, Laria C, Auletta G, Franzé A. X-Linked Sensorineural Hearing Loss: A Literature Review. Curr Genomics 2018; 19:327-338. [PMID: 30065609 PMCID: PMC6030855 DOI: 10.2174/1389202919666171218163046] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 11/10/2017] [Accepted: 12/04/2017] [Indexed: 01/01/2023] Open
Abstract
Sensorineural hearing loss is a very diffuse pathology (about 1/1000 born) with several types of transmission. X-linked hearing loss accounts for approximately 1% - 2% of cases of non-syndromic forms, as well as for many syndromic forms. To date, six loci (DFNX1-6) and five genes (PRPS1 for DFNX1, POU3F4 for DFNX2, SMPX for DFNX4, AIFM1 for DFNX5 and COL4A6 for DFNX6) have been identified for X-linked non-syndromic hearing loss. For the syndromic forms, at least 15 genes have been identified, some of which are also implicated in non-syndromic forms. Moreover, some syndromic forms, presenting large chromosomal deletions, are associated with mental retardation too. This review presents an overview of the currently known genes related to X-linked hearing loss with the support of the most recent literature. It summarizes the genetics and clinical features of X-linked hearing loss to give information useful to realize a clear genetic counseling and an early diagnosis. It is important to get an early diagnosis of these diseases to decide the investigations to predict the evolution of the disease and the onset of any other future symptoms. This information will be clearly useful for choosing the best therapeutic strategy. In particular, regarding audiological aspects, this review highlights risks and benefits currently known in some cases for specific therapeutic intervention.
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Affiliation(s)
- Virginia Corvino
- Unit of Audiology, Department of Neurosciences, Reproductives and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Pasqualina Apisa
- Unit of Audiology, Department of Neurosciences, Reproductives and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Rita Malesci
- Unit of Audiology, Department of Neurosciences, Reproductives and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Carla Laria
- Unit of Audiology, Department of Neurosciences, Reproductives and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Gennaro Auletta
- Unit of Audiology, Department of Neurosciences, Reproductives and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Annamaria Franzé
- Unit of Audiology, Department of Neurosciences, Reproductives and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
- CEINGE Biotecnologie Avanzate, Naples, Italy
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Sennaroğlu L, Bajin MD. Incomplete partition type III: A rare and difficult cochlear implant surgical indication. Auris Nasus Larynx 2018; 45:26-32. [DOI: 10.1016/j.anl.2017.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/06/2017] [Accepted: 02/16/2017] [Indexed: 10/20/2022]
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36
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Barashkov NA, Klarov LA, Teryutin FM, Solovyev AV, Pshennikova VG, Konnikova EE, Romanov GP, Tobokhov AV, Morozov IV, Bondar AA, Posukh OL, Dzhemileva LU, Tomsky MI, Khusnutdinova EK, Fedorova SA. A novel pathogenic variant c.975G>A (p.Trp325*) in the POU3F4 gene in Yakut family (Eastern Siberia, Russia) with the X-linked deafness-2 (DFNX2). Int J Pediatr Otorhinolaryngol 2018; 104:94-97. [PMID: 29287890 DOI: 10.1016/j.ijporl.2017.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 10/18/2022]
Abstract
Here, we report a novel hemizygous transition c.975G>A (p.Trp325*) in POU3F4 gene (Xq21) found in two deaf half-brothers from one Yakut family (Eastern Siberia, Russia) with identical inner ear abnormalities ("corkscrew" cochlea with an absence of modiolus) specific to X-linked deafness-2 (DFNX2). Comprehensive clinical evaluation (CT and MR-imaging, audiological and stabilometric examinations) of available members of this family revealed both already known (mixed progressive hearing loss) and additional (enlargement of semicircular canals and postural disorders) clinical DFNX2 features in affected males with c.975G>A (p.Trp325*). Moreover, mild enlargement of semicircular canals, postural abnormalities and different types of hearing thresholds were found in female carrier of this POU3F4-variant.
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Affiliation(s)
- Nikolay A Barashkov
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation; Laboratory of Molecular Biology, Institute of Natural Sciences, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation.
| | - Leonid A Klarov
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation; Department of Radiology, Republican Hospital #1- National Medical Centre, Ministry of Public Health of the Sakha Republic, Yakutsk, Russian Federation; Institute of Medicine, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Fedor M Teryutin
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation; Laboratory of Molecular Biology, Institute of Natural Sciences, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Aisen V Solovyev
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation; Laboratory of Molecular Biology, Institute of Natural Sciences, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Vera G Pshennikova
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation; Laboratory of Molecular Biology, Institute of Natural Sciences, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Edilia E Konnikova
- Institute of Medicine, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Georgii P Romanov
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation; Laboratory of Molecular Biology, Institute of Natural Sciences, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Alexander V Tobokhov
- Institute of Medicine, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Igor V Morozov
- SB RAS Genomics Core Facility, Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation; Novosibirsk State University, Novosibirsk, Russian Federation
| | - Alexander A Bondar
- SB RAS Genomics Core Facility, Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Olga L Posukh
- Novosibirsk State University, Novosibirsk, Russian Federation; Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Lilya U Dzhemileva
- Laboratory of Human Molecular Genetics, Institute of Biochemistry and Genetics, Ufa Scientific Centre, Russian Academy of Sciences, Ufa, Russian Federation; Department of Immunology and Human Reproductive Health, Bashkir State Medical University, Ufa, Russian Federation
| | - Mikhail I Tomsky
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
| | - Elza K Khusnutdinova
- Laboratory of Human Molecular Genetics, Institute of Biochemistry and Genetics, Ufa Scientific Centre, Russian Academy of Sciences, Ufa, Russian Federation; Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russian Federation
| | - Sardana A Fedorova
- Department of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation; Laboratory of Molecular Biology, Institute of Natural Sciences, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
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Abstract
Morphologically congenital sensorineural hearing loss can be investigated under two categories. The majority of congenital hearing loss causes (80%) are membranous malformations. Here, the pathology involves inner ear hair cells. There is no gross bony abnormality and, therefore, in these cases high-resolution computerized tomography and magnetic resonance imaging of the temporal bone reveal normal findings. The remaining 20% have various malformations involving the bony labyrinth and, therefore, can be radiologically demonstrated by computerized tomography and magnetic resonance imaging. The latter group involves surgical challenges as well as problems in decision-making. Some cases may be managed by a hearing aid, others need cochlear implantation, and some cases are candidates for an auditory brainstem implantation (ABI). During cochlear implantation, there may be facial nerve abnormalities, cerebrospinal fluid leakage, electrode misplacement or difficulty in finding the cochlea itself. During surgery for inner ear malformations, the surgeon must be ready to modify the surgical approach or choose special electrodes for surgery. In the present review article, inner ear malformations are classified according to the differences observed in the cochlea. Hearing and language outcomes after various implantation methods are closely related to the status of the cochlear nerve, and a practical classification of the cochlear nerve deficiency is also provided.
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Affiliation(s)
- Levent Sennaroğlu
- Department of Otolaryngology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Münir Demir Bajin
- Department of Otolaryngology, Hacettepe University School of Medicine, Ankara, Turkey
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Liang S, Jiang N, Li S, Jiang X, Yu D. A maternally inherited 8.05 Mb Xq21 deletion associated with Choroideremia, deafness, and mental retardation syndrome in a male patient. Mol Cytogenet 2017. [PMID: 28630650 PMCID: PMC5471966 DOI: 10.1186/s13039-017-0324-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Deletions in Xq21 cause various congenital defects in males including choroideremia, deafness and mental retardation, depending on their size and gene content. Until now only a limited number of patients with Xq21 deletions has been reported. Case presentation Here we describe a 17-year-old male with choroideremia, deafness, and mental retardation syndrome. Using SNP arrays, an 8.05 Mb deletion in Xq21 was identified inherited from the apparently healthy mother. The deleted region harbors 12 OMIM genes, of which POU3F4, CHM, and ZNF711 might have contributed to the patient’s phenotype including hearing loss, poor vision, and intellectual disability. Moreover, the patient’s mother exhibits a normal phenotype while carrying the same deletion, which is often observed in previous studies on female carriers in families with this syndrome. Conclusions Our study confirms the causative effect between the Xq21 deletion in males and choroideremia, deafness and mental retardation.
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Affiliation(s)
- Siying Liang
- Genetic Testing Center, Qingdao Women and Children's Hospital, Qingdao University, #217, Liaoyangxi Road, Qingdao, 266034 China
| | - Nan Jiang
- Genetic Testing Center, Qingdao Women and Children's Hospital, Qingdao University, #217, Liaoyangxi Road, Qingdao, 266034 China
| | - Shuo Li
- Genetic Testing Center, Qingdao Women and Children's Hospital, Qingdao University, #217, Liaoyangxi Road, Qingdao, 266034 China
| | - Xiaohu Jiang
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Dongyi Yu
- Genetic Testing Center, Qingdao Women and Children's Hospital, Qingdao University, #217, Liaoyangxi Road, Qingdao, 266034 China
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39
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CT and MR Imaging of the Pediatric Temporal Bone: Normal Variants and Pitfalls. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0225-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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40
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Du W, Han MK, Wang DY, Han B, Zong L, Lan L, Yang J, Shen Q, Xie LY, Yu L, Guan J, Wang QJ. A POU3F4 Mutation Causes Nonsyndromic Hearing Loss in a Chinese X-linked Recessive Family. Chin Med J (Engl) 2017; 130:88-92. [PMID: 28051029 PMCID: PMC5221118 DOI: 10.4103/0366-6999.196565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: The molecular genetic research showed the association between X-linked hearing loss and mutations in POU3F4. This research aimed to identify a POU3F4 mutation in a nonsyndromic X-linked recessive hearing loss family. Methods: A series of clinical evaluations including medical history, otologic examinations, family history, audiologic testing, and a high-resolution computed tomography scan were performed for each patient. Bidirectional sequencing was carried out for all polymerase chain reaction products of the samples. Moreover, 834 controls with normal hearing were also tested. Results: The pedigree showed X-linkage recessive inheritance pattern, and pathogenic mutation (c.499C>T) was identified in the proband and his family member, which led to a premature termination prior to the entire POU domains. This mutation co-segregated with hearing loss in this family. No mutation of POU3F4 gene was found in 834 controls. Conclusions: A nonsense mutation is identified in a family displaying the pedigree consistent with X-linked recessive pattern in POU3F4 gene. In addition, we may provide molecular diagnosis and genetic counseling for this family.
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Affiliation(s)
- Wan Du
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Ming-Kun Han
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Da-Yong Wang
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Bing Han
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Liang Zong
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Lan Lan
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Ju Yang
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Qi Shen
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Lin-Yi Xie
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Lan Yu
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Jing Guan
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Qiu-Ju Wang
- Department of Otolaryngology Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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Wester JL, Merna C, Peng KA, Lewis R, Sepahdari AR, Ishiyama G, Hosokawa K, Kumakawa K, Ishiyama A. Facial nerve stimulation following cochlear implantation for X-linked stapes gusher syndrome leading to identification of a novel POU3F4 mutation. Int J Pediatr Otorhinolaryngol 2016; 91:121-123. [PMID: 27863625 DOI: 10.1016/j.ijporl.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 11/17/2022]
Abstract
We report a case of a nine-year-old male who presented with facial nerve stimulation four years after cochlear implantation. Computed tomography was performed revealing a dilated internal auditory meatus and the cochlear implant electrode was found to be protruding into the fallopian canal at the level of the geniculate ganglion. Subsequent genetic analysis demonstrated X-linked deafness type 2 (DFNX2) caused by a novel c.769C > T nucleotide change in the POU domain, class 3, transcription factor 4 gene (POU3F4). Inactivation of electrodes 1 and 19-21 successfully abated facial nerve stimulation.
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Affiliation(s)
- Jacob L Wester
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine Merna
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Kevin A Peng
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Rebecca Lewis
- Department of Audiology and Speech Pathology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ali R Sepahdari
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Gail Ishiyama
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Kumiko Hosokawa
- Department of Otolaryngology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kozo Kumakawa
- Department of Otolaryngology, Toranomon Hospital, Minato-ku, Tokyo, Japan
| | - Akira Ishiyama
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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Classic signs in head and neck imaging. Clin Radiol 2016; 71:1211-1222. [DOI: 10.1016/j.crad.2016.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 07/09/2016] [Accepted: 09/08/2016] [Indexed: 11/24/2022]
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Kanno A, Mutai H, Namba K, Morita N, Nakano A, Ogahara N, Sugiuchi T, Ogawa K, Matsunaga T. Frequency and specific characteristics of the incomplete partition type III anomaly in children. Laryngoscope 2016; 127:1663-1669. [DOI: 10.1002/lary.26245] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 07/11/2016] [Accepted: 07/14/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Ayako Kanno
- Division of Hearing and Balance Research; National Institute of Sensory Organs; National Hospital Organization Tokyo Medical Center; Tokyo Japan
- Department of Otolaryngology; Inagi Municipal Hospital; Tokyo Japan
- Department of Otolaryngology; Keio University School of Medicine; Tokyo Japan
| | - Hideki Mutai
- Division of Hearing and Balance Research; National Institute of Sensory Organs; National Hospital Organization Tokyo Medical Center; Tokyo Japan
| | - Kazunori Namba
- Division of Hearing and Balance Research; National Institute of Sensory Organs; National Hospital Organization Tokyo Medical Center; Tokyo Japan
| | - Noriko Morita
- Department of Otolaryngology; Kobari General Hospital; Chiba Japan
| | - Atsuko Nakano
- Division of Otolaryngology; Chiba Children's Hospital; Chiba Japan
| | - Noboru Ogahara
- Department of Otorhinolaryngology; Kanagawa Children's Medical Center; Kanagawa Japan
| | - Tomoko Sugiuchi
- Department of Otolaryngology; Kanto Rosai Hospital; Kanagawa Japan
| | - Kaoru Ogawa
- Department of Otolaryngology; Keio University School of Medicine; Tokyo Japan
| | - Tatsuo Matsunaga
- Division of Hearing and Balance Research; National Institute of Sensory Organs; National Hospital Organization Tokyo Medical Center; Tokyo Japan
- Medical Genetics Center; National Hospital Organization Tokyo Medical Center; Tokyo Japan
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Revision Stapedectomy in a Female Patient with Inner Ear Malformation. Case Rep Otolaryngol 2016; 2016:8520703. [PMID: 27144044 PMCID: PMC4837267 DOI: 10.1155/2016/8520703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 03/29/2016] [Indexed: 11/17/2022] Open
Abstract
Objectives. We describe an unusual case of surgical management of congenital mixed hearing loss in a female patient with inner ear malformation. This report outlines the role of temporal bone imaging and previous surgical history in evaluating a patient's risk of perilymph gusher during stapes surgery. Methods. A 68-year-old female patient with a history of profound bilateral mixed hearing loss due to ossicular and cochlear malformation presented to our otology clinic. She had undergone multiple unsuccessful previous ear surgeries. Computed tomography revealed bilateral inner ear malformations. She elected to proceed with revision stapedectomy. Results. The patient received modest benefit to hearing, and no operative complications occurred. Conclusions. Although stapedectomy has been shown to improve hearing in patients with stapes fixation, there is risk of perilymph gusher in patients with inner ear abnormalities. Evaluation and counseling of the risk of gusher during stapes surgery should be done on a case-by-case basis.
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Kumar S, Mawby T, Sivapathasingam V, Humphries J, Ramsden J. X-linked deafness: A review of clinical and radiological findings and current management strategies. World J Otorhinolaryngol 2016; 6:19-22. [DOI: 10.5319/wjo.v6.i1.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/17/2015] [Accepted: 01/19/2016] [Indexed: 02/06/2023] Open
Abstract
X-linked deafness is a rare genetic disorder causing a severe mixed hearing loss. This is due to an abnormal connection between the internal auditory meatus (IAM) and the basal turn of the cochlear leading to a “3rd window effect” and cochlear conductive hearing loss. Patients are traditionally treated with conventional hearing aids however these are often unsatisfactory. Cochlear implantation is a high-risk procedure in such cases due to the risk of inadvertent electrode placement in the IAM. We present three paediatric cases where the hearing loss was managed with a combination of a bone anchored hearing aid in combination with a conventional behind the ear hearing aid. We also present a review of the current literature regarding the management of X-linked deafness.
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Truesdale CM, Peterson RB, Hudgins PA, Vivas EX. Internal auditory canal meningocele-perilabyrinthine/translabyrinthine fistula: Case report and imaging. Laryngoscope 2015; 126:1931-4. [DOI: 10.1002/lary.25787] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Carl M. Truesdale
- Department of Otolaryngology; University of Michigan; Ann Arbor Michigan
| | - Ryan B. Peterson
- Department of Radiology and Imaging Sciences; Emory University School of Medicine; Atlanta Georgia U.S.A
| | - Patricia A. Hudgins
- Department of Radiology and Imaging Sciences; Emory University School of Medicine; Atlanta Georgia U.S.A
| | - Esther X. Vivas
- Department of Otolaryngology; Emory University School of Medicine; Atlanta Georgia U.S.A
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DeMarcantonio M, Choo DI. Radiographic Evaluation of Children with Hearing Loss. Otolaryngol Clin North Am 2015; 48:913-32. [DOI: 10.1016/j.otc.2015.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Arkink E, Frijns J, Verbist B. Answer to quiz case: Temporal bone imaging. SA J Radiol 2015. [DOI: 10.4102/sajr.v19i1.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Computed tomographic scanning of the petrous bone and magnetic resonance imaging sequences of the inner ear and cerebellopontine angle of a deaf patient were performed to find an explanation for his deafness, and to establish whether he would be a good candidate for cochlear implantation. The imaging features were considered pathognomonic for incomplete partition type III (IP type III). Further management and discussion of this deafness subtype are detailed.
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Cosetti MK, Friedmann DR, Heman-Ackah SE, Perez R, Waltzman SB, Roland JT. Surgical techniques and outcomes of cochlear implantation in patients with radiographic findings consistent with X-linked deafness. Int J Pediatr Otorhinolaryngol 2015; 79:1689-93. [PMID: 26250436 DOI: 10.1016/j.ijporl.2015.07.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 07/19/2015] [Accepted: 07/20/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES X-linked deafness is a potential etiology of sensorineural hearing loss characterized by bulbous dilatation of the fundus of the internal auditory canal (IAC) and the absence of the bony plates separating the basal turn of the cochlea and IAC. These malformations predispose patients to IAC insertion during cochlear implantation (CI). Our objective is to describe the surgical technique, audiometric and speech performance outcomes in a group of patients with this unique cochlear malformation. METHODS A retrospective chart review was performed of all patients at a tertiary care facility who underwent CI between January 2006 and July 2011. RESULTS A total of five patients were identified with radiographic findings characteristic of X-linked deafness, specifically a deficient modiolous, absent lamina cribrosa and bulbous IAC. A modified cochleostomy was utilized to ensure electrode insertion within the scala tympani avoiding the IAC. In each case, fluoroscopy was utilized to visual electrode progression during insertion and complete insertion was accomplished. All patients demonstrated improved speech performance following implantation. CONCLUSIONS Utilizing the techniques described, patients with these unique radiographic findings consistent with X-linked deafness may successfully undergo CI with excellent potential for auditory rehabilitation.
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Affiliation(s)
- Maura K Cosetti
- Departments of Otolaryngology-Head and Neck Surgery and Neurosurgery, Louisiana State University, Shreveport, LA, USA.
| | - David R Friedmann
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, USA
| | - Selena E Heman-Ackah
- Division of Otolaryngology, Beth Israel Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ronen Perez
- Department of Otolaryngology-Head and Neck Surgery, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel
| | - Susan B Waltzman
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, USA
| | - J Thomas Roland
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, USA
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