Genetics and molecular biology of deafness. Update

The role of temperament in traumatic hearing loss: a single case study of a cochlear-implanted patient

INTRODUCTION

The majority of existing research regarding cochlear-implanted patients focuses on acoustic perception and language skills in children and adolescents, or on the postoperative quality of life in adults.

PURPOSE

We hypothesized that a patient's psychological reaction to a cochlear implant (CI) may be influenced by the temperament of the implanted subject. This case study aims to assess whether temperament plays a role in the adaptation to CIs and if certain temperamental and character traits may be risk or protective factors for surgery and rehabilitation outcomes.

METHOD

We evaluated a 21-year-old male patient presenting a history of traumatic hearing loss. The Temperament and Character Inventory (TCI) was employed to obtain a psychological evaluation.

RESULTS

The findings suggest a connection between the scores obtained on the TCI questionnaire and the patient's behavior toward the CI. The effects of the operation may be mediated by some temperamental and character traits.

CONCLUSION

In the field of clinical psychology and hearing rehabilitation, psychological evaluation may contribute a more profound understanding of the personality dynamics that influence the patient's reaction toward traumatic hearing loss, compliance, and CI surgery outcomes.

Newborn hearing screening programme in Belgium: a consensus recommendation on risk factors

Background

Understanding the risk factors for hearing loss is essential for designing the Belgian newborn hearing screening programme. Accordingly, they needed to be updated in accordance with current scientific knowledge. This study aimed to update the recommendations for the clinical management and follow-up of newborns with neonatal risk factors of hearing loss for the newborn screening programme in Belgium.

Methods

A literature review was performed, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system assessment method was used to determine the level of evidence quality and strength of the recommendation for each risk factor. The state of scientific knowledge, levels of evidence quality, and graded recommendations were subsequently assessed using a three-round Delphi consensus process (two online questionnaires and one face-to-face meeting).

Results

Congenital infections (i.e., cytomegalovirus, toxoplasmosis, and syphilis), a family history of hearing loss, consanguinity in (grand)parents, malformation syndromes, and foetal alcohol syndrome presented a ‘high’ level of evidence quality as neonatal risk factors for hearing loss. Because of the sensitivity of auditory function to bilirubin toxicity, hyperbilirubinaemia was assessed at a ‘moderate’ level of evidence quality. In contrast, a very low birth weight, low Apgar score, and hospitalisation in the neonatal intensive care unit ranged from ‘very low’ to ‘low’ levels, and ototoxic drugs were evidenced as ‘very low’. Possible explanations for these ‘very low’ and ‘low’ levels include the improved management of these health conditions or treatments, and methodological weaknesses such as confounding effects, which make it difficult to conclude on individual risk factors. In the recommendation statements, the experts emphasised avoiding unidentified neonatal hearing loss and opted to include risk factors for hearing loss even in cases with weak evidence. The panel also highlighted the cumulative effect of risk factors for hearing loss.

Conclusions

We revised the recommendations for the clinical management and follow-up of newborns exhibiting neonatal risk factors for hearing loss on the basis of the aforementioned evidence-based approach and clinical experience from experts. The next step is the implementation of these findings in the Belgian screening programme.

Electronic supplementary material

The online version of this article (doi:10.1186/s12887-015-0479-4) contains supplementary material, which is available to authorized users.

Genetics of hearing loss: where are we standing now?

Hearing loss (HL) is the most common sensory impairment and is caused by a broad range of inherited to environmental causes. Inherited HL consists 50-60% of all HL cases. The inherited form of HL is further classified to different categories. More than 300 syndromes and 40 genes have been identified to result in different levels of HL. Although several diagnostic or screening tests have been developed, yet there are controversies around their use.

Você conhece esta síndrome?

Na síndrome de Waardenburg, genodermatose autossômica dominante, distúrbios da pigmentação (hipo ou acromia de pele e cabelos, heterocromia da íris) podem se associar a surdez, distopia do canto interno do olho e, eventualmente, outras malformações de intestino e ósseas. Os autores relatam um caso clínico da síndrome de Waardenburg tipo 2B, apresentam a classificação da doença com os critérios diagnósticos e discutem o diagnóstico diferencial, que deve ser feito com vitiligo, piebaldismo e diferentes formas de albinismo.