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Abstract
We compared the output of two electronic middle ear implants: the Otologics MET™ device and the Vibrant Soundbridge™ device. Both devices were programmed in the linear amplification mode. Aided minus unaided sound pressure levels recorded in the ear canal (objective gain) were compared to unaided minus aided soundfield thresholds (functional gain) in 13 patients with severe sensorineural hearing loss. In addition, input/output characteristics were studied with the help of ear canal measurements. Objective gain was consistently lower than functional gain, with wide variation between patients and frequencies. Using input/output data measured in the ear canal in combination with functional gain data, the mean maximum output of the two devices was estimated, expressed in dB SPL. In comparison to NAL-R target values, (functional) gain was adequate; however, the maximum output was low, especially for the Vibrant Soundbridge device.
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Affiliation(s)
- Ad Snik
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands.
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2
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Lagerkvist H, Carvalho K, Holmberg M, Petersson U, Cremers C, Hultcrantz M. Ten years of experience with the Ponto bone-anchored hearing system-A systematic literature review. Clin Otolaryngol 2020; 45:667-680. [PMID: 32386454 PMCID: PMC7496709 DOI: 10.1111/coa.13556] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/18/2020] [Indexed: 12/17/2022]
Abstract
Background Bone‐anchored hearing systems (BAHSs) are widely used for hearing rehabilitation and are indicated in cases of conductive and mixed hearing loss and in single‐sided deafness. The Ponto system, that is one available option, has been on the market since 2009. Objective of review The aim of this study is to systematically review the literature reporting on the Ponto system, with regard to audiological and surgical outcomes and patient's quality‐of‐life scores. Type of review A systematic literature search was performed in the PubMed database 2009‐July 2019. Search strategy Search term: ((osseointegrated hearing aid) OR (bone conduction implant) OR (bone anchored hearing) OR BAHA OR BAHS OR BAHI). Pre‐defined inclusion and exclusion criteria were applied. Evaluation method English‐language articles reporting original clinical data (audiological, surgical or quality‐of‐life outcomes) on the Ponto system were included. Articles reporting on Ponto and another BAHS system where the results on Ponto constituted less than 50% of the patient population or including only results on testband or softband devices were excluded. Results Audiological outcomes were discussed in 20 publications. Improvement against the unaided thresholds was demonstrated. The functional improvement was on average 33.9 dB. The effective gain or remaining air‐bone gap was on average 6.7 dB. All evaluated data showed aided speech reception thresholds significantly below normal speech level. Twenty‐seven publications reported surgical and follow‐up data for the Ponto system. Implant survival was 97.7%, adverse skin reactions (Holgers ≥ 2) were 5% across visits and 15% across patients. No complications were life‐threatening, causing permanent disability/damage or requiring a hospitalisation. Five studies reported quality of life using the Glasgow benefit inventory, 98% reported an improvement when analysing the score on an individual level. Conclusions The outcomes of this systematic review confirm that percutaneous systems provide consistent audiological benefits and improved quality of life for patients. Further, the review demonstrates that the percutaneous systems are safe, with relatively low complication rates. Skin‐related complications are the most common complication type and are experienced by approximately one patient out of seven, or in less than one of 20 follow‐up visits.
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Affiliation(s)
| | | | | | | | - Cor Cremers
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
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Burggraaf J, Mylanus EAM, Pennings RJE, Cremers C. Malleostapedotomy with the self-fixing and articulated titanium piston. Eur Arch Otorhinolaryngol 2018; 275:1715-1722. [PMID: 29779038 PMCID: PMC5992232 DOI: 10.1007/s00405-018-4999-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/12/2018] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the results of malleostapedotomy performed by applying the self-fixing and articulated titanium piston according to Häusler. STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS AND INTERVENTIONS This study concerns a retrospective analysis of the results of malleostapedotomy with the use of a self-fixing articulated titanium piston in 16 ears of 16 consecutively treated patients between 2005 and 2009. The medical files were used for the acquisition of data on medical and surgical history and to obtain pre- and postoperative audiometry. Diagnosis and outcomes of mainly revision surgeries are presented and compared to the literature. MAIN OUTCOME MEASURES Effect of (revision) malleostapedotomy by evaluating postoperative audiometry and air-bone gap closure. RESULTS The postoperative air-bone gap closure was ≤ 10 dB in 9/16 (56%) ears and within ≤ 20 dB in 13/16 (81%) ears. The mean postoperative air-bone gap was 14.3 dB HL (0.5-2.0 kHz) and 17.3 dB HL (0.5-4.0 kHz). Postoperatively, there was no increase in bone conduction thresholds larger than 3 dB (0.5-2.0 kHz) and postoperative dizziness was absent or very limited and transient. CONCLUSIONS The malleostapedotomy procedure has become surgically less demanding over time by the technical improvements present in the nowadays available pistons. The design of the self-fixing and articulated titanium piston used in the present group of patients allows a safe and straight-forward malleostapedotomy procedure. Present hearing outcomes match with results presented in the literature.
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Affiliation(s)
- J Burggraaf
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - E A M Mylanus
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - R J E Pennings
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Cor Cremers
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Jurzinsky T, Bär R, Cremers C, Tübke J, Elsner P. Highly active carbon supported palladium-rhodium PdXRh/C catalysts for methanol electrooxidation in alkaline media and their performance in anion exchange direct methanol fuel cells (AEM-DMFCs). Electrochim Acta 2015. [DOI: 10.1016/j.electacta.2015.07.176] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Niether C, Rau M, Cremers C, Jones D, Pinkwart K, Tübke J. Development of a novel experimental DEMS set-up for electrocatalyst characterization under working conditions of high temperature polymer electrolyte fuel cells. J Electroanal Chem (Lausanne) 2015. [DOI: 10.1016/j.jelechem.2015.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bach Delpeuch A, Chatenet M, Cremers C, Tübke T. Mass spectrometric investigation of ethanol and acetaldehyde adsorbates electrooxidation on Pt electrocatalyst. Electrochim Acta 2014. [DOI: 10.1016/j.electacta.2014.06.143] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Morava E, Kühnisch J, Drijvers JM, Robben JH, Cremers C, van Setten P, Branten A, Stumpp S, de Jong A, Voesenek K, Vermeer S, Heister A, Claahsen-van der Grinten HL, O'Neill CW, Willemsen MA, Lefeber D, Deen PMT, Kornak U, Kremer H, Wevers RA. Autosomal recessive mental retardation, deafness, ankylosis, and mild hypophosphatemia associated with a novel ANKH mutation in a consanguineous family. J Clin Endocrinol Metab 2011; 96:E189-98. [PMID: 20943778 PMCID: PMC5393418 DOI: 10.1210/jc.2010-1539] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Mutations in ANKH cause the highly divergent conditions familial chondrocalcinosis and craniometaphyseal dysplasia. The gene product ANK is supposed to regulate tissue mineralization by transporting pyrophosphate to the extracellular space. OBJECTIVE We evaluated several family members of a large consanguineous family with mental retardation, deafness, and ankylosis. We compared their skeletal, metabolic, and serological parameters to that of the autosomal recessive progressive ankylosis (ank) mouse mutant, caused by a loss-of-function mutation in the murine ortholog Ank. PARTICIPANTS The studied patients had painful small joint soft-tissue calcifications, progressive spondylarthropathy, osteopenia, mild hypophosphatemia, mixed hearing loss, and mental retardation. RESULTS After mapping the disease gene to 5p15, we identified the novel homozygous ANK missense mutation L244S in all patients. Although L244 is a highly conserved amino acid, the mutated ANK protein was detected at normal levels at the plasma membrane in primary patient fibroblasts. The phenotype was highly congruent with the autosomal recessive progressive ankylosis (ank) mouse mutant. This indicates a loss-of-function effect of the L244S mutation despite normal ANK protein expression. Interestingly, our analyses revealed that the primary step of joint degeneration is fibrosis and mineralization of articular soft tissues. Moreover, heterozygous carriers of the L244S mutation showed mild osteoarthritis without metabolic alterations, pathological calcifications, or central nervous system involvement. CONCLUSION Beyond the description of the first human progressive ankylosis phenotype, our results indicate that ANK influences articular soft tissues commonly involved in degenerative joint disorders. Furthermore, this human disorder provides the first direct evidence for a role of ANK in the central nervous system.
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Affiliation(s)
- Eva Morava
- Radboud University Nijmegen, Department of Pediatrics, Nijmegen, The Netherlands.
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Abstract
OBJECTIVE To assess the relation between cost and effectiveness of implantable middle ear hearing devices in patients with pure sensorineural hearing loss. DESIGN Literature review. RESULTS Four studies were identified that described the effect of middle ear implantation on quality of life in groups of at least 20 patients. Several different quality of life questionnaires were used. CONCLUSIONS Our review demonstrated that middle ear implantation is a cost-effective health care intervention in patients with sensorineural hearing loss who suffered an additional therapy-resistant chronic external otitis.
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Van Eyken E, Van Laer L, Fransen E, Topsakal V, Hendrickx JJ, Demeester K, Van de Heyning P, Mäki-Torkko E, Hannula S, Sorri M, Jensen M, Parving A, Bille M, Baur M, Pfister M, Bonaconsa A, Mazzoli M, Orzan E, Espeso A, Stephens D, Verbruggen K, Huyghe J, Dhooge I, Huygen P, Kremer H, Cremers C, Kunst S, Manninen M, Pyykkö I, Rajkowska E, Pawelczyk M, Sliwinska-Kowalska M, Steffens M, Wienker T, Van Camp G. The contribution of GJB2 (Connexin 26) 35delG to age-related hearing impairment and noise-induced hearing loss. Otol Neurotol 2007; 28:970-5. [PMID: 17909436 DOI: 10.197/mao.0b013e3180dca1b9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
HYPOTHESIS The common GJB2 (Connexin 26) 35delG mutation might contribute to the development of age-related hearing impairment (ARHI) and noise-induced hearing loss (NIHL). BACKGROUND GJB2, a gene encoding a gap junction protein expressed in the inner ear, has been suggested to be involved in the potassium recycling pathway in the cochlea. GJB2 mutations account for a large number of individuals with nonsyndromic recessive hearing loss, with 35delG being the most frequent mutation in populations of European origin. Other genes involved in potassium homeostasis have been suggested to be associated with ARHI and NIHL, and distortion product otoacoustic emission distortions indicative of hearing loss alterations have been found in 35delG carriers. METHOD We genotyped 35delG in two distinct sample sets: an ARHI sample set, composed of 2,311 Caucasian samples from nine different centers originating from seven different countries with an age range between 53 and 67 years, and an NIHL sample set consisting of 702 samples from the two extremes of a noise-exposed Polish sample. RESULTS After statistical analysis, we were unable to detect an association between 35delG and ARHI, nor between 35delG and NIHL. CONCLUSION Our findings indicate that there is no increased susceptibility in 35delG carriers for the development of ARHI or NIHL.
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Affiliation(s)
- Els Van Eyken
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
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Snik A, Cremers C. Audiometric evaluation of an attempt to optimize the fixation of the transducer of a middle-ear implant to the ossicular chain with bone cement. Clin Otolaryngol Allied Sci 2004; 29:5-9. [PMID: 14961845 DOI: 10.1111/j.1365-2273.2004.00749.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Typically, an implantable hearing device consists of a transducer that is coupled to the ossicular chain and electronics. The coupling is of major importance. The Vibrant Soundbridge (VSB) is such an implantable device; normally, the VSB transducer is fixed to the ossicular chain by means of a special clip that is crimped around the long process of the incus. In addition to crimping, bone cement was used to optimize the fixation in six patients. Long-term results were compared to those of five controls with crimp fixation alone. To assess the effect of bone cement (SerenoCem, Corinthian Medical Ltd, Nottingham, UK) on hearing thresholds, long-term post-surgery thresholds were compared to pre-surgery thresholds. Bone cement did not have any negative effect. Next, to test the hypothesis that aided thresholds might be better with the use of bone cement, aided thresholds were studied. After correction for the severity of hearing loss, only a small difference was found between the two groups at one frequency, viz. 2 kHz. It was concluded that there was no negative effect of using bone cement; however, there is also no reason to use bone cement in VSB users on a regular basis.
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Affiliation(s)
- A Snik
- Department of Otorhinolaryngology, University Hospital, Nijmegen, the Netherlands.
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Nuijten I, Admiraal R, Van Buggenhout G, Cremers C, Frijns JP, Smeets D, van Ravenswaaij-Arts C. Congenital Aural Atresia in 18q Deletion or de Grouchy Syndrome. Otol Neurotol 2003; 24:900-6. [PMID: 14600472 DOI: 10.1097/00129492-200311000-00014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study the occurrence of congenital aural atresia in patients with a deletion of the long arm of chromosome 18 (18q- deletion or de Grouchy syndrome). STUDY DESIGN AND PATIENTS This retrospective study presents an overview of the otologic findings in 33 Dutch and Belgian patients with a deletion of 18q. MATERIALS AND METHODS Detailed information on otorhinolaryngological findings was obtained from otorhinolaryngologists and audiologic centers. Data about medical and developmental history and phenotype were collected from physical examination by a clinical geneticist, by interviewing parents, and by reviewing medical and developmental records. Determination of deletion breakpoints was established by routine karyotyping, prometaphase studies, and/or fluorescence in-situ hybridization (FISH). RESULTS Twenty out of 33 patients (61%) with a deletion 18q had congenital aural atresia (CAA) ranging from narrow external auditory canals to meatal atresia type IIB. Fifteen patients (45%) had conductive hearing impairment (range: 30 dB-70 dB). Twelve of these 15 patients (80%) received hearing aids, which resulted in improved hearing but not in speech development. CAA was found only in patients with a distal deletion of 18q (including band 18q22.3 or 18q23) and not in patients with more proximal 18q deletions. CONCLUSION In patients with narrow ear canals or meatal atresia and unexplained mental retardation, chromosomal analysis is indicated. If de Grouchy syndrome is diagnosed in a young patient, auditory examination and surveillance are highly recommended.
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Affiliation(s)
- Inge Nuijten
- Department of Human Genetics, University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Wagenaar M, Schuknecht H, Nadol J, Benraad-Van Rens M, Pieke-Dahl S, Kimberling W, Cremers C. Histopathologic features of the temporal bone in usher syndrome type I. Arch Otolaryngol Head Neck Surg 2000; 126:1018-23. [PMID: 10922238 DOI: 10.1001/archotol.126.8.1018] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Temporal bones of 2 patients with Usher syndrome type I were examined using light microscopy. In both patients, findings from histopathologic examination of the cochlea were characterized by degeneration of the organ of Corti, which was most marked in the basal turn, atrophy of the stria vascularis, and a decrease in the number of spiral ganglion cells. The cochlear nerve appeared to be diminished. The sensory epithelium of the saccular and utricular maculae of patient 1 was normal for age. The left temporal bone of patient 2, classified as Usher syndrome genetic subtype USH1D or USH1F, demonstrated the typical signs of severe cochleosaccular degeneration. Present cases and cases from the literature were reviewed in search of an explanation for the above-described differences in histologic findings.
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Affiliation(s)
- M Wagenaar
- Department of Otorhinolaryngology, University Hospital Nijmegen, the Netherlands
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Weston MD, Eudy JD, Fujita S, Yao SF, Usami S, Cremers C, Greenburg J, Ramesar R, Martini A, Moller C, Smith RJ, Sumegi J, Kimberling WJ. Genomic structure and identification of novel mutations in usherin, the gene responsible for Usher syndrome type IIa. Am J Hum Genet 2000; 66:1199-210. [PMID: 10729113 PMCID: PMC1288187 DOI: 10.1086/302855] [Citation(s) in RCA: 138] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/1999] [Accepted: 01/14/2000] [Indexed: 01/11/2023] Open
Abstract
Usher syndrome type IIa (USHIIa) is an autosomal recessive disorder characterized by moderate to severe sensorineural hearing loss and progressive retinitis pigmentosa. This disorder maps to human chromosome 1q41. Recently, mutations in USHIIa patients were identified in a novel gene isolated from this chromosomal region. The USH2A gene encodes a protein with a predicted molecular weight of 171.5 kD and possesses laminin epidermal growth factor as well as fibronectin type III domains. These domains are observed in other protein components of the basal lamina and extracellular matrixes; they may also be observed in cell-adhesion molecules. The intron/exon organization of the gene whose protein we name "Usherin" was determined by direct sequencing of PCR products and cloned genomic DNA with cDNA-specific primers. The gene is encoded by 21 exons and spans a minimum of 105 kb. A mutation search of 57 independent USHIIa probands was performed with a combination of direct sequencing and heteroduplex analysis of PCR-amplified exons. Fifteen new mutations were found. Of 114 independent USH2A alleles, 58 harbored probable pathologic mutations. Ten cases of USHIIa were true homozygotes and 10 were compound heterozygotes; 18 heterozygotes with only one identifiable mutation were observed. Sixty-five percent (38/58) of cases had at least one mutation, and 51% (58/114) of the total number of possible mutations were identified. The allele 2299delG (previously reported as 2314delG) was the most frequent mutant allele observed (16%; 31/192). Three new missense mutations (C319Y, N346H, and C419F) were discovered; all were restricted to the previously unreported laminin domain VI region of Usherin. The possible significance of this domain, known to be necessary for laminin network assembly, is discussed in the context of domain VI mutations from other proteins.
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Affiliation(s)
- M. D. Weston
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - J. D. Eudy
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - S. Fujita
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - S.-F. Yao
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - S. Usami
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - C. Cremers
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - J. Greenburg
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - R. Ramesar
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - A. Martini
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - C. Moller
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - R. J. Smith
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - J. Sumegi
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
| | - William J. Kimberling
- Department of Genetics, Boys Town National Research Hospital, and Center for Molecular Genetics, Monroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha; Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, and Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan; Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands; University of Cape Town Medical School, Department of Genetics, Cape Town, South Africa; ENT Department, Universita di Ferrara, Ferrara, Italy; Department of Audiology, Sahlgrenska University Hospital, Gotebörg, Sweden; Molecular Otolaryngology Research Laboratories, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
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Kunst H, Huybrechts C, Marres H, Huygen P, Van Camp G, Cremers C. The phenotype of DFNA13/COL11A2: nonsyndromic autosomal dominant mid-frequency and high-frequency sensorineural hearing impairment. Am J Otol 2000; 21:181-7. [PMID: 10733181 DOI: 10.1016/s0196-0709(00)80006-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To study nonsyndromic progressive sensorineural hearing impairment in patients with a COL11A2 mutation (DFNA13) in a Dutch kindred. STUDY DESIGN Survey. SETTING Department of otorhinolaryngology of a university hospital. PATIENTS Twenty-one living members of a Dutch family (150 relatives in 5 generations; 49 were studied) with autosomal dominant nonsyndromic sensorineural hearing impairment showed linkage to the DFNA13 locus. Mutation analysis revealed a missense mutation in the COL11A2 gene. METHODS History was taken, hearing threshold levels were measured in all affected persons, and penetrance was evaluated. Longitudinal analysis (using linear regression analysis of threshold-on-age data) was possible in only 1 case. Cross-sectional analysis comprised the comparison of threshold levels between different generations of the family. Also, hearing thresholds were corrected for median presbyacusis to find out whether the hearing impairment characteristic of this trait is stationary or progressive. Vestibular functions were evaluated with electronystagmography, by use of rotatory and caloric tests. RESULTS Most of the affected persons dated their first hearing impairment symptoms to the second to third decade of life. A possibly reduced penetrance was found. Anamnestically, 4 affected persons had hearing impairment symptoms from early childhood onward. Longitudinal analysis in the proband (IV26) revealed the exceptional combination of congenital offset and substantial early progression. Most of the threshold levels differed significantly between the frequencies within each age group and, at the high frequencies (2-8 kHz), between the two age groups covered by generations IV and III (ages 30-38 years and 58-74 years, respectively); the latter could be attributed to presbyacusis. Various caloric abnormalities, including areflexia, were found in about half (8/17) of the tested subjects with sensorineural hearing impairment. CONCLUSIONS Correction for age, hearing impairment-presumably present and stationary from an early age onward-showed the worst or second-worst threshold usually at 1, 2, and 6 kHz (3540 dB) or 8 kHz (50 dB), whereas the best or second-best threshold was found at 0.25 to 0.5 and 4 kHz (25 dB). Presbyacusis, presumably from the fourth decade of life onward, caused a change of the typically shaped audiogram described as midfrequency hearing impairment with additional high-frequency impairment.
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MESH Headings
- Adult
- Aged
- Auditory Threshold/physiology
- Chromosome Aberrations
- Chromosome Disorders
- Chromosomes, Human, Pair 6
- DNA Mutational Analysis
- Female
- Follow-Up Studies
- Gene Expression/genetics
- Genes, Dominant/genetics
- Hearing Loss, High-Frequency/complications
- Hearing Loss, High-Frequency/diagnosis
- Hearing Loss, High-Frequency/genetics
- Hearing Loss, Sensorineural/complications
- Hearing Loss, Sensorineural/diagnosis
- Hearing Loss, Sensorineural/genetics
- Humans
- Male
- Middle Aged
- Mutation, Missense/genetics
- Pedigree
- Penetrance
- Phenotype
- Point Mutation/genetics
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Affiliation(s)
- H Kunst
- Department of Otorhinolaryngology, University Hospital, Nijmegen, The Netherlands
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16
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Kunst H, Marres H, Huygen P, van Duijnhoven G, Krebsova A, van der Velde S, Reis A, Cremers F, Cremers C. Non-syndromic autosomal dominant progressive non-specific mid-frequency sensorineural hearing impairment with childhood to late adolescence onset (DFNA21). Clin Otolaryngol Allied Sci 2000; 25:45-54. [PMID: 10764236 DOI: 10.1046/j.1365-2273.2000.00327.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An autosomal dominant trait of progressive, non-syndromic, non-specific mid-frequency sensorineural hearing impairment was identified in a Dutch family. Many affected family members (n = 21) were identified, among whom seven out of nine relatives aged < 30 years do not show pure mid-frequency hearing impairment, which suggests variable expression. Regression analysis was used to evaluate the age-related hearing threshold data in a cross-sectional analysis in 24 affected patients and in a longitudinal analysis in five of these. At all frequencies, progression in hearing impairment (i.e. the regression coefficient) was significant and fairly similar: the pooled value was about 1.0 dB/y. There was no significant (i.e. not =0 dB) offset threshold (i.e. Y intercept at age 0) found at any frequency. The regression lines could be pooled for the low frequencies (0.25-0.5 kHz) and the mid/high frequencies (1-8 kHz) and this produced apparent onset ages of about 3 and 4 years and annual threshold increases of 0.75 and 1.1 dB/y, respectively. In most patients there is a relatively late onset age (maximum in the range of at least 25-45 years). However, based on the longitudinal analysis of a patient from the age of 4 years onwards in some patients sensorineural hearing impairment might be congenital/prelingual. Oculo-vestibular function was found to be normal. Results from linkage studies tentatively position the underlying gene defect telomeric to the repositioned DFNA13 locus at chromosome 6p21-22.
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Affiliation(s)
- H Kunst
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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17
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Wagenaar M, Draaijer P, Meek H, ten Donkelaar HJ, Wesseling P, Kimberling W, Cremers C. The cochlear nuclei in two patients with Usher syndrome type I. Int J Pediatr Otorhinolaryngol 1999; 50:185-95. [PMID: 10595664 DOI: 10.1016/s0165-5876(99)00246-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
HYPOTHESIS Does long-term sound deprivation lead to degeneration of the cochlear nuclei in two Usher type I patients? METHODS The cochlear nuclei of these patients were morphometrically analyzed and compared with two age-matched controls. Routine autopsy of the brainstems was performed before the design of this study was known. During this procedure, the ventral cochlear nucleus (VCN) can easily be damaged. Five partially damaged VCN could nevertheless be analyzed for this study, including the right VCN of Usher patient 1 and both VCN of Usher patient 2. Using 15 microm thick serial paraffine sections of the cochlear nuclei, estimates of volume, neuronal densities, number of cells and mean cell diameter of the dorsal cochlear nucleus (DCN) and VCN were obtained. RESULTS This study presents unique material of the cochlear nuclei in two patients with Usher syndrome type I. Data regarding volume and total cell number of the VCN are influenced by the absence of a part of the VCN. Results suggest a decrease in mean cell diameter of the VCN in Usher patients. Other parameters of the VCN and DCN, however, showed no major differences between Usher type I patients and controls. CONCLUSION Only minor degenerative changes are apparent in the cochlear nuclei of two patients with Usher type I, who were deprived of acoustic stimuli since birth.
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Affiliation(s)
- M Wagenaar
- Department of Otorhinolaryngology, University Hospital Nijmegen and Faculty of Medical Sciences, University of Nijmegen, The Netherlands
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18
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Declau F, Cremers C, Van de Heyning P. Diagnosis and management strategies in congenital atresia of the external auditory canal. Study Group on Otological Malformations and Hearing Impairment. Br J Audiol 1999; 33:313-27. [PMID: 10890146 DOI: 10.3109/03005369909090115] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This consensus report represents a distillation of current opinion regarding diagnosis and management of congenital aural atresia. It also takes into account the philosophical differences which exist in Europe. Congenital aural atresia requires prompt diagnosis, genetic counselling and an early assessment of hearing. In bilateral atresia, early amplification with a bone conduction hearing aid is essential for proper speech development. Further rehabilitation in bilateral cases is managed with surgical reconstruction in selected patients or by implantation of a bone-anchored hearing aid. Atresia repair surgery is worthwhile if proper patient selection is made by use of stringent audiological and radiological criteria and state of the art surgery is performed. The divergent views concerning indications, ideal age for surgery and surgical approach to achieve better hearing are discussed. Review of the literature demonstrated that even in the hands of the best surgeons a mean hearing gain of only 20-25 dB is achieved in atresia Type II, with 30-35 dB in Type I. Therefore, surgical reconstruction should only be done in the more favourable cases where post-operative hearing of <25-30 dB is attainable. Less favoured patients should be helped with bone-anchored hearing aids, as this type of surgery does not interfere with the future use of new techniques.
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Affiliation(s)
- F Declau
- Department of Otorhinolaryngology, Head and Neck Surgery and Communication Disorders, University of Antwerp, Edegem, Belgium
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19
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van Aarem A, Wagenaar M, Tonnaer E, Pieke Dahl S, Bisseling J, Janssen H, Bastiaans B, Kimberling W, Cremers C. Semen analysis in the Usher syndrome type 2A. ORL J Otorhinolaryngol Relat Spec 1999; 61:126-30. [PMID: 10325550 DOI: 10.1159/000027656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Semen analysis in patients with Usher syndrome suggested that defective connecting cilia axonemes may be involved in the irreversible, progressive loss of photoreceptors in Usher's syndrome. In the framework of clinical genetic research into Usher syndrome, a pilot study was set up to test these findings. The semen of 6 Usher 2A patients was analysed. The fertility status of the study group of Usher 2A patients was evaluated, including semen analysis, supplemented by electron microscopic examination of the spermatozoa. Except for a significantly increased pH value, no abnormalities were found in the functional semen analysis, whereas electron microscopy revealed microtubular tail abnormalities. The latter finding was of little relevance, however, in view of the normal motility of the spermatozoa observed in these patients. There were no fertility problems in our group of Usher 2A patients, nor have any been mentioned in Usher patients in general. Earlier study findings were not supported by our data.
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Affiliation(s)
- A van Aarem
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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20
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Kunst H, Marres H, Huygen P, Van Camp G, Joosten F, Cremers C. Autosomal dominant non-syndromal low-frequency sensorineural hearing impairment linked to chromosome 4p16 (DFNA14): statistical analysis of hearing threshold in relation to age and evaluation of vestibulo-ocular functions. Audiology 1999; 38:165-73. [PMID: 10437687 DOI: 10.3109/00206099909073018] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A Dutch kindred was studied with low-frequency sensorineural hearing impairment linked to a new locus on chromosome 4p16 (DFNA14). Of the affected individuals, 21 (aged 11-75 years) were examined and the most recent audiogram was used for cross-sectional analysis of hearing threshold in relation to age. Suitable serial audiograms were available for a longitudinal analysis in nine cases: they had been obtained from the age of six years onwards and covered a follow-up period from 14 to 36 years. The presumably congenital (offset) component of SNHI was extrapolated or estimated from average values and offset thresholds were found of about 45 dB at 0.25-1 kHz, 25 dB at 2 kHz and 10 dB at 4-8 kHz. Significant progression in hearing impairment occurred at all frequencies, but could be attributed to presbyacusis. The combination of congenital, stationary low-frequency SNHI and presbyacusis resulted in an up-sloping audiogram in the first five decades of life, which evolved into a flat-type audiogram in the sixth or seventh decade and a down-sloping audiogram at a more advanced age. With few exceptions, vestibular function was intact.
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Affiliation(s)
- H Kunst
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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21
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Wagenaar M, van Aarem A, Huygen P, Pieke-Dahl S, Kimberling W, Cremers C. Hearing impairment related to age in Usher syndrome types 1B and 2A. Arch Otolaryngol Head Neck Surg 1999; 125:441-5. [PMID: 10208682 DOI: 10.1001/archotol.125.4.441] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To evaluate hearing impairment in 2 common genetic subtypes of Usher syndrome, USH1B and USH2A. DESIGN Cross-sectional analysis of hearing threshold related to age in patients with genotypes determined by linkage and mutation analysis. SETTING Otolaryngology department, university referral center. PATIENTS Nineteen patients with USH1B and 27 with USH2A were examined. All participants were living in the Netherlands and Belgium. MAIN OUTCOME MEASURE Pure tone audiometry of the best ear at last visit. RESULTS The patients with USH1B had residual hearing without age dependence, with minimum thresholds of 80, 95, and 120 dB at 0.25, 0.5, and 1 to 2 kHz, respectively. Mean thresholds of patients with USH2A were about 45 to 55 dB better than these minimum values. Distinctive audiographic features of patients with USH2A were maximum hearing thresholds of 70, 80, and 100 dB at 0.25, 0.5, and 1 kHz, respectively, only at younger than 40 years. Progression of hearing impairment in USH2A was 0.7 dB/y on average for 0.25 to 4 kHz and could not be explained by presbyacusis alone. CONCLUSIONS The USH1B and USH2A can be easily distinguished by hearing impairment at younger than 40 years at the low frequencies. Hearing impairment in our patients with USH2A could be characterized as progressive.
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Affiliation(s)
- M Wagenaar
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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22
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Cremers C, Degen J. Spectroscopic evidence for the coexistence of tetragonal and trigonal minima within the exited state adiabatic potential energy surfaces of hexachlorotellurate and -selenate complexes. J Chem Phys 1998. [DOI: 10.1063/1.477517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Eudy JD, Weston MD, Yao S, Hoover DM, Rehm HL, Ma-Edmonds M, Yan D, Ahmad I, Cheng JJ, Ayuso C, Cremers C, Davenport S, Moller C, Talmadge CB, Beisel KW, Tamayo M, Morton CC, Swaroop A, Kimberling WJ, Sumegi J. Mutation of a gene encoding a protein with extracellular matrix motifs in Usher syndrome type IIa. Science 1998; 280:1753-7. [PMID: 9624053 DOI: 10.1126/science.280.5370.1753] [Citation(s) in RCA: 258] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Usher syndrome type IIa (OMIM 276901), an autosomal recessive disorder characterized by moderate to severe sensorineural hearing loss and progressive retinitis pigmentosa, maps to the long arm of human chromosome 1q41 between markers AFM268ZD1 and AFM144XF2. Three biologically important mutations in Usher syndrome type IIa patients were identified in a gene (USH2A) isolated from this critical region. The USH2A gene encodes a protein with a predicted size of 171.5 kilodaltons that has laminin epidermal growth factor and fibronectin type III motifs; these motifs are most commonly observed in proteins comprising components of the basal lamina and extracellular matrixes and in cell adhesion molecules.
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Affiliation(s)
- J D Eudy
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
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24
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Affiliation(s)
- H Kunst
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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25
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Kunst H, Marres H, Huygen P, Ensink R, Van Camp G, Van Hauwe P, Coucke P, Willems P, Cremers C. Nonsyndromic autosomal dominant progressive sensorineural hearing loss: audiologic analysis of a pedigree linked to DFNA2. Laryngoscope 1998; 108:74-80. [PMID: 9432071 DOI: 10.1097/00005537-199801000-00014] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An analysis was performed of the regression of the individual hearing threshold on age in the affected persons in a six-generation Dutch family with nonsyndromic autosomal dominant sensorineural hearing loss, which showed linkage to the DFNA2(1p34) region, similar to at least four previously reported nonrelated families. The offset threshold was significantly higher at the high frequencies (around 30 dB at 2 to 8 kHz) than at the lower ones (approximately 0 dB at 0.25 to 1 kHz). Hearing impairment at the higher frequencies may therefore have been present already at birth or in early childhood. The regression coefficient, or the 'annual threshold increase,' expressed in dB/y, was about 1 dB/y on average, but the higher frequencies (1 to 8 kHz) showed significantly more rapid progression than the lower frequencies (0.25 to 0.5 kHz).
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Affiliation(s)
- H Kunst
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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26
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Marres H, van Ewijk M, Huygen P, Kunst H, van Camp G, Coucke P, Willems P, Cremers C. Inherited nonsyndromic hearing loss. An audiovestibular study in a large family with autosomal dominant progressive hearing loss related to DFNA2. Arch Otolaryngol Head Neck Surg 1997; 123:573-7. [PMID: 9193215 DOI: 10.1001/archotol.1997.01900060015002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To study nonsyndromic progressive sensorineural hearing loss (SNHL) with significant linkage to the DFNA2 locus on chromosome 1p in a Dutch kindred. DESIGN A 6-generation family with 194 family members was studied. Of the presumably affected persons, 43 were examined in detail to obtain audiograms and 37 underwent vestibulo-ocular examination. RESULTS Regression analysis showed significant and equal linear progression in SNHL with age (by about 1 dB per year) at all frequencies. Offset values were close to zero at the low frequencies (0.25, 0.5, and 1 kHz) but increased systematically with the frequency. It is likely that they represent congenital high-frequency SNHL: about 15 dB at 2 kHz, 30 dB at 4 kHz, and 50 dB at 8 kHz. Bilateral caloric weakness was not observed. A significant finding was that 25% to 35% (depending on the exclusion criteria) of the patients showed an increased vestibulo-ocular reflex (hyperreactivity) as measured by rotatory responses. Forty-one patients showed significant linkage to the 1p locus. CONCLUSIONS Including the present family, 4 families have been reported to show linkage to chromosome 1p. Statistical analysis of the audiological data shows a progression of 1 dB per octave per year in this type of progressive SNHL.
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Affiliation(s)
- H Marres
- Department of Otorhinolaryngology, University Hospital Nijmegen, the Netherlands
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27
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Abstract
Sensorineural hearing loss affects approximately 1 in 2 persons at about 80 years of age and 1 in 750 in childhood. The best known forms of hearing loss with an autosomal dominant pattern of inheritance are the syndromic-mediated ones. At present, the non-syndromic autosomal dominant inherited forms can only be distinguished by the shape of the tone-audiogram. Based on gene linkage studies twelve different genotypes for autosomal dominant hereditary non-syndromic forms of sensorineural hearing loss have been recognized in a period of almost 2 years. In view of the great diversity of types that have been recognized in such a short period, it can be expected that over the next 10 years, several dozens genetically-mediated forms of autosomal dominant inherited sensorineural hearing loss will be detected. Similar developments are taking place in the non-syndromic autosomal recessive hereditary forms of sensorineural hearing loss and deafness. The above indicates clearly that before too long, new genetic investigation techniques will enable us to distinguish between forms of sensorineural hearing loss that could not be distinguished in the past.
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Affiliation(s)
- C Stinckens
- Department of Otorhinolaryngology, University Hospitals Leuven, Belgium
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28
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Weston MD, Kelley PM, Overbeck LD, Wagenaar M, Orten DJ, Hasson T, Chen ZY, Corey D, Mooseker M, Sumegi J, Cremers C, Moller C, Jacobson SG, Gorin MB, Kimberling WJ. Myosin VIIA mutation screening in 189 Usher syndrome type 1 patients. Am J Hum Genet 1996; 59:1074-83. [PMID: 8900236 PMCID: PMC1914835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Usher syndrome type 1b (USH1B) is an autosomal recessive disorder characterized by congenital profound hearing loss, vestibular abnormalities, and retinitis pigmentosa. The disorder has recently been shown to be caused by mutations in the myosin VIIa gene (MYO7A) located on 11q14. In the current study, a panel of 189 genetically independent Usher I cases were screened for the presence of mutations in the N-terminal coding portion of the motor domain of MYO7A by heteroduplex analysis of 14 exons. Twenty-three mutations were found segregating with the disease in 20 families. Of the 23 mutations, 13 were unique, and 2 of the 13 unique mutations (Arg212His and Arg212Cys) accounted for the greatest percentage of observed mutant alleles (8/23, 31%). Six of the 13 mutations caused premature stop codons, 6 caused changes in the amino acid sequence of the myosin VIIa protein, and 1 resulted in a splicing defect. Three patients were homozygotes or compound heterozygotes for mutant alleles; these three cases were Tyr333Stop/Tyr333Stop, Arg212His-Arg302His/Arg212His-Arg302His, and IVS13nt-8c-->g/Glu450Gln. All the other USH1B mutations observed were simple heterozygotes, and it is presumed that the mutation on the other allele is present in the unscreened regions of the gene. None of the mutations reported here were observed in 96 unrelated control samples, although several polymorphisms were detected. These results add three patients to single case reported previously where mutations have been found in both alleles and raises the total number of unique mutations in MYO7A to 16.
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Affiliation(s)
- M D Weston
- Department of Genetics, Boys Town National Research Hospital, University of Nebraska Medical Center, Omaha, USA
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29
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Wagenaar M, ter Rahe B, van Aarem A, Huygen P, Admiraal R, Bleeker-Wagemakers E, Pinckers A, Kimberling W, Cremers C. Clinical findings in obligate carriers of type I Usher syndrome. Am J Med Genet 1995; 59:375-9. [PMID: 8599365 DOI: 10.1002/ajmg.1320590319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Seventeen obligate carriers from nine families with autosomal recessive Usher syndrome type I underwent otological, audiological, vestibular, and ophthalmological examination in order to identify possible manifestations of heterozygosity. Linkage studies were performed and six families showed linkage to chromosome region 11q13.5 while 3 families have so far failed to show linkage to the candidate regions. Eight obligate carriers had an abnormal pure-tone audiogram. Two different audiometric patterns could be distinguished when hearing loss was corrected for age and sex. Four carriers (24%) had significant sensorineural hearing loss (SNHL) which increased at higher frequencies. The other 13 carriers had SNHL of about 10 dB at 0.25 and 0.5 kHz, but less at higher frequencies. Vestibular findings were generally normal. Electro-oculography demonstrated a significant lower mean light peak/dark trough ratio in Usher type I carriers compared to normal control individuals. The methods used in this study were found not to be specific enough to clinically identify carriers of Usher type I syndrome. Nevertheless it is remarkable that a number of obligate carriers showed significant audiological and ophthalmological abnormalities.
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Affiliation(s)
- M Wagenaar
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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30
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Abstract
Between 1968 and 1986 stapes surgery has been performed in the Nijmegen University Department of Otorhinolaryngology in 11 patients (14 ears) with osteogenesis imperfecta. Detailed information about pre- and postoperative hearing levels, findings at surgery, and the follow-up period are presented. In most cases the stapedectomy has been successful.
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Affiliation(s)
- C Cremers
- Department of Otorhinolaryngology, University of Nijmegen, The Netherlands
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31
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Abstract
Autosomal recessive progressive high-frequency sensorineural deafness in childhood occurred in six patients from two families. This progressive sensorineural hearing loss starts mainly in the higher frequencies. There is an abrupt decline in the audiogram that slowly decreases with the increase of the hearing loss in the lower frequencies.
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Affiliation(s)
- C Cremers
- Department of Otorhinolaryngology, University of Nijmegen, The Netherlands
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Abstract
A father and his two sons had an autosomal-dominant syndrome of proximal symphalangia and conductive hearing loss. Exploratory tympanotomy revealed a congenitally fixed stapes and incus in the oldest boy. Surgical intervention resulted in normal hearing. To our knowledge, this is the first such histologic report of a stapes in this syndrome.
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Widdershoven J, Monnens L, Assmann K, Cremers C. Renal disorders in the branchio-oto-renal syndrome. Helv Paediatr Acta 1983; 38:513-522. [PMID: 6668201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Intravenous urography and measurements of renal function were performed in 16 patients suffering from branchio-oto-renal syndrome. Malformations were visible by intravenous urography in all patients. Four out of 16 patients had a diminished glomerular filtration rate. Renal histology available in two patients revealed oligomeganephronic renal hypoplasia and multicystic dysplasia, respectively. Without renal agenesis or severe renal hypoplasia or dysplasia present in early infancy, renal abnormality does not seem to be a progressive disorder.
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van Baars F, van den Broek P, Cremers C, Veldman J. Familial non-chromaffinic paragangliomas (glomus tumors) : clinical aspects. Laryngoscope 1981; 91:988-96. [PMID: 6264239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The clinical aspects of a study of a large family suffering from glomus tumors are presented. A great deal of fragmentary information is obtained from the literature, but never before has so much information been obtained from one single family. The aim of this study was to screen the individual members of this family by careful history, with special interest taken in symptoms which could be indicative of glomus tumors, and by a physical examination. Because these tumors may be without symptoms or signs, the screening was extended with dynamic angioscintigraphy.
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Cremers C. Early identification of hearing loss. Eur J Obstet Gynecol Reprod Biol 1976. [DOI: 10.1016/0028-2243(76)90059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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