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遗传性感音神经性听力损失的诊断流程与方法

Diagnosis routine and approach in genetic sensorineural hearing loss.

作者信息

Abreu Alves Fatima Regina, Quintanilha Ribeiro Fernando de Andrade

机构信息

Otorhinolaryngology, FCMSC, SP.

出版信息

Braz J Otorhinolaryngol. 2007 May-Jun;73(3):412-7. doi: 10.1016/s1808-8694(15)30087-2.

Abstract

AIM

To develop a screening in order to determine the more common syndromic and non-syndromic genetic SNHL, considering epidemiological data, information and the development of new technologies; clinical implications and bioethical issues.

MATERIALS AND METHODS

We reviewed the literature in order to develop a screening that includes: history, patterns of inheritance, physical evaluation, laboratory tests, image studies, multidisciplinary approaches and genetic tests.

CONCLUSION

The epidemiologic data estimates that at least 50% of prelingual HL can be determined by genetic alterations. Medical and family histories are extremely important to help one achieve a genetic-based SNHL diagnosis, and help determine inheritance patterns. Through a high suspicion index, syndromic cases can be diagnosed or excluded, with a careful evaluation and molecular basis tests used to better determine the hearing loss. Genetic tests and mitochondrial inheritance should be considered in any family with many affected individuals, except when the hearing loss was clearly transmitted by a male. In cases of non-syndromic SNHL, GJB2 mutation analysis must be proposed.

摘要

目的

结合流行病学数据、信息及新技术发展情况、临床意义和生物伦理问题,制定一项筛查方法,以确定更常见的综合征型和非综合征型遗传性感音神经性听力损失(SNHL)。

材料与方法

我们查阅文献以制定一项筛查方法,该方法包括:病史、遗传模式、体格检查、实验室检查、影像学检查、多学科方法及基因检测。

结论

流行病学数据估计,至少50%的语前聋可由基因改变来确定。医学和家族史对于实现基于基因的SNHL诊断及确定遗传模式极为重要。通过高度怀疑指数,可对综合征型病例进行诊断或排除,同时进行仔细评估并采用分子基础检测以更好地确定听力损失情况。对于有多个受累个体的任何家族,均应考虑基因检测和线粒体遗传情况,除非听力损失明确由男性传递。对于非综合征型SNHL病例,必须进行GJB2基因突变分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f182/9445739/93d68dffccd2/gr1.jpg

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