Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Laryngoscope. 2011 Jun;121(6):1287-93. doi: 10.1002/lary.21751. Epub 2011 May 6.
OBJECTIVES/HYPOTHESIS: To explore the genetic characteristics of children with cochlear implants (CIs) and to correlate the auditory performance after implantation to the genetic diagnosis of children with CIs.
Prospective cohort study.
Mutations of four common deafness-associated genes, GJB2, SLC26A4, the mitochondrial 12S rRNA gene, and OTOF, were screened in 743 unrelated children with idiopathic sensorineural hearing impairment, including 180 and 563 children with and without CIs, respectively. The allele frequencies and audiologic features were compared between both groups. The Categories of Auditory Performance (CAP) scores at 3 years after implantation were then analyzed according to the genotypes.
A definitive genetic diagnosis was made in 37 (20.6%) of the 180 CI children. A significant difference in allele frequencies between CI and non-CI children was found in GJB2 mutations (chi-square test, P < .01), but not in SLC26A4 mutations, mitochondrial 12S rRNA mutations, or OTOF mutations (all P > .05). Further analysis revealed that the difference might have resulted from distinct audiological features in each group. Among the 110 CI children who had received more than 3 years of rehabilitation after implantation, the 35 children with mutations had better CAP scores than the 75 children without mutations.
A significant prevalence of genetic mutations was identified in children with CIs, suggesting the need for routine genetic assessments. The frequencies of common deafness-associated mutations were different between children with and without CIs. The presence of genetic mutations was associated with an excellent long-term auditory performance outcome after implantation.
目的/假设:探索人工耳蜗植入(CI)儿童的遗传特征,并将植入后听觉表现与 CI 儿童的遗传诊断相关联。
前瞻性队列研究。
在 743 例特发性感音神经性听力损失的无亲缘关系儿童中,包括 180 例和 563 例有和无 CI 的儿童,分别筛查了四个常见耳聋相关基因 GJB2、SLC26A4、线粒体 12S rRNA 基因和 OTOF 的突变。比较两组的等位基因频率和听力学特征。然后根据基因型分析植入后 3 年的听觉绩效类别(CAP)评分。
在 180 例 CI 儿童中,有 37 例(20.6%)做出明确的遗传诊断。在 GJB2 突变中,CI 和非 CI 儿童的等位基因频率存在显著差异(卡方检验,P <.01),但在 SLC26A4 突变、线粒体 12S rRNA 突变或 OTOF 突变中没有差异(均 P >.05)。进一步分析表明,这种差异可能是由于每组的听力学特征不同所致。在 110 例接受植入后超过 3 年康复的 CI 儿童中,有突变的 35 例儿童的 CAP 评分优于无突变的 75 例儿童。
在 CI 儿童中发现了遗传突变的显著流行率,表明需要进行常规遗传评估。CI 儿童和非 CI 儿童常见耳聋相关突变的频率不同。遗传突变的存在与植入后长期听觉表现良好相关。