Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea.
Sci Rep. 2020 Apr 1;10(1):5768. doi: 10.1038/s41598-020-62647-y.
Recent advances in molecular genetic testing (MGT) have improved identification of genetic aetiology of candidates for cochlear implantation (CI). However, whether genetic information increases CI outcome predictability in post-lingual deafness remains unclear. Therefore, we evaluated the outcomes of CI with respect to genetic aetiology and clinical predictors by comparing the data of study subjects; those with an identified genetic aetiology (GD group), and those without identifiable variants (GUD group). First, we identified the genetic aetiology in 21 of 40 subjects and also observed genetic etiologic heterogeneity. The GD group demonstrated significantly greater improvement in speech perception scores over a 1-year period than did the GUD group. Further, inverse correlation between deafness duration and the 1-year improvement in speech perception scores was tighter in the GD group than in the GUD group. The weak correlation between deafness duration and CI outcomes in the GUD group might suggest the pathophysiology underlying GUD already significantly involves the cortex, leading to lesser sensitivity to further cortex issues such as deafness duration. Under our MGT protocol, the correlation between deafness duration and CI outcomes were found to rely on the presence of identifiable genetic aetiology, strongly advocating early CI in individual with proven genetic aetiologies.
近年来,分子遗传学检测(MGT)的进步提高了对候选人工耳蜗植入(CI)患者遗传病因的识别能力。然而,遗传信息是否能提高后天性耳聋患者 CI 结果的可预测性尚不清楚。因此,我们通过比较研究对象的数据,评估了遗传病因和临床预测因素对 CI 结果的影响;这些数据来自有明确遗传病因(GD 组)和无可识别变异的患者(GUD 组)。首先,我们在 40 名受试者中的 21 名中确定了遗传病因,并观察到遗传病因异质性。GD 组在 1 年内言语感知评分的改善明显大于 GUD 组。此外,GD 组中耳聋持续时间与言语感知评分 1 年改善之间的负相关关系比 GUD 组更紧密。GUD 组中耳聋持续时间与 CI 结果之间的弱相关性可能表明,GUD 背后的病理生理学已经明显涉及到大脑皮层,导致对进一步的大脑皮层问题(如耳聋持续时间)的敏感性降低。在我们的 MGT 方案下,耳聋持续时间与 CI 结果之间的相关性取决于是否存在可识别的遗传病因,强烈主张对有明确遗传病因的个体进行早期 CI。