Aldè Mirko, Ambrosetti Umberto, Guazzo Raffaella, Rocca Maria Santa, Piatti Gioia
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
J Clin Med. 2025 May 25;14(11):3692. doi: 10.3390/jcm14113692.
Primary ciliary dyskinesia (PCD) is a rare hereditary disorder caused by defective motile cilia, predominantly affecting the respiratory system. Conductive hearing loss (CHL) due to chronic otitis media with effusion (OME) is a typical feature of PCD, particularly in childhood. However, the underlying mechanisms contributing to sensorineural hearing loss (SNHL) in patients with PCD remain unclear. : We present the case of a 52-year-old male with a clinical diagnosis of PCD, confirmed by the presence of situs inversus, chronic respiratory symptoms, and ultrastructural ciliary defects. Despite a history of recurrent acute otitis media (AOM), the patient developed severe bilateral SNHL, a relatively uncommon and poorly understood manifestation of PCD. Genetic testing revealed a pathogenic SH3TC2 variant, a gene classically associated with Charcot-Marie-Tooth disease type 4C (CMT4C), raising the possibility of an alternative or contributory genetic etiology for the patient's auditory dysfunction. : This case highlights the importance of comprehensive audiological and genetic evaluations in PCD patients, particularly those presenting with progressive or atypical HL. The presence of a pathogenic SH3TC2 mutation suggests a potential neuropathic component to the patient's HL, underscoring the need for further research into the intersection between ciliary dysfunction and genetic neuropathies. Early identification and intervention are critical to optimizing auditory outcomes and quality of life in affected individuals.
原发性纤毛运动障碍(PCD)是一种由运动性纤毛缺陷引起的罕见遗传性疾病,主要影响呼吸系统。慢性中耳炎伴积液(OME)导致的传导性听力损失(CHL)是PCD的典型特征,尤其是在儿童期。然而,PCD患者发生感音神经性听力损失(SNHL)的潜在机制仍不清楚。我们报告一例52岁男性患者,临床诊断为PCD,通过内脏反位、慢性呼吸道症状和超微结构纤毛缺陷得以证实。尽管有复发性急性中耳炎(AOM)病史,但该患者出现了严重的双侧SNHL,这是PCD一种相对罕见且了解较少的表现。基因检测发现了一种致病性SH3TC2变异,该基因通常与4C型夏科-马里-图斯病(CMT4C)相关,这增加了该患者听觉功能障碍存在另一种或辅助性遗传病因的可能性。该病例强调了对PCD患者进行全面听力学和基因评估的重要性,尤其是那些表现为进行性或非典型听力损失的患者。致病性SH3TC2突变的存在提示该患者听力损失可能存在神经病变成分,强调需要进一步研究纤毛功能障碍与遗传性神经病变之间的交叉点。早期识别和干预对于优化受影响个体的听觉结果和生活质量至关重要。