Abstract

Genetic factors, the most common etiology in severe to profound hearing loss, are one of the key determinants of Cochlear Implantation (CI) and Electric Acoustic Stimulation (EAS) outcomes. Satisfactory auditory performance after receiving a CI/EAS in patients with certain deafness gene mutations indicates that genetic testing would be helpful in predicting CI/EAS outcomes and deciding treatment choices. However, because of the extreme genetic heterogeneity of deafness, clinical application of genetic information still entails difficulties. Target exon sequencing using massively parallel DNA sequencing is a new powerful strategy to discover rare causative genes in Mendelian disorders such as deafness. We used massive sequencing of the exons of 58 target candidate genes to analyze 8 (4 early-onset, 4 late-onset) Japanese CI/EAS patients, who did not have mutations in commonly found genes including GJB2, SLC26A4, or mitochondrial 1555A>G or 3243A>G mutations. We successfully identified four rare causative mutations in the MYO15A, TECTA, TMPRSS3, and ACTG1 genes in four patients who showed relatively good auditory performance with CI including EAS, suggesting that genetic testing may be able to predict the performance after implantation.

Highlights

  • Cochlear Implantation (CI) has been established as a standardized therapy for severe to profound hearing loss [1]

  • All except TMPRSS3 were first reported in patients with CI/Electric Acoustic Stimulation (EAS)

  • MYO15A has been reported mainly in severe to profound hearing loss [10]. It is not surprising the patient with the MYO15A mutation was found among the CI patients

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Summary

Introduction

Cochlear Implantation (CI) has been established as a standardized therapy for severe to profound hearing loss [1]. Electric Acoustic Stimulation (EAS) is a hearing implant system combining a cochlear implant and acoustic amplification technology in one device, and has recently become a standard intervention for the patients with partial deafness, defined as a mild to moderate lowfrequency sensorineural hearing loss sloping to a profound hearing loss in the higher frequencies [1]. One difficult point is that outcomes of CI/EAS are variable and many factors are thought to be involved in post-implantation performance. Satisfactory auditory performance in the patients with various deafness gene mutations indicates that genetic background would be helpful in predicting performance after CI [2]. When genetic background is involved in intra-cochlear etiology, there is potential for good performance. One advantage of genetic testing is that the possible prognosis for hearing, i.e., progressive or not, can be predicted for individual patients

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