Association between phenotype, performance with hearing aids, and genotype of childhood hearing loss in children with and without genetic alteration.

Eliara Pinto Vieira Biaggio, Marisa Frasson de Azevedo, Maria Cecilia Martinelli Iório, Maria Carolina Costa Melo Svidnicki, Edi Lúcia Satorato
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Abstract

Purpose: To establish the frequency of genetic mutations related to sensorineural hearing loss (SNHL); to verify if there is association between the degree of SNHL and the presence of genetic alteration; and to verify if the Minimal Response Levels (MRL) with hearing aids vary according to the genetic alteration.

Methods: Thirty hearing aids users with ages between 8 and 111 months were evaluated. The evaluation procedures used were: pure-tone audiometry; the auditory steady state response (ASSR) on sound field, with and without hearing aids; and genetic study of the hearing loss.

Results: Three genetic mutations were diagnosed: 35delG, A1555G and A827G, and the children with these mutations showed higher degree of SNHL. There was no difference between the genetic patterns regarding the degree of SNHL, except for patients with A827G mitochondrial mutation, because all subjects with this mutation had profound SNHL. The difference between the MRL obtained with and without amplification, considering the presence of mutation and the degree of SNHL, was higher in children with moderate SNHL without genetic alterations, both in behavioral and electrophysiological evaluations.

Conclusion: Genetic mutations were found in 36.7% of the sample, justifying the importance of genetic tracking in the hearing habilitation process. Children with genetic mutations showed higher degrees of hearing loss. The different mutation patterns do not directly determine the degree of hearing loss. The best thresholds with amplification were found in children with moderate hearing loss without genetic alterations.

在有或没有基因改变的儿童中,表型、助听器的表现和儿童听力损失的基因型之间的关系。
目的:了解与感音神经性听力损失(SNHL)相关的基因突变频率;验证SNHL的程度与是否存在基因改变之间是否存在关联;并验证助听器的最低反应水平(MRL)是否根据基因改变而变化。方法:对30例年龄在8 ~ 111个月的助听器使用者进行评价。使用的评估程序为:纯音测听;配戴助听器和不配戴助听器的声场听觉稳态响应(ASSR);以及听力损失的基因研究。结果:诊断出35delG、A1555G和A827G三个基因突变,这些突变的患儿SNHL程度较高。除了A827G线粒体突变患者外,不同遗传模式之间SNHL程度没有差异,因为所有携带该突变的受试者均为重度SNHL。考虑到突变的存在和SNHL的程度,在没有基因改变的中度SNHL儿童中,在行为和电生理评估中,经扩增和未扩增获得的MRL之间的差异更高。结论:36.7%的样本存在基因突变,说明基因追踪在听力康复过程中的重要性。基因突变的儿童表现出更高程度的听力损失。不同的突变模式并不能直接决定听力损失的程度。放大的最佳阈值出现在无基因改变的中度听力损失儿童中。
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