TCOF1 Gene variation in Treacher Collins syndrome and evaluation of speech rehabilitation after bone bridge surgery / 临床耳鼻咽喉头颈外科杂志

Objective:By analyzing the clinical phenotypic characteristics and gene sequences of two patients with Treacher Collins syndrome（TCS）, the biological causes of the disease were determined. Then discuss the therapeutic effect of hearing intervention after bone bridge implantation. Methods:All clinical data of the two family members were collected, and the patients signed the informed consent. The peripheral blood of the proband and family members was extracted, DNA was extracted for whole exome sequencing, and Sanger sequencing was performed on the family members for the mutation site.TCOF1genetic mutations analysis was performed on the paitents. Then, the hearing threshold and speech recognition rate of family 2 proband were evaluated and compared under the sound field between bare ear and wearing bone bridge. Results:In the two pedigrees, the probands of both families presented with auricle deformity, zygomatic and mandibular hypoplasia, micrognathia, hypotropia of the eye fissure, and hypoplasia of the medial eyelashes. The proband of Family 1 also presents with specific features including right-sided narrow anterior nasal aperture and dental hypoplasia, which were consistent with the clinical diagnosis of Treacher Collins syndrome. Genetic testing was conducted on both families, and two heterozygous mutations were identified in the TCOF1 gene: c. 1350_1351dupGG（p. A451Gfs*43） and c. 4362_4366del（p. K1457Efs*12）, resulting in frameshift mutations in the amino acid sequence. Sanger sequencing validation of the TCOF1 gene in the parents of the proband in Family 1 did not detect any mutations. Proband 1 TCOF1 c. 1350_1351dupGG heterozygous variants have not been reported previously. The postoperative monosyllabic speech recognition rate of family 2 proband was 76%, the Categories of Auditory Performance（CAP） score was 6, and the Speech Intelligibility Rating（SIR） score was 4. Assessment using the Meaningful Auditory Integration Scale（MAIS） showed notable improvement in the patient's auditory perception, comprehension, and usage of hearing aids. Evaluation using the Glasgow Children's Benefit Inventory and quality of life assessment revealed significant improvements in the child's self care abilities, daily living and learning, social interactions, and psychological well being, as perceived by the parents. Conclusion:This study has elucidated the biological cause of Treacher Collins syndrome, enriched the spectrum of TCOF1 gene mutations in the Chinese population, and demonstrated that bone bridge implantation can improve the auditory and speech recognition rates in TCS patients.

Relationship between otoacoustic emissions and blood-lead levels in school children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the relationship between blood levels of lead and the function states of cochlear outer hair cells (OHC).@*METHOD@#Two hundred and fifty-six children lived in Pb-Zn mine area and Yiliang country, aged from 6 to 7 years were enrolled in this study. Blood lead (B-Pb) levels were measured. Otoacoustic emission (OAE) tests including transient evoked otoacoustic emissions (TEOAE) and distortion products otoacoustic emission (DPOAE) were also measured in these children.@*RESULT@#The difference in B-Pb levels between the school children who lived in mine area and children lived in country was significant (P < 0.01). There were negative correlations between the B-Pb levels and the signal to noise ratio (SNR) on DPOAE test in children who lived in country and those lived in mine area (P < 0.01). The difference in relative coefficients of B-Pb levels between the children lived in mine and children lived in country were significant (P < 0.01).@*CONCLUSION@#The B-Pb levels of children who lived in mine area were higher than that of those lived in country. SNR decreased in plumbism cases. Long-term Pb expose may influence the function of cochlear OHC and higher B-Pb levels may lead to worse function of OHC.