Kyoko Nagao1, Thierry Morlet2, Elizabeth Haley3, Jennifer Padilla4, Julianne Nemith5, Robert W Mason6, Shunji Tomatsu7. 1. Department of Biomedical Research, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE, United States; Department of Linguistics and Cognitive Science, University of Delaware, Newark, DE, United States; College of Health Sciences, University of Delaware, Newark, DE, United States. Electronic address: kyoko.nagao@nemours.org. 2. Department of Biomedical Research, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE, United States; Department of Linguistics and Cognitive Science, University of Delaware, Newark, DE, United States; Georges Osborne College of Audiology, Salus University, Elkins Park, PA, United States. 3. Department of Communication Science & Disorders, University of Pittsburgh, Pittsburgh, PA, United States. 4. Siemens Healthcare Diagnostics Inc, Newark, DE, United States. 5. College of Health Sciences, University of Delaware, Newark, DE, United States. 6. Department of Biomedical Research, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE, United States. 7. Department of Biomedical Research, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE, United States; Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, United States. Electronic address: stomatsu@nemours.org.
Abstract
BACKGROUND: Hearing impairment is a common problem in patients with mucopolysaccharidosis IV (MPS IV) throughout their life. Many of the adult patients with MPS IV exhibit permanent or severe hearing loss. However, there has been no systematic review of detailed audiological test results in MPS IV. MATERIALS AND METHODS: Fourteen individuals with MPS IV (13 MPS IVA and 1 MPS IVB; aged between 12 and 38 years old) participated in the current study. We obtained auditory neurophysiological responses (auditory brainstem responses and otoacoustic emissions test) in addition to pure-tone audiometry and middle ear function tests (tympanometry and acoustic reflexes). RESULTS: The results indicated various levels and types of hearing loss with abnormal neurophysiological responses even in those patients with MPS IVA with normal pure tone thresholds. We also found a strong relationship between height (short stature is an indicator of skeletal severity) and hearing sensitivity as well as a strong relationship between height and outer hair cell function in the inner ear (measured by otoacoustic emissions) among MPS IVA patients. CONCLUSION: The strong correlation between reduced height and hearing loss indicates that patients with severe skeletal dysplasia may be at higher risk of developing more severe hearing loss. More importantly, the spectrum of hearing disorders indicates that MPS IV patients should have annual neurophysiological hearing tests in addition to audiometric testing from an early age regardless of their skeletal severity to more carefully monitor disease progression.
BACKGROUND: Hearing impairment is a common problem in patients with mucopolysaccharidosis IV (MPS IV) throughout their life. Many of the adult patients with MPS IV exhibit permanent or severe hearing loss. However, there has been no systematic review of detailed audiological test results in MPS IV. MATERIALS AND METHODS: Fourteen individuals with MPS IV (13 MPS IVA and 1 MPS IVB; aged between 12 and 38 years old) participated in the current study. We obtained auditory neurophysiological responses (auditory brainstem responses and otoacoustic emissions test) in addition to pure-tone audiometry and middle ear function tests (tympanometry and acoustic reflexes). RESULTS: The results indicated various levels and types of hearing loss with abnormal neurophysiological responses even in those patients with MPS IVA with normal pure tone thresholds. We also found a strong relationship between height (short stature is an indicator of skeletal severity) and hearing sensitivity as well as a strong relationship between height and outer hair cell function in the inner ear (measured by otoacoustic emissions) among MPS IVA patients. CONCLUSION: The strong correlation between reduced height and hearing loss indicates that patients with severe skeletal dysplasia may be at higher risk of developing more severe hearing loss. More importantly, the spectrum of hearing disorders indicates that MPS IV patients should have annual neurophysiological hearing tests in addition to audiometric testing from an early age regardless of their skeletal severity to more carefully monitor disease progression.
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Authors: Mehmet Umut Akyol; Tord D Alden; Hernan Amartino; Jane Ashworth; Kumar Belani; Kenneth I Berger; Andrea Borgo; Elizabeth Braunlin; Yoshikatsu Eto; Jeffrey I Gold; Andrea Jester; Simon A Jones; Cengiz Karsli; William Mackenzie; Diane Ruschel Marinho; Andrew McFadyen; Jim McGill; John J Mitchell; Joseph Muenzer; Torayuki Okuyama; Paul J Orchard; Bob Stevens; Sophie Thomas; Robert Walker; Robert Wynn; Roberto Giugliani; Paul Harmatz; Christian Hendriksz; Maurizio Scarpa Journal: Orphanet J Rare Dis Date: 2019-06-13 Impact factor: 4.123