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. 2024 Nov;171(5):1518-1525.
doi: 10.1002/ohn.838. Epub 2024 Jun 1.

Etiology of Childhood Profound Sensorineural Hearing Loss: The Role of Hearing Loss Gene Panel Testing

Kaukab Rajput  1 , Umar Akhtar  1 , Waheeda Pagarkar  1 , Sarah Rajput  1 , Claire Walder  1 , Felice D'Arco  1 , Lesley Cochrane  1 , Robert Nash  1 , Maria Bitner-Glindzicz  1 , Rohani Omar  1   2
Affiliations

Etiology of Childhood Profound Sensorineural Hearing Loss: The Role of Hearing Loss Gene Panel Testing

Kaukab Rajput et al. Otolaryngol Head Neck Surg. 2024 Nov.

Abstract

Objective: Establishing the cause of hearing loss (HL) is important and rewarding, though not without its challenges. While our ability to identify the etiology for HL has improved with advances in scientific knowledge, a significant proportion of cases remain of unknown etiology. Recent protocol changes within the NHS Genomic Medicine Service support the utilization of the HL gene panel test, rather than individual gene tests. In light of these changes, determining the yield of these more extensive panel tests is important in informing future practice.

Study design: Retrospective study.

Setting: The Cochlear Implant (CI) Department at Great Ormond Street Hospital (GOSH).

Methods: Four hundred seventy-six children with profound HL were identified from a database of referrals to the GOSH CI Department. Data on etiology of HL including genetic diagnosis was collected from hospital notes on an electronic patient records system and hospital genetics database.

Results: We identified a positive result in 163/476 (34%) cases through the gene panel test, representing an additional 19% yield to current level 1 investigations. Genetic HL, including both syndromic (including those not covered by the HL gene panel) and nonsyndromic (209/476, 44%) was the most common etiology in our cohort. Perinatal, intrauterine, ototoxicity, meningitis, and encephalitis categories altogether comprised 97/476 (20%) cases.

Conclusion: Gene panel testing provides significant additional yield over current level 1 investigations which include GJB2 testing only. This has far-reaching implications for how we optimize investigations into HL in children and counsel families, and for future early interventions.

Keywords: GJB2; cochlear implant; connexin; etiology of hearing loss; genetic testing; hearing loss panel; next generation sequencing; profound hearing loss.

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