Hearing impairment in Stickler syndrome: a systematic review

• Main Authors: Acke Frederic R E, Dhooge Ingeborg J M, Malfait Fransiska, De Leenheer Els M R
• Format: Article
• Language: English
• Published: BMC 2012-10-01
• Series: Orphanet Journal of Rare Diseases
• Subjects: Stickler syndrome; Arthro-ophthalmopathy; Collagen; <it>COL2A1</it>; Hearing loss; Cleft palate
• Online Access: http://www.ojrd.com/content/7/1/84

<p>Abstract</p> <p>Background</p> <p>Stickler syndrome is a connective tissue disorder characterized by ocular, skeletal, orofacial and auditory defects. It is caused by mutations in different collagen genes, namely <it>COL2A1</it>, <it>COL11A1</it> and <it>COL11A2</it> (autosomal dominant inheritance), and <it>COL9A1</it> and <it>COL9A2</it> (autosomal recessive inheritance). The auditory phenotype in Stickler syndrome is inconsistently reported. Therefore we performed a systematic review of the literature to give an up-to-date overview of hearing loss in Stickler syndrome, and correlated it with the genotype.</p> <p>Methods</p> <p>English-language literature was reviewed through searches of PubMed and Web of Science, in order to find relevant articles describing auditory features in Stickler patients, along with genotype. Prevalences of hearing loss are calculated and correlated with the different affected genes and type of mutation.</p> <p>Results</p> <p>313 patients (102 families) individually described in 46 articles were included. Hearing loss was found in 62.9%, mostly mild to moderate when reported. Hearing impairment was predominantly sensorineural (67.8%). Conductive (14.1%) and mixed (18.1%) hearing loss was primarily found in young patients or patients with a palatal defect. Overall, mutations in <it>COL11A1</it> (82.5%) and <it>COL11A2</it> (94.1%) seem to be more frequently associated with hearing impairment than mutations in <it>COL2A1</it> (52.2%).</p> <p>Conclusions</p> <p>Hearing impairment in patients with Stickler syndrome is common. Sensorineural hearing loss predominates, but also conductive hearing loss, especially in children and patients with a palatal defect, may occur. The distinct disease-causing collagen genes are associated with a different prevalence of hearing impairment, but still large phenotypic variation exists. Regular auditory follow-up is strongly advised, particularly because many Stickler patients are visually impaired.</p>