Abstract
Hair cells are physiologically and structurally unique. However, the expression of the majority of macromolecules used for development and maintenance of their remarkable complexity appears to have been epigenetically hijacked from other functions during the evolution of the auditory system. The broad expression of many of these purloined genes should suggest caution when assuming that a particular mutated gene is causing simple isolated (nonsyndromic) hearing loss with no other medically significant features. Medically relevant issues accompanying hearing loss may be overlooked inadvertently. Narrowly focused medical history questions to be asked of study subjects and the selection of specific clinical tests often follow from knowledge of gene function in the various organ systems. These data are usually available only after deafness gene identification and the study of mouse models that recapitulate the inherited human deafness, and such studies may take several years. How many of the reported nonsyndromic deafness disorders are syndromic, in reality, remains to be determined. Early in a study of hereditary deafness, this can be an inherently difficult issue to resolve. Therefore, we suggest provisional classification of a specific human hereditary hearing loss as nonsyndromic only until there is adequate understanding of the normal function and expression pattern of a deafness gene that can then guide a focused clinical evaluation. This chapter examines these issues.
“It ain’t necessarily so” is a song about doubt in George and Ira Gershwin’s opera Porgy and Bess.
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Acknowledgments
We thank Dennis Drayna, Andrew J. Griffith, and Julie Schultz for their comments and suggestions. SR is supported by Higher Education Commission, Islamabad, Pakistan. Intramural research fund DC000039-16 to TBF is from the National Institute on Deafness and Other Communication Disorders at the National Institutes of Health, Bethesda, MD.
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Friedman, T.B., Riazuddin, S. (2014). Nonsyndromic Deafness: It Ain’t Necessarily So. In: Popper, A., Fay, R. (eds) Perspectives on Auditory Research. Springer Handbook of Auditory Research, vol 50. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9102-6_9
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