Biomedical

X-Linked Gusher Disease DFNX2 in Children, a Rare Inner Ear Dysplasia with Mixed Hearing and Vestibular Loss







  Peer Reviewed

Abstract

Key Questions

X-Linked Gusher Disease

What is X-linked gusher disease? How rare is DFNX2 in children? What causes X-linked gusher disorder?

Symptoms and Diagnosis

What are the symptoms of X-linked gusher disease? How is X-linked gusher disorder diagnosed? What imaging findings indicate X-linked gusher disease?

Hearing and Balance

How does X-linked gusher disease affect hearing? Can X-linked gusher disease cause balance problems? What type of hearing loss occurs in DFNX2?

Treatment and Management

How is X-linked gusher disease treated? Can cochlear implants help patients with X-linked gusher disease? What is the long-term outlook for children with DFNX2?

Conductive hearing losses are typically present in disorders of the external/middle ear. However, there is a rare group of inner ear conditions called third windows that can also generate a conductive hearing loss. This is due to an abnormal connection between the middle and the inner ear or between the inner ear and the cranial cavity. X-linked gusher disorder is an extremely rare congenital inner ear dysplastic syndrome with an abnormal connection due to a characteristic incomplete cochlear partition type III and an incomplete internal auditory meatus fundus. The disorder is inherited in an X-linked fashion due to the mutation of the POU3F4 gene. We present two siblings diagnosed with the condition and their long-term follow-ups. They both presented audiovestibular symptoms and showed progressive mixed losses and bilateral vestibular weakness. They were treated with cochlear implant, digital amplification and with vestibular rehabilitation. Significant others around them were involved in their journey with the medical team, and in both, a very favourable outcome was achieved. This is the first time that we have reported evolving audiovestibular function with vestibular quantification in X-linked gusher disorder and emphasize on the multidisciplinary holistic approach to manage these children effectively.