Deafness symphalangism
Deafness symphalangism is a rare genetic disorder characterized by the combination of hearing loss and symphalangism, which is the fusion of joints (synostosis) in the fingers or toes. This condition affects both the development of the auditory system and the skeletal system, leading to conductive deafness and limited mobility or flexibility in the affected joints. The condition is inherited in an autosomal dominant manner, meaning that only one copy of the altered gene in each cell is sufficient to cause the disorder.
Symptoms and Diagnosis
The primary symptoms of deafness symphalangism include moderate to severe conductive hearing loss and symphalangism affecting the proximal interphalangeal joints. This can lead to a characteristic fixed position of the fingers and/or toes, often with limited movement or flexibility. The severity and extent of joint involvement can vary significantly among affected individuals. Diagnosis is typically based on clinical examination, family history, and may be confirmed through genetic testing to identify mutations in the specific gene associated with the condition.
Genetics
Deafness symphalangism syndrome is most commonly associated with mutations in the NOG gene, which plays a crucial role in the development and maintenance of many body tissues, including those in the ears and the joints. The NOG gene provides instructions for making a protein that is involved in the development of bones, joints, and other tissues. Mutations in this gene disrupt the normal development of these tissues, leading to the symptoms of the syndrome.
Treatment
There is no cure for deafness symphalangism, and treatment focuses on managing the symptoms and improving the quality of life for affected individuals. For hearing loss, options may include hearing aids, cochlear implants, or other assistive listening devices. Physical therapy and, in some cases, surgery may help improve joint mobility and reduce discomfort associated with symphalangism. Genetic counseling is recommended for affected individuals and their families to discuss the risk of passing the condition to future generations.
Prognosis
The prognosis for individuals with deafness symphalangism varies depending on the severity of the symptoms. While hearing loss and joint issues can significantly impact quality of life, with appropriate management and support, many affected individuals can lead active and fulfilling lives.
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Contributors: Prab R. Tumpati, MD