Otological aspects and surgical outcome in a consanguineous family with a novel ANKH gene mutation

ObjectivesTo report the hearing impairment in a new autosomal recessive metabolic disorder due to a mutation in the ANKH gene and to report the outcomes of exploratory tympanotomy.Study designRetrospective chart study.SettingTertiary referral center.PatientsOne large consanguineous family was examined. Three patients underwent exploratory tympanotomy.InterventionExploratory tympanotomies in three patients.Main outcome measuresMedical and otological histories; postoperative hearing outcomes.ResultsIn the patients who received tympanotomies, a postoperative hearing gain of between 5 and 20 dB was noted, with a residual air-bone gap of between 6 and 35 dB (follow-up between 4 and 67 months). The sensorineural component of the hearing impairment varies greatly, between 4 and 23 dB, and this factor might also affect the final hearing outcome.ConclusionsExploratory tympanotomy might improve the hearing outcome in patients with this syndrome and therefore surgery has a limited audiometric benefit in general. Based on anatomical findings, a congenital origin for the ossicular chain anomaly seems likely. It remains unclear whether the sensorineural component of the hearing impairment is progressive and this should be investigated further.