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A newborn fails the newborn hearing screen. Audiologic evaluation confirms bilateral severe-to-profound sensorineural hearing loss. Physical exam is normal. Genetic testing reveals two pathogenic variants in GJB2.

AR; GJB2 gene (connexin 26)

  • Most common cause of genetic non-syndromic hearing loss
  • c.35delG most common variant in Caucasians
  • c.167delT in Ashkenazi Jewish population
  • c.235delC in East Asian populations
  • Non-syndromic sensorineural hearing loss
  • Usually congenital, bilateral, stable
  • Severity varies (mild to profound)
  • Normal vestibular function
  • Cochlear implant candidates
  • Newborn hearing screen (OAE/ABR), with diagnostic audiometry to confirm bilateral sensorineural hearing loss
  • Normal physical exam and absence of syndromic features support a non-syndromic etiology
  • Molecular confirmation: GJB2 (connexin 26) sequencing, including testing for large GJB6 deletions in compound cases
  • Hearing rehabilitation: early hearing aids; cochlear implantation for severe-to-profound loss
  • Early intervention with speech-language therapy and a communication-modality plan
  • Serial audiometry to monitor for progression and titrate amplification