Genomics, Epigenetics, and Hearing Loss in Neurofibromatosis Type 2

Christine T. Dinh, Eric Nisenbaum, Darius Chyou, Carly Misztal, Denise Yan, Rahul Mittal, Juan Young, Mustafa Tekin, Fred Telischi, Cristina Fernandez-Valle, Xue Zhon Liu

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Objectives:In this review, we discuss current knowledge about the genetics and epigenetics of vestibular schwannoma (VS) in relation to hearing loss. A multistep and sequential genetic algorithm suitable for the identification of Neurofibromatosis Type 2 (NF2) constitutional and somatic mutations is discussed.Data Sources, Study Selection:A review was performed of the English literature from 1990 to 2019 using PubMed regarding genetics and epigenetics of vestibular schwannoma and NF2.Conclusion:NF2 is a genetic disorder characterized by NF2 mutations that affect the function of a tumor suppressor called merlin. In particular, individuals with NF2 develop bilateral VS that can lead to hearing loss and even deafness. Recent advances in genetic and epigenetic studies have improved our understanding of the genotype-phenotype relationships that affect hearing in NF2 patients. Specific constitutional NF2 mutations including particular truncating, deletion, and missense mutations have been associated with poorer hearing outcomes and more severe clinical manifestations. Epigenetic events, such as DNA methylation and histone modifications, also contribute to the development and progression of hearing loss in NF2 patients. Furthermore, the accumulation of multiple NF2 and non-NF2 genetic and epigenetic abnormalities at the level of the tumor may contribute to worse hearing outcomes. Understanding genetic and epigenetic signatures in individual NF2 patients and particularly in each VS will allow us to develop novel gene therapies and precision medicine algorithms to preserve hearing in NF2 individuals.

Original languageEnglish (US)
Pages (from-to)e529-e537
JournalOtology and Neurotology
Issue number5
StatePublished - Jun 1 2020


  • Epigenetic
  • Genetic
  • NF2
  • Neurofibromatosis type 2
  • VS
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology


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