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Original research
TMPRSS3 expression is limited in spiral ganglion neurons: implication for successful cochlear implantation
  1. Yuan-Siao Chen1,
  2. Ernesto Cabrera1,
  3. Brady J Tucker1,
  4. Timothy J Shin1,
  5. Jasmine V Moawad1,
  6. Douglas J Totten1,
  7. Kevin T Booth2,3,
  8. Rick F Nelson1
  1. 1 Department of Otolaryngology—Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
  2. 2 Neurobiology, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
  1. Correspondence to Dr Rick F Nelson, Department of Otolaryngology—Head and Neck Surgery, Indiana University School of Medicine, Indianapolis IN 46202, Indiana, USA; ricnelso{at}


Background It is well established that biallelic mutations in transmembrane protease, serine 3 (TMPRSS3) cause hearing loss. Currently, there is controversy regarding the audiological outcomes after cochlear implantation (CI) for TMPRSS3-associated hearing loss. This controversy creates confusion among healthcare providers regarding the best treatment options for individuals with TMPRSS3-related hearing loss.

Methods A literature review was performed to identify all published cases of patients with TMPRSS3-associated hearing loss who received a CI. CI outcomes of this cohort were compared with published adult CI cohorts using postoperative consonant-nucleus-consonant (CNC) word performance. TMPRSS3 expression in mouse cochlea and human auditory nerves (HAN) was determined by using hybridisation chain reaction and single-cell RNA-sequencing analysis.

Results In aggregate, 27 patients (30 total CI ears) with TMPRSS3-associated hearing loss treated with CI, and 85% of patients reported favourable outcomes. Postoperative CNC word scores in patients with TMPRSS3-associated hearing loss were not significantly different than those seen in adult CI cohorts (8 studies). Robust Tmprss3 expression occurs throughout the mouse organ of Corti, the spindle and root cells of the lateral wall and faint staining within <5% of the HAN, representing type II spiral ganglion neurons. Adult HAN express negligible levels of TMPRSS3.

Conclusion The clinical features after CI and physiological expression of TMPRSS3 suggest against a major role of TMPRSS3 in auditory neurons.

  • otolaryngology
  • otorhinolaryngologic diseases
  • clinical decision-making
  • disease management
  • gene expression profiling

Data availability statement

Data are available on reasonable request.

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  • Contributors Conception and design: KTB and RFN. Data collection and analysis: Y-SC, EC, BJT, TJS, JVM, DJT, KTB and RFN. Performed experiments: Y-SC, EC, BJT, TJS, JVM, DJT and RFN. Drafted original manuscript: Y-SC, BJT, KTB and RFN. All authors have reviewed and approved the final manuscript. Guarantor: RFN.

  • Funding This work was supported by the National Institutes of Health (K08-DC016034 to RFN), the Triological Society and American College of Surgeons (Clinician Scientist Development Award to RFN) and NIGMS T32 Training in Genetics Fellowship (T32 GM007748 to KTB).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.