Genes, viruses, and ear disease.

The association between genetic composition and viral infection is described by Niedermeyer and associates in this issue of EAR, NOSE & THROAT JOURNAL. Their article, "Persistent measles virus infection as a possible cause of otosclerosis: State of the art," was first presented to the Otosclerosis Study Group in September 1998 in San Antonio, Texas. Their work, as well as that of Michael McKenna of Boston and others, begins to not only explain the cause of otosclerosis, but also to suggest methods for the nonsurgical elimination of hearing loss from causes of this type.

Carol G. Shores and Wendell G. Yarbrough of Chapel Hill, N.C., presented a poster at the Southern Section Meeting of the Triological Society in St. Petersburg Beach, Fla., this past January. The title of their presentation was, "Evaluation of prelingual deafness in the new millennium: Genetic testing." They pointed out that our understanding of the molecular biology of auditory sensation and hearing loss is expanding exponentially, and it will soon change how otolaryngologists diagnose and possibly treat sensorineural hearing loss. They stated that autosomal-recessive mutations in the gap junction protein connexin 26 gene are responsible for 20% of all childhood hearing loss, with a carrier rate of 0.5 to 4%. Laboratory tests are now available to screen patients for the most common mutation in this gene. We might expect that in addition to using genetic engineering and vaccines to prevent viral infections, otologists might eventually be able to treat and eliminate the offending viruses to prevent hearing los s or restore hearing.

The late Sir Terrence Cawthorne, a prominent surgeon who had performed many stapedectomies, once joked that he had had a sobering dream that someone had found a medical cure for otosclerosis. The observations of Niedermeyer and colleagues suggest that Sir Terrence's dream is about to become a reality.

JACK L. PULEC

Editor-in-Chief