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Disease Profile

Branchiootorenal syndrome

Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.


US Estimated

Europe Estimated

Age of onset

All ages





Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease.


Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype.


dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.


recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder.


Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.

Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.


Not applicable


Other names (AKA)

Branchiootorenal dysplasia; Melnick-Fraser syndrome; Branchio oto renal syndrome;


Congenital and Genetic Diseases; Ear, Nose, and Throat Diseases; Kidney and Urinary Diseases;


Branchiootorenal syndrome is characterized by birth defects or anomalies of tissues in the neck, malformations of the external ear, hearing loss, and kidney malformations. Symptom and symptom severity can vary greatly from person to person. It can be caused by mutations in the EYA1, SIX1, or SIX5 genes.[1][2][3][4][5] It is passed through families in an autosomal dominant fashion. Treatment may include surgery to remove the anomalies of the neck (i.e., branchial fistulae or cysts), careful assessment and management of hearing loss, and follow-up by a kidney specialist (nephrologist). In some cases dialysis or kidney transplant may be required.[2][4]


Signs and symptoms of branchiootorenal syndrome can vary greatly from person to person and even between people within the same family.[4] Hearing loss is the most common symptom and is shared by approximately 90% of people with this syndrome. Hearing loss may be conductive, sensorineural, or a combination of both.[2][5] Other common signs and symptoms include branchial cleft cysts, branchial fistulae, outer, middle, and inner ear malformations, and kidney malformations.[1][2][3][4] Specifically mutations in the EYA1 or SIX1 genes can be associated with kidney malformations.[3]

You can find more details regarding the signs and symptoms of branchiootorenal syndrome by visiting the Genetic Home Reference Web site at the following link:

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Medical Terms Other Names
Learn More:
80%-99% of people have these symptoms
Hearing impairment
Hearing defect

[ more ]

30%-79% of people have these symptoms
Abnormality of the middle ear ossicles
Atresia of the external auditory canal
Absent ear canal
Branchial cyst
Enlarged cochlear aqueduct
External ear malformation
Hypoplasia of the cochlea
Preauricular skin tag
Renal hypoplasia/aplasia
Absent/small kidney
Absent/underdeveloped kidney

[ more ]

Stenosis of the external auditory canal
Narrowing of passageway from outer ear to middle ear
5%-29% of people have these symptoms
Abnormal lacrimal duct morphology
Cleft palate
Cleft roof of mouth
Facial palsy
Bell's palsy
Multicystic kidney dysplasia
Renal insufficiency
Renal failure
Renal failure in adulthood

[ more ]

Receding chin
Receding lower jaw
Weak chin
Weak jaw

[ more ]

Ureteropelvic junction obstruction
Vesicoureteral reflux
1%-4% of people have these symptoms
Cupped ear
Cup-shaped ears
Simple, cup-shaped ears

[ more ]

Lacrimal duct aplasia
Absent tear duct
Lacrimal duct stenosis
Narrowing of the tear duct
Small ears
Underdeveloped ears

[ more ]

Mixed hearing impairment
Hearing loss, mixed
Mixed hearing loss

[ more ]

Preauricular pit
Pit in front of the ear
Percent of people who have these symptoms is not available through HPO
Abnormal cerebral morphology
Abnormal renal collecting system morphology
Autosomal dominant inheritance
Bifid uvula
Branchial fistula
Congenital hip dislocation
Dislocated hip since birth
Dilatated internal auditory canal
Euthyroid goiter
Gustatory lacrimation
High palate
Elevated palate
Increased palatal height

[ more ]

Incomplete partition of the cochlea type II
Incomplete penetrance
Intestinal malrotation
Lacrimation abnormality
Abnormality of tear production
Long face
Elongation of face
Increased height of face
Increased length of face
Vertical elongation of face
Vertical enlargement of face
Vertical overgrowth of face

[ more ]

Decreased width of tooth
Narrow face
Decreased breadth of face
Decreased width of face

[ more ]

Polycystic kidney dysplasia
Renal agenesis
Absent kidney
Missing kidney

[ more ]

Renal dysplasia
Renal malrotation
Abnormal rotation of the kidneys
Renal steatosis
Fatty kidney
Variable expressivity


Mutations in the genes, EYA1, SIX1, and SIX5, are known to cause branchiootorenal syndrome. About 40 percent of people with this condition have a mutation in the EYA1 gene. SIX1 and SIX5 mutations are much less common causes of the disorder.[5] There are likely other genes that have not yet been identified that when mutated can cause this syndrome as well.[2]


Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional.

Testing Resources

  • The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.


    Hereditary hearing loss conditions, in general, tend to be managed by a team that includes an otolaryngologist, an audiologist, a clinical geneticist, a pediatrician, sometimes an educator of the Deaf, a neurologist, and in case of branchiootorenal syndrome, a nephrologist (kidney doctor). Treatment of hearing loss may include determining which aids would be most helpful, for example hearing aids or vibrotactile devices; cochlear implantation may be considered in children over age 12 months with severe-to-profound hearing loss. Early hearing intervention through amplification, surgery, or cochlear implantation may be recommended for children who are at risk to lose their hearing before they learn to speak.[2]

    People with hereditary hearing loss often require regular follow-up with a hearing specialist such as an audiologist to monitor stability or progression of the hearing loss.[2]

    Treatment of branchial fistulae or cysts may require surgery. For people with branchiootorenal syndrome and severe kidney malformations or complications, dialysis or kidney transplant may be required.[4]


    Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

    Organizations Supporting this Disease

      Organizations Providing General Support

        Learn more

        These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

        Where to Start

        • Genetics Home Reference (GHR) contains information on Branchiootorenal syndrome. This website is maintained by the National Library of Medicine.
        • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

          In-Depth Information

          • GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions.
          • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
          • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
          • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
          • PubMed is a searchable database of medical literature and lists journal articles that discuss Branchiootorenal syndrome. Click on the link to view a sample search on this topic.


            1. Husein M, Smith JH. Genetic Sensorineural Hearing Loss. In: Cummings et al., eds. Otolaryngology: Head & Neck Surgery, 4th ed. Philadelphia, PA: Mosby, Inc; 2005;
            2. Smith RJH, Van Camp G. Deafness and Hereditary Hearing Loss Overview. GeneReviews. 2008; https://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=deafness-overview. Accessed 1/8/2010.
            3. Swiatecka-Urban A. Multicystic Renal Dysplasia. eMedicine. 2009; https://emedicine.medscape.com/article/982560-overview. Accessed 1/8/2010.
            4. Niaudet P. Branchiootorenal (BOR) syndrome. Orphanet. 2007; Accessed 1/8/2010.
            5. Branchiootorenal syndrome. Genetics Home Reference. 2008; https://ghr.nlm.nih.gov/condition=branchiootorenalsyndrome. Accessed 1/8/2010.
            6. What are the different ways in which a genetic condition can be inherited?. Genetics Home Reference Web site. January 25, 2016; https://ghr.nlm.nih.gov/handbook/inheritance/inheritancepatterns.

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