CDH23 and Usher syndrome: CDH23 gene mutations generally follow an autosomal recessive inheritance pattern, where carriers of a single heterozygous mutation do not develop the disease, but individuals carrying 2 or more compound heterozygous mutations may manifest as NSHL or Usher syndrome.[15] Mutations in the CHD7 and CDH23 genes are commonly associated with hearing loss and typically occur in an autosomal recessive manner.