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- Title
Hearing loss in children with congenital cytomegalovirus infection.
- Authors
Garbaruk, E.; Vikhnina, S.; Savenko, I.; Boboshko, M.
- Abstract
Introduction: The problem of congenital cytomegalovirus (CMV) infection becomes more and more relevant nowadays. One of the most common congenital CMV complications is sensorineural hearing loss (SNHL). In addition congenital CMV infection remains a leading cause of late-onset and progressive hearing loss in children. An absence of definite audiological follow-up algorithm makes difficult the early diagnosis of SNHL even in the case of timely verification of congenital CMV infection. It leads to delayed intervention and can negatively impact child's language development. The aim is to investigate clinical profile of hearing loss in children with congenital CMV infection and to develop the audiological followup algorithm for these children. Material and methods: 60 children of the age ranged from 1 month to 5 years old with verified congenital CMV infection were involved into audiological follow-up. The control group included 61 infants of the same age with risk factors for SNHL, excluding congenital CMV infection (verified by negative PCR results). The following SNHL risk factors were taken into consideration: complications during pregnancy, prematurity, low birth weight, low APGAR score, neonatal jaundice, treatment regimen (ototoxic drugs), birth asphyxia, etc. The follow-up duration was 4 years. Audiological methods included recording of transient evoked and distortion product otoacoustic emissions, impedancemetry, registration of auditory brainstem response, auditory steady-state response and pure tone audiometry (visual reinforcement audiometry, play audiometry, conventional audiometry depending on child's age and development). Tests for auditory processing disorders (APD) consisted of speech audiometry in quiet and noise, dichotic digital test. The audiological examination was performed every 1--3 months at the age 0--12 months; every 4--6 months at the age 12--36 months; twice a year for children from 3 to 5 years old. APD tests have been performed in children elder than 4 years old. Results: The prevalence of SNHL was significantly higher in children with CMV infection (16.7%) than in the control group (4.9%). The degree of hearing loss varied from mild to moderate, there were 2 cases of uni- and 8 cases of bilateral SNHL. Delayed-onset hearing loss was diagnosed in 5% of all children with congenital CMV infection (in 3 of 10 children with SNHL). Time of onset of SNHL is the most probable during first three years of life. Tests for APD have been performed in 10 children with normal hearing level of both groups. 7 children of the main group and only 1 child of the control one failed the tests. So APD were suspected significantly more frequently in children with congenital CMV infection in comparison with the control group (70% and 10% respectively). Conclusions: Congenital CMV infection affects both peripheral and central parts of auditory pathways and may lead to SNHL and APD occurrence, thus long-term audiological evaluation is strictly recommended in this group of patients. The audiological examination has to be conducted: every 3 month during the first year of life; every 6 months at the second year and the third year of life; once a year later till 6 years old. This algorithm is a common recommendation and needs to be adapted individually for each child. The recommended APD test battery is appropriate for children elder 4 years old and has to be included into a protocol of examination in children with congenital CMV infection.
- Subjects
POLAND; RISK of deafness; PATIENT aftercare; CYTOMEGALOVIRUS diseases; AUDIOLOGY; NEONATAL diseases; CONFERENCES &; conventions; WORD deafness; RISK assessment; ALGORITHMS; DISEASE risk factors; DISEASE complications; CHILDREN
- Publication
Journal of Hearing Science, 2022, Vol 12, Issue 1, p95
- ISSN
2083-389X
- Publication type
Article