Otolaryngol Head Neck Surg

for the Congenital Cytomegalovirus Longitudinal Study Group

Objectives Compare hearing trajectories among children with symptomatic and asymptomatic congenital CMV infection through age 18 years and identify brain abnormalities associated with sensorineural hearing loss (SNHL) in asymptomatic case-patients. Study Design Longitudinal prospective cohort study. Setting Tertiary medical center. Subjects and Methods Ninety-six (4 symptomatic and 92 asymptomatic) case-patients identified through hospital-based newborn CMV screening during 1982–1992 and 72 symptomatic case-patients identified through referrals during 1993–2005. We used growth curve modeling to analyze hearing thresholds (0.5–8 kHz) by ear with increasing age and Cox regression to determine abnormal findings on head computed tomography (CT) scan associated with SNHL (hearing threshold ≥25 dB in any audiometric frequency) among asymptomatic case-patients. Results Fifty-six (74%) symptomatic and 20 (22%) asymptomatic case-patients had SNHL: congenital/early-onset SNHL was diagnosed in 78 (51%) and 10 (5%) ears, respectively, and delayed-onset SNHL in 25 (17%) and 20 (11%) ears; 49 (32%) and 154 (84%) ears had normal hearing. In affected ears, all frequency-specific hearing thresholds worsened with age. Congenital/early-onset SNHL was significantly worse (severe-profound range [>70dB]) than delayed-onset SNHL (mild-moderate range [26–55db]). Frequency-specific hearing thresholds were significantly different between symptomatic and asymptomatic case-patients at 0.5–1 kHz but not at higher frequencies (2–8 kHz). Among asymptomatic case-patients, white matter lucency was significantly associated with SNHL by age 5 years (hazard ratio=4.4; 95% confidence interval: 1.3–15.6). Conclusion Congenital/early-onset SNHL frequently resulted in severe to profound loss in both symptomatic and asymptomatic case-patients. White matter lucency in asymptomatic case-patients was significantly associated with SNHL by age 5 years.

29557247

PMC5880689

Journal Article

CDC Public Access