Should You Follow the Better-Hearing Ear for Congenital Cytomegalovirus Infection and Isolated Sensorineural Hearing Loss?

Otolaryngol Head Neck Surg. 2020 Jan;162(1):114-120. doi: 10.1177/0194599819880348. Epub 2019 Oct 8.

Abstract

Objective: To describe the progression of sensorineural hearing loss (SNHL) in the better- and poorer-hearing ears in children with asymptomatic congenital cytomegalovirus (CMV) infection with isolated SNHL.

Study design: Longitudinal prospective cohort study.

Setting: Tertiary medical center.

Subjects and methods: We analyzed hearing thresholds of the better- and poorer-hearing ears of 16 CMV-infected patients with isolated congenital/early-onset or delayed-onset SNHL identified through hospital-based CMV screening of >30,000 newborns from 1982 to 1992.

Results: By 12 months of age, 4 of 7 patients with congenital/early-onset SNHL developed worsening thresholds in the poorer-hearing ear, and 1 had an improvement in the better-hearing ear. By 18 years of age, all 7 patients had worsening thresholds in the poorer-hearing ear and 3 patients had worsening thresholds in the better-hearing ear. Hearing loss first worsened at a mean age of 2 and 6 years in the poorer- and better-hearing ears, respectively. Nine patients were diagnosed with delayed-onset SNHL (mean age of 9 years vs 12 years for the poorer- and better-hearing ears), 6 of whom had worsening thresholds in the poorer-hearing ear and 1 in both ears.

Conclusion: In most children with congenital CMV infection and isolated SNHL, the poorer-hearing ear worsened earlier and more precipitously than the better-hearing ear. This study suggests that monitoring individual hearing thresholds in both ears is important for appropriate interventions and future evaluation of efficacy of antiviral treatment.

Keywords: asymptomatic; cytomegalovirus; hearing; infection; sensorineural hearing loss.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Age of Onset
  • Asymptomatic Diseases*
  • Auditory Threshold
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cytomegalovirus Infections / congenital*
  • Disease Progression*
  • Female
  • Follow-Up Studies
  • Hearing Loss, Sensorineural / epidemiology*
  • Hearing Loss, Sensorineural / etiology*
  • Hearing Loss, Sensorineural / physiopathology
  • Hearing Tests
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Monitoring, Physiologic / methods
  • Neonatal Screening / methods
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Time Factors
  • United States