Park Albert H, Duval Melanie, McVicar Stephanie, Bale James F, Hohler Nancy, Carey John C
Division of Otolaryngology-Head and Neck Surgery, Salt Lake City, Utah, U.S.A.
Laryngoscope. 2014 Nov;124(11):2624-9. doi: 10.1002/lary.24752. Epub 2014 Jun 26.
OBJECTIVES/HYPOTHESIS: To determine the feasibility and cost effectiveness of incorporating cytomegalovirus (CMV) testing to determine the etiology of pediatric hearing loss.
Retrospective study of children presenting with sensorineural hearing loss (SNHL) at one institution from 2008 to 2013.
Children aged 3 years or younger who presented to the senior author (A.P.) between May 2008 and September 2013 with confirmed SNHL were evaluated. These children underwent a sequential diagnostic paradigm that incorporated CMV testing if no obvious etiology could be determined from the history or physical examination.
One hundred eleven children with SNHL were evaluated between 2008 and 2013. Eighty-three children underwent CMV testing, imaging, and a genetic evaluation. Those with confirmed or probable CMV-induced SNHL made up 30% of all children tested (n = 25), the largest group identified. CMV screening had the lowest cost compared to genetic testing or imaging for all types of hearing loss, except for those with auditory neuropathy spectrum disorder.
We present the first sequential diagnostic paradigm utilizing CMV testing for children presenting with SNHL. The relatively high incidence of CMV-induced SNHL, the low cost for this assay, and the indirect benefits from early diagnosis support the role of early CMV testing for these patients.
目的/假设：确定将巨细胞病毒（CMV）检测纳入以确定儿童听力损失病因的可行性和成本效益。
对2008年至2013年在一家机构出现感音神经性听力损失（SNHL）的儿童进行回顾性研究。
对2008年5月至2013年9月间向资深作者（A.P.）就诊且确诊为SNHL的3岁及以下儿童进行评估。如果从病史或体格检查中无法确定明显病因，这些儿童将接受包括CMV检测在内的序贯诊断模式。
2008年至2013年间对111例SNHL儿童进行了评估。83名儿童接受了CMV检测、影像学检查和基因评估。确诊或可能由CMV引起的SNHL儿童占所有检测儿童的30%（n = 25），是确定的最大群体。除了患有听神经病谱系障碍的儿童外，对于所有类型的听力损失，CMV筛查的成本低于基因检测或影像学检查。
我们提出了首个针对患有SNHL儿童的利用CMV检测的序贯诊断模式。CMV引起的SNHL发病率相对较高、该检测成本低以及早期诊断带来的间接益处支持了对这些患者进行早期CMV检测的作用。
4级。
