Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Department of Population Health Sciences, Division of Biostatistics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Otolaryngol Head Neck Surg. 2020 Jan;162(1):114-120. doi: 10.1177/0194599819880348. Epub 2019 Oct 8.
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.
Longitudinal prospective cohort study.
Tertiary medical center.
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.
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.
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.
描述无症状先天性巨细胞病毒（CMV）感染伴孤立性感音神经性听力损失（SNHL）儿童中，听力较好耳和听力较差耳 SNHL 的进展情况。
纵向前瞻性队列研究。
三级医疗中心。
我们分析了 1982 年至 1992 年通过对 3 万多名新生儿进行基于医院的 CMV 筛查，确定的 16 例伴先天性/早发性或迟发性 SNHL 的 CMV 感染患者的听力阈值，这些患者的听力较好耳和听力较差耳均有孤立性先天性/早发性或迟发性 SNHL。
在 12 个月时，7 例先天性/早发性 SNHL 患者中有 4 例听力较差耳的阈值恶化，1 例听力较好耳的阈值改善。18 岁时，7 例患者听力较差耳的阈值均恶化，3 例患者听力较好耳的阈值恶化。听力损失首先在听力较差耳和听力较好耳分别在平均年龄 2 岁和 6 岁时恶化。9 例患者被诊断为迟发性 SNHL（听力较差耳和听力较好耳的平均年龄分别为 9 岁和 12 岁），其中 6 例听力较差耳的阈值恶化，1 例双耳阈值恶化。
在大多数患有先天性 CMV 感染和孤立性 SNHL 的儿童中，听力较差耳比听力较好耳更早且更急剧地恶化。本研究表明，监测双耳的个体听力阈值对于适当的干预措施以及未来抗病毒治疗效果的评估非常重要。
