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先天性巨细胞病毒感染与人工耳蜗植入术结果的相关性。

The Correlation of Congenital CMV Infection and the Outcome of Cochlear Implantation.

机构信息

Department of Ophthalmology - Otolaryngology-Head and Neck Surgery, Laval University, Quebec;Quebec Centre of Expertise in Cochlear Implant, Quebec.

出版信息

J Int Adv Otol. 2021 May;17(3):190-194. doi: 10.5152/iao.2021.9335.

Abstract

OBJECTIVES

Cytomegalovirus (CMV) infection is the most common intrauterine viral infection, affecting approximately 0.5-2.5% of all live births in the world. The majority of patients are asymptomatic at birth, but several clinical consequences are related to this infection, including neurosensory hearing loss. The cochlear implant is the treatment of choice when the hearing loss is severe to profound. Compare the audiological evolution after cochlear implant surgery in a group of children born with congenital CMV infection compared to a control group of children born with a genetic cause of congenital hearing loss. Determine prognostic factors predicting the outcome of patients with congenital hearing loss secondary to CMV infection following cochlear implantation.

METHODS

Our retrospective study aimed at the analysis of 48 patients with cochlear implants, 25 patients with congenital CMV, and 23 patients in the control group with cochlear cause of hearing loss, who were matched for gender, age of onset, and type of hearing loss. Primary outcomes are auditory evolution with the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and the multimedia audiologic test (MAT). Secondary outcomes are evaluation of prognostic factors for the CMV group, like MRI severity sign, antiviral treatment, and neuropsychological disorder.

RESULTS

For the MAT, the results are 73.9% in the CMV group and 81.6% in the control group (P = .03). For the IT-MAIS, the results are 29.3/40 in the CMV group and 29.2/40 in the control group (P = .96). In the CMV group, the children treated with antiviral treatment have IT-MAIS difference of 28.5/40 compared to 23.2/40 for the children without antiviral treatment (P = .03). We found a little trend in the correlation between auditory results and the presence of neuropsychological disorders, but there are no statistically significant results.

CONCLUSION

The results of the audiological tests in the CMV group allow an adequate functioning, even if lower than in the control group. There are benefits of implantation in patients with CMV, and audiological results are still satisfactory for proper functioning. CMV patients enjoy superior results in terms of hearing, with antiviral treatment.

摘要

目的

巨细胞病毒(CMV)感染是最常见的宫内病毒感染,影响全球约 0.5-2.5%的活产儿。大多数患者出生时无症状,但与这种感染相关的一些临床后果包括感觉神经性听力损失。当听力损失严重至重度时,人工耳蜗植入是首选治疗方法。将先天性 CMV 感染患儿与因遗传原因导致先天性听力损失的对照组患儿的人工耳蜗植入术后听力演变进行比较。确定预测 CMV 感染后人工耳蜗植入患者听力损失结局的预后因素。

方法

我们进行了一项回顾性研究,分析了 48 例人工耳蜗植入患者,其中 25 例为先天性 CMV 感染,23 例为对照组(因遗传性原因导致听力损失),两组患者在性别、发病年龄和听力损失类型方面相匹配。主要结局是采用婴幼儿有意义听觉整合量表(IT-MAIS)和多媒体听觉测试(MAT)评估听觉变化。次要结局是评估 CMV 组的预后因素,如 MRI 严重程度标志、抗病毒治疗和神经心理障碍。

结果

对于 MAT,CMV 组的结果为 73.9%,对照组为 81.6%(P=0.03)。对于 IT-MAIS,CMV 组的结果为 29.3/40,对照组为 29.2/40(P=0.96)。在 CMV 组中,接受抗病毒治疗的儿童与未接受抗病毒治疗的儿童相比,IT-MAIS 差异为 28.5/40(P=0.03)。我们发现听觉结果与神经心理障碍的存在之间存在一定的相关性趋势,但没有统计学意义的结果。

结论

CMV 组的听力测试结果表明其功能尚可,尽管比对照组低。CMV 患者接受植入物治疗有获益,且听力结果仍足以满足正常功能需求。抗病毒治疗可使 CMV 患者的听力结果更好。

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