Prakash Rudra, Bhavana Kranti, Kumar Chandan, Bharti Bhartendu, Kumar Vijay
Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences (AIIMS), Patna, Bihar India 801507.
Audiologist & Speech Language Pathologist, Founder & Clinical Director Speech & Hearing Care Pvt. Ltd, Patna, India.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6455-6461. doi: 10.1007/s12070-021-02554-4. Epub 2021 Apr 21.
TORCH group of infections are one of the most common causes of bilateral profound hearing loss in a developing country like ours. Seroprevalance is quite high in eastern part of our country. Screening for TORCH infections in children's with profound hearing loss has significant prognostic, planning and policy forming implications. To evaluate the seroprevalance of TORCH infections in prospective cochlear implant children and its significance. Ours is a retrospective study conducted from 2017 to 2018 on 50 children with bilateral profound hearing loss attending the Department of ENT at AIIMS, Patna. Thorough clinical and audiological assessment of the patients was done using objective tests like OAE (otoacoustic emission), ABR (auditory brainstem response) and subjective tests like BOA(behavioural audiometry) and PTA (puretone audiometry) wherever feasible. Blood samples were collected and serotesting was done using ELISA for Toxoplasma, Rubella, Cytomegalovirus (CMV) and Herpes Simplex Virus (HSV) (TORCH). We found that IgM was negative for all patients. Seroprevalance for IgG was 16.3% for toxoplasma, 74.4% for rubella, 69.8% for CMV and 20.9% for HSV. All the children had bilateral severe to profound loss on ABR and bilateral REFER on OAE. As prevalence of TORCH infection is quite common in India and is an established risk factor for sensorineural hearing loss with multisystem involvement screening for the same will help in early identification and in decision making for cochlear implantation thus improving the prognosis and also aid in policy making.
在像我们这样的发展中国家,TORCH感染组是导致双侧重度听力损失的最常见原因之一。在我国东部地区,血清阳性率相当高。对重度听力损失儿童进行TORCH感染筛查具有重要的预后、规划和政策制定意义。为了评估前瞻性人工耳蜗植入儿童中TORCH感染的血清阳性率及其意义。我们进行了一项回顾性研究,研究对象为2017年至2018年在巴特那全印医学科学研究所耳鼻喉科就诊的50例双侧重度听力损失儿童。在可行的情况下,使用客观测试如耳声发射(OAE)、听性脑干反应(ABR)以及主观测试如行为测听(BOA)和纯音测听(PTA)对患者进行全面的临床和听力学评估。采集血样并使用酶联免疫吸附测定法(ELISA)对弓形虫、风疹、巨细胞病毒(CMV)和单纯疱疹病毒(HSV)(TORCH)进行血清检测。我们发现所有患者的IgM均为阴性。弓形虫IgG的血清阳性率为16.3%,风疹为74.4%,CMV为69.8%,HSV为20.9%。所有儿童的ABR均显示双侧重度至极重度听力损失,OAE均显示双侧反应消失。由于TORCH感染在印度相当常见,并且是感音神经性听力损失伴多系统受累的既定危险因素,对其进行筛查将有助于早期识别以及人工耳蜗植入的决策制定,从而改善预后,也有助于政策制定。