title: Hearing status in children with congenital cytomegalovirus: up-to-6-years audiological follow-up.
abstract: OBJECTIVE
  To evaluate the audiological outcome of children with congenital cytomegalovirus infection.
  
  
  METHODS
  In a prospective study, the hearing of ninety seven congenitally cytomegalovirus-infected children, born between January 2003 and July 2009, was systematically evaluated until the age of six, applying the Flemish CMV protocol. Depending on the age of the child, the protocol provides hearing evaluation by objective-, play- or conventional audiometry. Symptomatic children with hearing loss at birth were treated with ganciclovir, if parents consented.
  
  
  RESULTS
  Seventy children had a pass on initial screening, 27 had unilateral or bilateral hearing loss. Within the normal hearing group, one asymptomatic and two symptomatic children developed late-onset hearing loss. Within the group with hearing loss, 8 children received ganciclovir, while 8 symptomatic and 11 asymptomatic children did not receive ganciclovir. As for the treated group, 37.5% of the children had stable hearing loss, one child had progressive and one child had fluctuating hearing loss. Improvement of hearing threshold occurred in 37.5% of the children. Among the untreated symptomatic children, hearing loss remained stable in 50%, while progression occurred in 37.5%. In the group of asymptomatic children with hearing loss, hearing loss was most commonly stable (72.7%). Within the group of normal hearing ears at birth (n=156), there is a significant better progression in pure tone average for ears of asymptomatic subjects in comparison to ears of symptomatic subjects (p≤0.0001). As for the group of ears with hearing loss at birth (n=38), analysis shows no evidence for a difference in pure tone average progression between the different groups (p=0.38).
  
  
  CONCLUSIONS
  Cytomegalovirus infection may cause hearing loss, in both symptomatic and asymptomatic children. Our data show a significant difference, between both groups, in the progression of pure tone average of normal hearing ears at birth, in favor of the asymptomatic children. This is not the case for ears with hearing loss at birth. However, this may be due to the small number of ears in this group. Our data show the tendency that treatment with ganciclovir increases the likelihood of improvement and reduces the likelihood of deterioration of the hearing.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium. liesbeth.royackers@uzleuven.be
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Royackers
authors.forename: Desloovere
authors.initials: D
authors.lastname: Christian
authors.forename: Debruyne
authors.initials: D
authors.lastname: Frans
authors.forename: Rector
authors.initials: R
authors.lastname: Ermelinde
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000627:therapeutic use*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir