title: Hearing thresholds in children with a congenital CMV infection: a prospective study.
abstract: OBJECTIVE
  Hearing thresholds in children with a congenital cytomegalovirus (cCMV) infection are not always stable. Children can develop late onset hearing loss, fluctuations, progression (worsening) and improvement of hearing loss. Knowledge about these characteristics is important to understand why long term follow up in these children is mandatory.
  
  
  METHODS
  We prospectively follow a cohort of 154 children with cCMV infection, 68 of which met the inclusion criteria of at least 3 hearing evaluations over a period of at least 18 months in the absence of other risk factors for hearing loss. In those 68 children we evaluated the occurrence of unstable hearing thresholds: late onset hearing loss, fluctuations, progression and improvement of hearing loss.
  
  
  RESULTS
  Unstable hearing thresholds were observed in 29.4% of children with cCMV infection of which 19.2% were found in the group of children with ultimately normal hearing and in 62.5% of children with sensorineural hearing loss (SNHL) (p=0.0027). Fluctuations occurred in 16.2%. Late onset hearing loss occurred in 4.3% of children with a normal hearing at birth. In children with SNHL, progression or worsening of hearing thresholds occurred in 27.3% and improvement of thresholds in 40.9%. Important changes in thresholds only occurred in 13.2% of all children and predominantly in children who finally develop SNHL.
  
  
  CONCLUSIONS
  Unstable hearing thresholds are frequently found in children with cCMV infection and occur not only in children who develop hearing losses but also in children who have a normal hearing at the last visit. Important changes in hearing thresholds of > 30 dB are more frequently seen in children who ultimately will develop SNHL.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. ina.foulon@uzbrussel.be
authors.forename: Ina
authors.initials: I
authors.lastname: Foulon
authors.forename: Anne
authors.initials: A
authors.lastname: Naessens
authors.forename: Gilles
authors.initials: G
authors.lastname: Faron
authors.forename: Walter
authors.initials: W
authors.lastname: Foulon
authors.forename: Anna C
authors.initials: AC
authors.lastname: Jansen
authors.forename: Frans
authors.initials: F
authors.lastname: Gordts
mesh_terms: D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital*; D034381:Hearing Loss / Q000209:etiology*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D012307:Risk Factors