title: Developmental disabilities and intracranial abnormalities in children with symptomatic cytomegalovirus and cochlear implants.
abstract: Objective. To examine the association of intracranial radiographic abnormalities and developmental measures with outcomes in children with congenital symptomatic cytomegalovirus (CMV) and cochlear implants (CI). Design/Methods. It was a retrospective review of 15 children implanted from 2004 to 2010. Preimplant nonverbal intelligence quotient/developmental quotient (IQ/DQ) and head circumference (HC) were obtained. Computed tomography and magnetic resonance imaging of the brain and post-CI audiometry and language assessments were reviewed. Results. Eleven children (73%) had cognitive delay. Most had >1 developmental disability. Median IQ/DQ was 65 (23-90). All had imaging abnormalities. Most imaging abnormalities were in parietal (60%) and temporal (60%) lobes. Children with HC < 5th percentile had poorer median post-CI PTA (38 dB versus 27 dB, P = 0.02). Periventricular calcifications were associated with lower receptive (r b = -0.75, P = 0.03) and expressive (r b = -0.84, P = 0.008) language. Because IQ/DQ was associated with periventricular calcifications (r b = -0.53, P = 0.04) and small HC (r b = -0.73, P = 0.002), their relationships with language appear partially driven by IQ/DQ. Conclusions. The location of brain abnormalities appears to correlate with worse outcomes after CI. These findings may allow for more accurate counseling of parents regarding anticipated postimplantation performance.
authors.affiliation: Division of Pediatric Otolaryngology Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Catherine K
authors.initials: CK
authors.lastname: Hart
authors.forename: Susan
authors.initials: S
authors.lastname: Wiley
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Choo
authors.forename: Christine
authors.initials: C
authors.lastname: Eby
authors.forename: Laura
authors.initials: L
authors.lastname: Tucker
authors.forename: Mark
authors.initials: M
authors.lastname: Schapiro
authors.forename: Jareen
authors.initials: J
authors.lastname: Meinzen-Derr