title: A diagnostic paradigm including cytomegalovirus testing for idiopathic pediatric sensorineural hearing loss.
abstract: OBJECTIVE
  To determine the feasibility and cost effectiveness of incorporating cytomegalovirus (CMV) testing to determine the etiology of pediatric hearing loss.
  
  
  METHODS
  Retrospective study of children presenting with sensorineural hearing loss (SNHL) at one institution from 2008 to 2013.
  
  
  METHODS
  Children aged 3 years or younger who presented to the senior author (A.P.) between May 2008 and September 2013 with confirmed SNHL were evaluated. These children underwent a sequential diagnostic paradigm that incorporated CMV testing if no obvious etiology could be determined from the history or physical examination.
  
  
  RESULTS
  One hundred eleven children with SNHL were evaluated between 2008 and 2013. Eighty-three children underwent CMV testing, imaging, and a genetic evaluation. Those with confirmed or probable CMV-induced SNHL made up 30% of all children tested (n = 25), the largest group identified. CMV screening had the lowest cost compared to genetic testing or imaging for all types of hearing loss, except for those with auditory neuropathy spectrum disorder.
  
  
  CONCLUSIONS
  We present the first sequential diagnostic paradigm utilizing CMV testing for children presenting with SNHL. The relatively high incidence of CMV-induced SNHL, the low cost for this assay, and the indirect benefits from early diagnosis support the role of early CMV testing for these patients.
  
  
  METHODS
  4.
authors: Division of Otolaryngology-Head and Neck Surgery, Salt Lake City, Utah, U.S.A.
authors: Albert H
authors: AH
authors: Park
authors: Melanie
authors: M
authors: Duval
authors: Stephanie
authors: S
authors: McVicar
authors: James F
authors: JF
authors: Bale
authors: Nancy
authors: N
authors: Hohler
authors: John C
authors: JC
authors: Carey
mesh_terms: D001299:Audiometry / Q000191:economics / Q000379:methods; D002675:Child, Preschool; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D016208:Databases, Factual; D005240:Feasibility Studies; D005260:Female; D005820:Genetic Testing / Q000191:economics / Q000379:methods; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000235:genetics / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D008487:Medical History Taking; D010808:Physical Examination / Q000191:economics / Q000379:methods; D012189:Retrospective Studies
keywords: Cytomegalovirus; sensorineural hearing loss