title: Does severity of cerebral MRI lesions in congenital CMV infection correlates with the outcome of cochlear implantation?
abstract: The objective is to investigate whether there is a correlation between the severity of typical brain lesions in congenital cytomegalovirus (cCMV) infection and cochlear implant (CI) outcome. The design of the study is a retrospective single-institutional chart review (2005-2015), performed in a tertiary academic referral center. 23 children with typical signs of cCMV infection on cerebral magnetic resonance imaging (MRI) and bilateral severe-to-profound sensorineural hearing loss were retrospectively evaluated. They were graded in three groups according to the severity of brain involvement. The average implantation age of the first CI is 1.8 years (range 0.6-5.8). Five patients were implanted unilaterally, 18 bilaterally. The average follow-up time after implantation was 3.3 years (range 0.6-6.9). Hearing performance was assessed using the Categories of Auditory Performance (CAP), and speech development was assessed using Speech Intelligibility Rating (SIR). The outcome in each group showed great variation. The majority of children achieved moderate-to-good auditory and speech rehabilitation. The children with severe MRI changes had comparatively better auditory than speech scores. There were children with good auditory performance (CAP ≥6) both in grades II and III, while poor performers (CAP ≤3) were encountered in each group. The severity of brain lesions on its own does not directly correlate with the outcome of cochlear implantation. Despite good retrospective diagnostic evidence of cCMV infection through MRI patterns, this has no predictive role for future hearing and speech rehabilitation.
authors.affiliation: Department of Otolaryngology, Hannover Medical School, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Lyutenski
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Götz
authors.affiliation: Department of Otolaryngology, Hannover Medical School, Hannover, Germany.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Giourgas
authors.affiliation: Department of Otolaryngology, Hannover Medical School, Hannover, Germany.
authors.forename: Omid
authors.initials: O
authors.lastname: Majdani
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Bültmann
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Lanfermann
authors.affiliation: Department of Otolaryngology, Hannover Medical School, Hannover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lenarz
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Giesemann.Anja@mh-hannover.de.
authors.forename: Anja M
authors.initials: AM
authors.lastname: Giesemann
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000601:surgery / Q000821:virology; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D065706:Polymicrogyria / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013065:Speech Intelligibility
keywords: Cochlear implant; Cytomegalovirus infection; MRI; Polymicrogyria