Sensorineural hearing loss (SNHL) and ophthalmic complications as a cause of congenital cytomegalovirus (CMV) infection in children
Journal Title: Annales Academiae Medicae Silesiensis - Year 2014, Vol 68, Issue 3
Abstract
INTRODUCTION Congenital cytomegalovirus (CMV) infection is a cause of sensorineural hearing loss (SNHL) in children. Symptomatic CVM is present in 5–10% of children with this disease and typical clinical signs of congenital cytomegalovirus infection are: microcephalia, mental retardation, progressive major amblyacousia, neuromuscular infection and ocular complications. One percent of live births has cytomegalovirus infection, 90% neonates with perinatal infection do not show symptoms of the disease. It is believed that symptomatic CMV is associated with a 90 % risk of neurological sequelae including hearing loss, or a risk of ophthalmic disorders. Ophthalmological symptoms of congenital CMV infection may affect between 5% and 30% of children. Most are disorders of the posterior segment of the eye such as retinochorioiditis, macular scars and peripheral retina, optic nerve atrophy and uveitis. Pathology of the anterior segment of the eye exists in the form of congenital cataract and corneal scarring. It is believed that with congenital CMV infection, strabismus, microphthalmia or lack of eyeball may coexist. Hypoacusis occurs in 30–60% of children with congenital symptomatic CVM. . The aim of the paper is to present the audiological examination schema in our Clinic for patients with CMV infection, involving the tonal audiometry threshold and objective hearing organ testing, as well as the ophthalmological view on these infections. MATERIAL AND METHOD The study group consisted of 30 children with cytomegalovirus infection at the age of 2–12 years, hospitalized at the Instytucie Centrum Zdrowia Matki Polki (Institute of Polish Mother's Health Center) in Lodz. 22 of them (73%) had congenital cytomegalovirus, 8 (27%) acquired cytomegalovirus. RESULTS AND DISCUSSION In the cases of congenital CMV infection, half of the patients in our study had bilateral profound sensorineural hearing loss (in pure tone audiometry threshold curves of air and bone conduction at low and medium frequencies of 70 dB, while for frequencies above 2000 Hz at 90 dB). The presence of wave V in the ABR examination was recorded on both sides at the level of 90 dB. Bilateral sensorineural hearing losses were associated with mental and physically retardation, brain malformation and microcephalia. In the group of children with acquired CMV, we did not observe hearing loss. CONCLUSIONS This research proved that only congenital cytomegalovirus infection caused hearing loss. In spite of this, all children with congenital and acquired CMV should be consistently controlled by an audiologist and ophthalmologist.
Authors and Affiliations
Małgorzata Śmiechura, Łukasz Konopka, Wiesław Konopka
Keywords
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