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10/09/2023  |   11:45 AM - 12:10 PM   |  6619

Trajectory of Hearing Loss in Children with Congenital Cytomegalovirus

Abstract Summary

Objective/Hypothesis: Sensorineural hearing loss (SNHL) is a common sequela of congenital cytomegalovirus (cCMV), potentially exacerbating neurocognitive delay. The objectives were to assess the characteristics, trajectory and rehabilitation of children who presented with SNHL due to cCMV. Methods: This retrospective study of a prospectively acquired cohort included 123 children with cCMV referred for hearing loss at a single tertiary referral hospital over 20-years. Outcome measures were results of newborn hearing screening (NHS), behavioral audiograms and rehabilitation. Results: At birth, 113 children with cCMV underwent NHS, 31 (27%) passed in both ears and 23 (20%) passed in one ear (no NHS data in 10 children). At first audiologic assessment, 32/123 (26%) had normal hearing bilaterally; 35/123 (28%) had unilateral SNHL; and 57/123 (46%) had bilateral SNHL. More than half (67/123, 54%) experienced hearing deterioration in at least one ear. Survival analyses suggested that 60% of children who developed SNHL did so by 2.5 years and 80% by 5 years. In those who passed NHS in one/both ears, 50% developed SNHL by 3.5 years in unilateral passes (n=23 ears) and 50% by 5 years in bilateral passes (n=62 ears). SNHL was significant enough in all but one child with isolated high frequency loss for rehabilitation to be indicated. Hearing thresholds in individual ears were in the CI range in 83% (102/123) although duration of deafness was sufficient to preclude implantation at our centre in 13 children with unilateral SNHL. Hearing aids were indicated in 16% (20/123). Conclusions: cCMV-related SNHL is often not detected by NHS but occurs with high prevalence in early childhood. Combined, the data show early and rapid deterioration of hearing in children with cCMV-related SNHL with potential for good outcomes if SNHL is identified and managed without delay. Findings support universal newborn screening for cCMV followed by careful audiological monitoring.

Learning Objectives

  • Recognize and predict the impact of congenital CMV on hearing
  • Consider the role of amplification and implantation in CMV related hearing loss, including single sided deafness.
  • Understand the methods through which hearing progression over time should be considered.


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Sharon Cushing | Primary Presenter

Dr. Sharon Cushing is a full-time paediatric otolaryngologist and the Director of the Cochlear Implant Program at The Hospital for Sick Children and a Professor in the Department of Otolaryngology Head and Neck Surgery at the University of Toronto, Canada. Dr. Cushing has a clinical and surgical interest in disorders of the ear, including hearing loss and vestibular dysfunction. Her research interest include vestibular and balance dysfunction in children, and its association with hearing loss and cochlear implantation.


Financial - Receives Intellectual property rights for Other activities from Cochlear Corporation.   Receives Speaker for Teaching and speaking from Cook Medical.   Receives Consulting fee for Consulting,Membership on advisory committee or review panels from Decibel Therapeutics.   Receives In kind for Other activities from Interacoustics.   Receives Royalty options or other ownership interest for Other activities from Plural Publishing.  

Nonfinancial - No relevant nonfinancial relationship exists.


Financial - Receives support from Cochlear Corporation Plural Publishing Decibel Therapeutics Cook Medical Interacoustics Patents #: 7041-0: Systems And Methods For Balance Stabilization for Research Support, Speakers Bureau Royalties: Editor of The Manual of Pediatric Balance Disorders Consultant Speaker's Bureau In kind equipment.