HEARING IMPAIRMENT AND CONGENITAL CMV IN YOUNG CHILDREN

该项目的主要目的是确定新生儿和幼儿中由于先天性巨细胞病毒（CMV）感染而最可能发生进行性和/或延迟性感音神经性听力损失（SNHL）的患病率和年龄。我们的项目还将确定新生儿期的危险因素，这些因素可以预测CMV感染婴儿无临床明显疾病的SNHL。我们的第三个目标是确定巨细胞病毒感染对人群中迟发性听力损失的相对贡献。这些目标将通过确定所有来自大学医院的先天性巨细胞病毒感染新生儿，并对他们进行连续测试以评估他们在不同年龄的听力敏感性来实现。此外，选择一组巨细胞病毒阴性并通过新生儿听觉筛查的新生儿作为对照，并与出生时没有听力损失的巨细胞病毒阳性儿童进行比较。所有在大学医院出生的婴儿目前都由本提案的研究人员进行先天性巨细胞病毒感染的病毒学筛查。在3周、3、6和12个月大时，每个CMV阳性婴儿将由临床听力学家进行完整的听力学评估，包括听觉脑干诱发反应（ABR）和每只耳朵的免疫阻抗测量。此外，每个孩子将在18、24和30个月大时进行完整的听力学评估，包括行为听力学评估（视觉强化或游戏听力学）和阻抗测量，以获得纯音阈值、言语接收阈值和言语辨别分数。对照组将在3周、6、12和18个月时接受类似的听力学评估。我们的建议将为CMV引起的SNHL的流行病学和自然史提供更好的知识。这一信息对于规划婴幼儿SNHL的早期发现和干预策略至关重要。

The primary objective of this project is to determine the prevalence and the ages when progressive and/or delayed onset of sensorineural hearing loss (SNHL) is most likely to occur in infants and young children due to congenital cytomegalovirus (CMV) infection. Our project will also define risk factors in the newborn period that prefict SNHL in CMV infected infants without clinically apparent disease. Our third aim will define the relative contribution of CMV infection to delayed onset hearing loss in the population. These aims will be achieved by identifying all newborns with congenital CMV infection from University Hospital and serially testing them to evaluate their hearing sensitivity at various ages. Also, a selected control group of newborns who are CMV negative and pass a newborn auditory screen will be followed and compared to CMV positive children without hearing loss at birth. All infants born at University Hospital are currently screened virologically for congenital CMV infection by the investigators of this proposal. At 3 weeks, 3, 6, and 12 months of age, each CMV positive infant will have a complete audiological evaluation by a clinical audiologist that will include an auditory brainstem evoked response (ABR) and immittance measures for each ear. Also, each child will have a complete audiological evaluation at 18, 24 and 30 months of age that will include behavioral audiometric assessment (visual reinforcement or play audiometry) and immittance measures to obtain pure tone thresholds, speech reception thresholds and speeh discrimination scores. The control group will receive similar audiological evaluations at 3 weeks, 6, 12, and 18 months of age. Our proposal will provide better knowledge of the epidemiology and natural history of SNHL due to CMV. This information is essential for planning early detection and intervention strategies for SNHL in infants and young children.