Comparison of Hearing Phenotypes Among Children With Congenital Cytomegalovirus and Other Non-Cytomegalovirus Conditions

Sunday, September 29, 2024

3:06 PM – 3:12 PM EDT

Location: MBCC, 225

Disclosure(s):

Shi Liang, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jordan C. Stout, BFA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Albert H. Park, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: We hypothesize that the hearing phenotype of the cCMV-infected child with isolated SNHL may be distinct from other types of SNHL and may provide an alternative approach for diagnosis.

Methods: Auditory brainstem response (ABR) and behavioral audiogram threshold scores were collected from SNHL patients between 2005-2022 at Primary Children’s Hospital and categorized into four different groups: cCMV with isolated SNHL, connexin 26 mutation, enlarged vestibular aqueduct (EVA), and idiopathic. Using one-way ANOVA tests, we compared each patient's first reliable hearing thresholds from 250 to 4,000 Hz, taking the maximum value among the ears and the differences between ears, resulting in 16 measures. Since connexin mutation and EVA can be distinguished from cCMV based on genetic testing and imaging, further analysis focused on comparing the cCMV and idiopathic groups. Area under the receiver operating characteristic curve (AUROC) was calculated for hearing measures to distinguish between cCMV and idiopathic groups. By maximizing the Youden Index, a cut point was selected to help predict cCMV infection. Lastly, plots of various parameters over time were evaluated to compare the cCMV and idiopathic groups.

Results: A total of 72 patients were evaluated, including 19 patients with cCMV, 13 with a connexin 26 mutation, 24 with EVA, and 16 with idiopathic SNHL. cCMV group displayed greater asymmetry of Pure Tone Average (PTA) between ears relative to the other groups (p < 0.001), especially compared to idiopathic (p = 0.006). The difference between ears for PTA had an AUROC of 0.81 (95% CI: 0.66, 0.95). There was a specificity of 0.94 and a sensitivity of 0.53 for cCMV infection if the difference of PTA was greater than 58.6 dB (Youden Index). There were no distinctive patterns in threshold trajectories between the cCMV and idiopathic groups.

Conclusions: Our study suggests that the hearing phenotype of the cCMV-infected child with isolated SNHL may differ from other causes of SNHL. However, our study had a limited sample size and further studies are needed to confirm this finding.

Presenting Author(s)

Shi Liang, BS

Medical Student
University of Utah
Salt Lake City, UT, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Emily Y. Huang, BS

Medical Student
Johns Hopkins School of Medicine
Baltimore, MD, United States

Disclosure information not submitted.
Jordan C. Stout, BFA

Medical Student / Research Fellow
University of Utah
Phoenix, AZ, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
CW

Candace Winterton, BS

University of Utah, United States

Disclosure information not submitted.
CZ

Chong Zhang, MS

University of Utah, United States

Disclosure information not submitted.
BD

Bridget Dorsey, BS

University of Utah, United States

Disclosure information not submitted.
AP

Angela Presson, PhD

University of Utah, United States

Disclosure information not submitted.
MF

Matthew A. Firpo, PhD

Research Associate Professor
3. Department of Surgery, University of Utah, Salt Lake City, UT
Salt Lake City, UT, United States

Disclosure information not submitted.

Senior Author(s)

Albert H. Park, MD

Chief Pediatric Otolaryngology
University of Utah, Department of Otolaryngology-Head & Neck Surgery
Salt Lake City, UT, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.