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Human cytomegalovirus labyrinthitis.

M Strauss1

  • 1Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, OH 44106.

American Journal of Otolaryngology
|September 1, 1990
PubMed
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Human cytomegalovirus (HCMV) labyrinthitis can cause significant hearing loss in infants, affecting up to 48% of symptomatic and 13% of asymptomatic children. This review examines clinical and histopathologic findings of HCMV inner ear infections.

Area of Science:

  • Otolaryngology
  • Virology
  • Pathology

Background:

  • Human cytomegalovirus (HCMV) infection is recognized in congenital disseminated and subclinical forms.
  • Endolabyrinthine HCMV infection was first reported in temporal bones in 1968.
  • Histopathologic findings in infants show HCMV inclusion-bearing cells in the cochlear and vestibular endolabyrinth.

Purpose of the Study:

  • To review clinical and histopathologic findings of human cytomegalovirus (HCMV) labyrinthitis.
  • To summarize audiological and vestibular outcomes in HCMV-infected children.
  • To discuss histopathologic evidence of acquired HCMV labyrinthitis.

Main Methods:

  • Review of published clinical and histopathologic case reports of HCMV labyrinthitis.
  • Analysis of audiological data from prospective studies on congenitally HCMV-infected children.

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  • Examination of histopathologic findings in temporal bones.

    • Main Results:

    • HCMV inclusion-bearing cells found in non-neuroepithelial cells of the cochlear and vestibular endolabyrinth.
    • Significant hearing loss reported in 33-48% of symptomatic and 6.9-13% of asymptomatic congenitally infected children.
    • Progressive hearing loss and potential Meniere's syndrome are long-term sequelae; vestibular dysfunction is less characterized.

    Conclusions:

    • Congenital HCMV labyrinthitis can lead to significant and progressive hearing loss.
    • Acquired HCMV infection is associated with sudden deafness and acute labyrinthitis, though histopathologic evidence is limited.
    • Further research is needed to fully characterize vestibular dysfunction and long-term outcomes.