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Developmental disabilities and intracranial abnormalities in children with symptomatic cytomegalovirus and cochlear

Catherine K Hart1, Susan Wiley, Daniel I Choo

  • 1Division of Pediatric Otolaryngology Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.

ISRN Otolaryngology
|June 14, 2013
PubMed

Insights

Children with congenital cytomegalovirus (CMV) and cochlear implants (CI) often have cognitive delays and brain abnormalities. Brain imaging findings correlate with outcomes, aiding in parental counseling for post-implantation performance.

Area of Science:

  • Pediatric Neurology
  • Audiology
  • Developmental Pediatrics

Background:

  • Congenital symptomatic cytomegalovirus (CMV) is a leading cause of sensorineural hearing loss in children.
  • Cochlear implants (CI) offer a potential auditory rehabilitation option for these children.
  • Understanding the impact of neurodevelopmental factors and brain abnormalities is crucial for predicting CI outcomes.

Purpose of the Study:

  • To investigate the association between intracranial radiographic abnormalities and developmental measures with outcomes in children with congenital symptomatic CMV receiving cochlear implants.
  • To identify specific neuroimaging findings and developmental parameters that correlate with post-CI performance.

Main Methods:

  • Retrospective review of 15 children with congenital symptomatic CMV who received cochlear implants between 2004 and 2010.
  • Analysis of pre-implant nonverbal intelligence quotient/developmental quotient (IQ/DQ) and head circumference (HC).
  • Review of brain CT/MRI, post-CI audiometry, and language assessments.

Main Results:

  • 73% of children exhibited cognitive delay, with a median IQ/DQ of 65. All children had intracranial imaging abnormalities, predominantly in the parietal and temporal lobes.
  • Smaller head circumference (<5th percentile) was associated with poorer post-CI pure-tone average (PTA).
  • Periventricular calcifications correlated with lower receptive and expressive language scores, with relationships partially mediated by IQ/DQ.

Conclusions:

  • The location and presence of brain abnormalities in children with congenital CMV are associated with outcomes following cochlear implantation.
  • Neurodevelopmental status, particularly IQ/DQ, plays a significant role in the relationship between brain abnormalities and language development.
  • These findings can inform more accurate counseling for parents regarding expected outcomes after cochlear implantation.

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