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Updated: Jan 21, 2026

High-Speed Human Temporal Bone Sectioning for the Assessment of COVID-19-Associated Middle Ear Pathology
Published on: May 18, 2022
Cytomegalovirus-induced pathology in human temporal bones with congenital and acquired infection
Vladimir Tsuprun1, Nevra Keskin2, Mark R Schleiss3
1Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.
Objective:
Publications on histopathology of human temporal bones with cytomegalovirus (CMV) infection are limited. We aim to determine histopathology of the inner ears and the middle ears in human temporal bones with congenital and acquired CMV infections.
Methods:
Temporal bones from 2 infants with congenital and 2 adults with acquired CMV infection were evaluated by light microscopy.
Results:
Two infants with congenital CMV infection showed striking pathological changes in the inner ear. There was a hypervascularization of the stria vascularis in the cochlea of the first infant, but no obvious loss of outer and inner hair cells was seen in the organ of Corti. However, cytomegalic cells and a loss of outer hair cells were found in the cochlea of the second infant. The vestibular organs of both infants showed cytomegalic cells, mostly located on dark cells. There was a loss of type I and type II hair cells in the macula of the saccule and utricle. Loss of hair cells and degeneration of nerve fibers was also seen in the semicircular canals. Both infants with congenital infection showed abundant inflammatory cells and fibrous structures in the middle ear cavity. No evidence of cytomegalic cells and hair cell loss was found in the cochlea or vestibular labyrinth in acquired CMV infection.
Conclusions:
In two infants with congenital CMV infection, the cochlea, vestibule, and middle ear were highly affected. Temporal bones of adult donors with acquired viral infection showed histological findings similar to donors of the same age without ear disease.
Insights
Congenital cytomegalovirus (CMV) infection severely impacts infant inner and middle ears, causing significant histopathology. Acquired CMV in adults shows no similar auditory system damage.
Area of Science:
- Otolaryngology
- Virology
- Pathology
Background:
- Histopathological studies on human temporal bones with cytomegalovirus (CMV) infection are scarce.
- This study investigates the inner and middle ear histopathology in human temporal bones affected by congenital and acquired CMV infections.
Observation:
- Two infants with congenital CMV infection exhibited severe inner ear pathology, including cochlear hypervascularization and hair cell loss.
- Vestibular organs in infants showed cytomegalic cells and significant hair cell loss.
- Middle ear cavities in infants presented with inflammatory cells and fibrous structures.
Findings:
- Congenital CMV infection led to pronounced cochlear, vestibular, and middle ear damage in infants.
- Acquired CMV infection in adults did not result in detectable cochlear or vestibular histopathological changes.
Implications:
- Congenital CMV infection poses a significant risk for auditory system development and function in infants.
- Histopathology in acquired CMV infection does not appear to affect the auditory system in adults.
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