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Vestibular Dysfunction in Pediatric Patients With Congenital Cytomegalovirus Infection and Hearing Loss: Occurrence

Guangwei Zhou, Hannah Peterson1, Alice Yun1

  • 1Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Waltham, Massachusetts.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|July 21, 2025
PubMed

Insights

Children with congenital cytomegalovirus (CMV) infection often experience significant vestibular dysfunction, frequently bilateral. Early balance and vestibular evaluation is crucial for managing this common complication beyond hearing loss.

Area of Science:

  • Pediatric Otolaryngology
  • Neuroscience
  • Infectious Diseases

Background:

  • Congenital cytomegalovirus (CMV) infection is a leading cause of non-genetic sensorineural hearing loss in children.
  • Vestibular dysfunction is an underrecognized consequence of congenital CMV infection.
  • The prevalence and characteristics of vestibular loss in this population require further elucidation.

Purpose of the Study:

  • To investigate the incidence of vestibular dysfunction in pediatric patients diagnosed with congenital CMV infection.
  • To characterize the nature of vestibular loss, including laterality and affected vestibular end-organs.
  • To compare vestibular function in congenital CMV patients with a control group having hearing loss due to GJB2 mutations.

Main Methods:

  • Retrospective study conducted at a tertiary pediatric referral center.
  • Included 50 pediatric patients with congenital CMV infection and hearing loss, and 48 controls with GJB2-associated hearing loss.
  • Utilized comprehensive vestibular evaluations, including Videonystagmography, rotary chair testing, and cervical vestibular evoked myogenic potentials.

Main Results:

  • 70% of children with congenital CMV infection exhibited bilateral vestibular loss, and 14% had unilateral loss.
  • In contrast, only 19% of the GJB2 control group showed bilateral vestibular loss, and 4% had unilateral loss.
  • Developmental and motor delays were noted in 70% of the congenital CMV cohort.

Conclusions:

  • Congenital CMV infection poses a high risk for significant vestibular loss, affecting both semicircular canals and otoliths.
  • Vestibular dysfunction is a common comorbidity alongside hearing loss in congenital CMV.
  • Routine, comprehensive vestibular and balance assessments are recommended for early detection and management in children with congenital CMV infection.
Abstract

Keywords:
Balance deficitCytomegalovirus (CMV)Pediatric vestibular dysfunctionVestibular evoked myogenic potential (VEMP)Vestibulo-ocular reflex (VOR)

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