CONGENITAL CYTOMEGALOVIRUS INFECTION (C-CMV) A CAUSE OF SENSORINEURAL HEARING LOSS (SNHL)

Abstract

C-CMV is exceedingly common in our low socioeconomic population (2.3% of all live births). Over 90% of the cases however, are asymptomatic at birth. Nevertheless, the chronic nature of this infection may lead in time to low grade morbidity in particular SNHL. To define the incidence and significance of this process, the hearing acuity of 59 patients (mean age 54 months, range 2-102) born with C-CMV and of 41 uninfected controls (mean age 46 months, range 7-124) was tested by pure tone audiometry in a sound field (<2 years of age) and/or under earphones. Significant SNHL (50 decibel or over) occurred in 10 infected patients (17%) and had a progressive course in 2 of them. In contrast only 1 uninfected subject had SNHL of borderline significance at 12 months of age.

To better define the CMV-SNHL etiologic relationship we performed histopathologic studies of the inner ear of 3 patients who died with symptomatic C-CMV. Typical inclusion bodies were found in the stria vascularls and the Reissner's membranes. By means of an anticomplementary immunofluorescent assay, CMV antigens were in addition detected in the cells of the organ of Corti and the neurones of the spiral ganglia. These findings clearly suggest that CMV has the potential to infect cells of the most vital structures of the inner ear and thus give further credence to the pathogenic role of this virus in SNHL.

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