Hilary McCrary1, Xiaoming Sheng2, Tom Greene3, Albert Park4. 1. University of Utah School of Medicine, Division of Otolaryngology - Head and Neck Surgery, Utah, United States. 2. University of Utah School of Nursing, Utah, United States. 3. University of Utah School of Medicine, Department of Population Health Sciences, Division of Biostatistics, Utah, United States. 4. University of Utah School of Medicine, Division of Otolaryngology - Head and Neck Surgery, Utah, United States. Electronic address: albert.park@hsc.utah.edu.
Abstract
OBJECTIVES: Congenital human cytomegalovirus (cCMV) is a leading cause of pediatric hearing loss. Recent literature has suggested that valganciclovir (VGCV) therapy can improve hearing outcomes. The objective of this study was to evaluate the long-term hearing outcomes among symptomatic CMV patients treated with VGCV. METHODS: A retrospective chart review of symptomatic CMV patients treated with VGCV was completed. The primary endpoint was the change in best ear hearing scores prior to treatment and after follow-up audiograms. A paired-sample t-test was used to evaluate the data. RESULTS: A total of 16 children were included in the study and participants were followed for an average of 3.2 years. There was a measurable worsening, but not a statistically significant change in the best ear hearing scores, where the mean change was 11.9 dB (p-value = 0.070). However, 14/16 patients (87.5%, p-value<0.001) were found to have clinically significant worsening of hearing. The mean change in hearing scores for the left and right ear was 14.2 dB (p-value = 0.023) and 15.5 dB (p-value = 0.032), respectively. Mean elapsed time for progressive loss was 2.6 ± 0.2 years. When comparing the better or worse ear, there was no pattern for which ear deteriorated earlier or more frequently. CONCLUSIONS: Our data did show a measurable, but not a statistically significant worsening outcome in best ear hearing. There was a significant change in both left and right ear hearing. Our results suggest that VGCV may provide only a short-term improvement in hearing outcomes; however, these preliminary post-hoc findings suggest the need for a more rigorous evaluation.
OBJECTIVES:Congenital human cytomegalovirus (cCMV) is a leading cause of pediatric hearing loss. Recent literature has suggested that valganciclovir (VGCV) therapy can improve hearing outcomes. The objective of this study was to evaluate the long-term hearing outcomes among symptomatic CMVpatients treated with VGCV. METHODS: A retrospective chart review of symptomatic CMVpatients treated with VGCV was completed. The primary endpoint was the change in best ear hearing scores prior to treatment and after follow-up audiograms. A paired-sample t-test was used to evaluate the data. RESULTS: A total of 16 children were included in the study and participants were followed for an average of 3.2 years. There was a measurable worsening, but not a statistically significant change in the best ear hearing scores, where the mean change was 11.9 dB (p-value = 0.070). However, 14/16 patients (87.5%, p-value<0.001) were found to have clinically significant worsening of hearing. The mean change in hearing scores for the left and right ear was 14.2 dB (p-value = 0.023) and 15.5 dB (p-value = 0.032), respectively. Mean elapsed time for progressive loss was 2.6 ± 0.2 years. When comparing the better or worse ear, there was no pattern for which ear deteriorated earlier or more frequently. CONCLUSIONS: Our data did show a measurable, but not a statistically significant worsening outcome in best ear hearing. There was a significant change in both left and right ear hearing. Our results suggest that VGCV may provide only a short-term improvement in hearing outcomes; however, these preliminary post-hoc findings suggest the need for a more rigorous evaluation.
Authors: David W Kimberlin; Penelope M Jester; Pablo J Sánchez; Amina Ahmed; Ravit Arav-Boger; Marian G Michaels; Negar Ashouri; Janet A Englund; Benjamin Estrada; Richard F Jacobs; José R Romero; Sunil K Sood; M Suzanne Whitworth; Mark J Abzug; Mary T Caserta; Sandra Fowler; Jorge Lujan-Zilbermann; Gregory A Storch; Roberta L DeBiasi; Jin-Young Han; April Palmer; Leonard B Weiner; Joseph A Bocchini; Penelope H Dennehy; Adam Finn; Paul D Griffiths; Suzanne Luck; Kathleen Gutierrez; Natasha Halasa; James Homans; Andi L Shane; Michael Sharland; Kari Simonsen; John A Vanchiere; Charles R Woods; Diane L Sabo; Inmaculada Aban; Huichien Kuo; Scott H James; Mark N Prichard; Jill Griffin; Dusty Giles; Edward P Acosta; Richard J Whitley Journal: N Engl J Med Date: 2015-03-05 Impact factor: 91.245
Authors: David W Kimberlin; Chin-Yu Lin; Pablo J Sánchez; Gail J Demmler; Wayne Dankner; Mark Shelton; Richard F Jacobs; Wendy Vaudry; Robert F Pass; Jan M Kiell; Seng-jaw Soong; Richard J Whitley Journal: J Pediatr Date: 2003-07 Impact factor: 4.406