Background The natural history of congenital CMV infection is scarcely known in populations with high maternal CMV seroprevalence. This study evaluated birth prevalence, clinical findings at birth, and hearing outcome in infected children from such a population. Methods Infants consecutively born were screened for the presence of CMV in urine and/or saliva within the first two weeks. Neonatal clinical findings were recorded and infected children were tested to document hearing function during follow-up. A subset of mothers of infected infants was prenatally tested for the presence of anti-CMV IgG antibodies. Results Congenital CMV infection was confirmed in 87/8047 infants (1.08%; 95%CI: 0.86–1.33). Seven (8.1%; 95%CI: 3.3–15.9) infants had at least one clinical finding suggestive of CMV infection and 4 (4.6%; CI95%: 1.3–11.3) had ≥ 3 findings of systemic disease. Sensorineural hearing loss was found in 5/58 (8.6%; CI95%: 2.9–19.0) children tested at a median age of 21 months. Bilateral profound hearing loss was observed in two children and hearing threshold was >60 dBHL in all five children with hearing loss, including two children born to mothers with probable non primary CMV infection. Conclusions The results of this first large newborn screening study in a population with high CMV seroimmunity provide additional evidence that congenital CMV disease occurs in populations with high seroprevalence rates with a similar incidence of CMV-related hearing loss to that reported in offspring of women from populations in the developed countries with lower rates of seroimmunity to CMV.

Background The burden of CMV-associated sensorineural hearing loss (SNHL) in populations with CMV seroprevalence approaching 100% is unknown. The purpose of this study was to assess the rate, associated factors and predictors of SNHL in CMV-infected infants identified by newborn screening in a highly seropositive maternal population. Methods Newborns with positive saliva CMV-DNA and confirmed by virus isolation in the first two weeks of life were enrolled in a prospective follow-up study to monitor hearing outcome. Results Of 12,195 infants screened, 121 (1%) were CMV-infected and 12 (10%) had symptomatic infection at birth. Hearing function could be assessed in 102/121 children who underwent at least one ABR testing at a median age of 12 months. SNHL was observed in 10/102 (9.8%; 95%CI: 5.1–16.7) children. Median age at the latest hearing evaluation was 47 months (12 to 84 months). Profound loss (>90dB) was found in 4/5 children with bilateral SNHL while all 5 children with unilateral loss had moderate to severe deficit. The presence of symptomatic infection at birth (OR 38.1; 95%CI: 1.6– 916.7) was independently associated with SNHL after adjusting for IUGR, gestational age, gravidity and maternal age. Among 10 infants with SNHL, six (60%) were born to mothers with non-primary CMV infection. Conclusions Even in populations with near universal immunity to CMV, congenital CMV infection is a significant cause of SNHL demonstrating the importance of CMV as a major cause of SNHL in children worldwide. As in other populations, SNHL is more frequently observed in symptomatic CMV infection.

Introdução:O diagnóstico e a intervenção precoces nas alterações auditivas são de fundamental importância no desenvolvimento infantil. O registro das emissões otoacústicas tem sido largamente indicado, por ser um exame rápido, de fácil aplicação. Objetivo: Os objetivos do presente estudo foram avaliar a função auditiva periférica de recém-nascidos a termo e pré-termo adequados e pequenos para a idade gestacional, por meio da pesquisa das emissões otoacústicas transitórias, identificando a prevalência de alterações auditivas nesta população; verificar a influência das variáveis idade gestacional e peso ao nascimento, assim como de tipos de tratamento, ventilação mecânica, administração de medicamentos ototóxicos e permanência em incubadora e analisar os fatores que interferem nos programas de triagem auditiva neonatal. Forma de estudo: Clínico prospectivo. Material e método: Foram avaliadas 157 crianças, sendo 43 nascidas a termo, 79 pré-termo adequadas à idade gestacional e 35 pré-termo pequenas à idade gestacional. Resultado: Observou-se que recém-nascidos prematuros falham mais nas respostas das emissões otoacústicas. A prevalência de perda auditiva condutiva na população estudada foi de 29 orelhas para 1000 e para perda auditiva neurossensorial de 16 orelhas para 1000. As crianças de peso baixo ao nascimento foram as mais difíceis de serem avaliadas. As emissões otoacústicas transitórias foram observadas a partir de 27 semanas de idade gestacional. Os tipos de tratamentos utilizados foram fatores que influenciaram negativamente nas respostas das emissões otoacústicas nos grupos de prematuros. Conclusão: O trabalho de diagnóstico precoce da perda auditiva deve ser objetivo de equipe interdisciplinar -neonatologista, pediatra, otorrinolaringologista, fonoaudiólogo, enfermeiro e familiares -e deve ser seguido, imediatamente, por programas de intervenção precoce. There were appraised 157 children, whose 43 were born full term, 79 preterm adequate to gestacional age and 35 small preterm to gestacional age. It had been observed that premature neonates fail more in the answers from otoacoustic emissions. Cristiane Fregonesi Results:The prevalence of conductive hearing impairment in the population studied was from 29 ears to 1000 and for the sensory-neural hearing impairment from the 16 to 1000. The low weight children in the birth were the most difficult to be appraised. The transient otoacoustic emissions were observed from the beginning of 27 gestacional weeks old. The kinds of treatments used were factors that influenced negatively in the answers of the otoacoustic emissions in premature groups. Conclusion:The early diagnostic work of the hearing impairment must be objective of the interdisciplinary teamneonatologist, pediatrician, ear/nose and throat doctor, audiologist and speech-language pathologist, nurse and relatives -and must be followed, immediately, by the early interventions programs. ORIGINAL ARTICLE ARTIGO ORIGINALRev Bras Otorrinolaringol.

Mi smatch Negativity (MMN) is used to evaluate the central auditory system. Aim: to characterize the MMN, in normal subjects. Materials and methods: prospective study, 12 subjects, six males and six females, between the ages of 18 and 24. "Mann-Whytnei" test. Exams: Pure Tone Audiometry (PTA), Tympanometry, Otoacoustic Emissions and Short and Long Latency Auditory Potentials (MMN). Results: in MMN variable amplitude, the mean value was of -2.757 µV and -3.548 µV, CZA1 and CZA2; of 1.435 µV and -1.867 µV, CZA1 and CZA2. In variable and medium latency, we found in 150.7ms and 153.2ms, CZA1 and CZA2; in 170.4ms and 184.0ms, CZA1 and CZA2 -for females and males respectively. Conclusion: related to latency, there was significant statistical difference between the genders in relation to CZA1 and CZA2; and it was lower for females and higher for males.

OBJETIVO: avaliar a satisfação do usuário de AAS (Aparelho de Amplificação Sonora) por meio da aplicação do questionário de autoavaliação IOI-HA (International Outcome Inventory For Hearing Aids) e correlacioná-lo às características dos indivíduos, da perda auditiva e do processo de adaptação do AAS. MÉTODO: foram avaliados 98 indivíduos, de ambos os gêneros, com perda auditiva neurossensorial, de um serviço público e usuários sistemáticos de AAS há, pelo menos, três meses. O questionário IOI-HA foi aplicado, como roteiro de entrevista estruturada, aos indivíduos. Correlacionaram-se as variáveis estudadas com o nível de satisfação do usuário, analisado pelo IOI-HA, por meio do fator 1 (que reflete a interação do indivíduo com seu AAS), o fator 2 (relacionado à interação do indivíduo com outras pessoas no seu ambiente) e a pontuação total de cada indivíduo. RESULTADOS: não houve correlação significante entre as variáveis estudadas e o nível de satisfação do usuário. Entretanto, é importante ressaltar que as médias obtidas nas análises, por item, foram positivas e, consequentemente, as análises da soma total do IOI-HA, fator 1 e fator 2, também foram positivas e se aproximaram dos escores máximos para cada fator. CONCLUSÃO: o presente estudo constatou que, no grupo estudado, os usuários de AAS estavam satisfeitos com a adaptação de seus aparelhos e não foram observadas correlações entre as variáveis estudadas e o grau de satisfação do usuário de AAS, por meio do questionário IOI-HA.