The main objective of this work was the development of the algorithm of dynamic audiological examination of children with congenital CMVI. Today, there are 60 children with congenital CMVI under dynamic observation, 8 children (13%) have hearing disorders, in two (25%) of them sensorineural hearing loss (SNHL) was delayed. The comparison group included 50 patients, where hearing disorders have been revealed in 4% of cases. Besides, this article presents a clinical case of peripheral hearing improvement in a child with the resolution of hydrocephalus associated with congenital CMVI. In consideration of the information from foreign literary sources and based on the available data about the period of occurrence of the delayed hearing disorders in children both with symptomatic and asymptomatic form of CMVI, the authors suggested an algorithm for dynamic audiological observation of children with congenital CMVI providing and examination once per three months over the first year of life, once per 6 months – during the 2nd year of life and once per year at the age of 2 through 6 years.
Intrauterine infections are a crucial pathogenic factor exerting an appreciable influence on the development of the fetus. They can provoke intrauterine death, cause multiple lesions in the organs and tissues as well as long-term complications that manifest themselves at the later stages of the growth and development of the child. One of such complications is the sensorineural loss of hearing. The importance of hearing impairment arises from the high prevalence of tis condition and frequent incapacitation it causes in the patients. The present publication is focused on various mechanisms underlying the development of hearing impairment depending on the primary infection. Special attention is given to the methods of diagnostics and treatment of intrauterine infections.
Intrauterine infections are represented by a large group of diseases evoked by viruses, bacteria and protozoa. Perinatal contamination can affect maturation, provoke prematurity, intrauterine death or acute form of infection in the early neonatal period. However, some congenital infections such as cytomegalovirus asymptomatic have no symptoms in the early neonatal period, but it doesn’t exclude occurrence of late–onset sequelae. Congenital cytomegalovirus (CMV) infection is one of the principle causes of nongenetic prelingual sensorineural hearing loss (SNHL) development. As reported, CMV is registered worldwide in 0.64–0.70% of newborns. The rate of CMV-induced SNHL varies from 15 to 21%. CMV infection can provoke either congenital SNHL or lateonset hearing loss. Due to the lack of neonatal CMV screening in Russia congenital asymptomatic CMV infection remains undiagnosed in many cases. Furthermore, even in the case of timely diagnostics of congenital CMV infection, there is no approved algorithm for subsequent monitoring of such patients. In the course of followup, the possibility of development of central hearing impairment should also be considered. In this article we present our algorithm of assessment of central and peripheral hearing functions in children from birth till 6 years old.
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