Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric Study
<b>Background/Objectives</b>: Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL) in children. In cases of severe-to-profound SNHL, cochlear implantation (CI) is a widely used intervention, but outcomes remain variable due...
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2025-07-01
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| author | Francesca Forli Silvia Capobianco Stefano Berrettini Francesco Lazzerini Rita Malesci Anna Rita Fetoni Serena Salomè Davide Brotto Patrizia Trevisi Leonardo Franz Elisabetta Genovese Andrea Ciorba Silvia Palma |
| author_facet | Francesca Forli Silvia Capobianco Stefano Berrettini Francesco Lazzerini Rita Malesci Anna Rita Fetoni Serena Salomè Davide Brotto Patrizia Trevisi Leonardo Franz Elisabetta Genovese Andrea Ciorba Silvia Palma |
| author_sort | Francesca Forli |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL) in children. In cases of severe-to-profound SNHL, cochlear implantation (CI) is a widely used intervention, but outcomes remain variable due to possible neurodevelopmental comorbidities. This study aimed to evaluate the long-term auditory and language outcomes in children with cCMV after CI and to explore clinical and radiological predictors of post-CI performance. <b>Methods</b>: Fifty-three children with cCMV and bilateral severe-to-profound SNHL who underwent CI at five tertiary referral centers in Italy were included in the study. Auditory and language outcomes were assessed pre- and post-implantation using the Categories of Auditory Performance II (CAP-II) scale, the Nottingham 3-Level Classification, and the Bates Language Development Scale. Brain MRI abnormalities were classified according to the Alarcón classification. Correlations were explored between outcome scores and symptomatic status at birth, MRI findings, and neurodevelopmental comorbidities. <b>Results</b>: At birth, 40 children (75.5%) were symptomatic and 13 (24.5%) asymptomatic. Neurodevelopmental comorbidities were present in 19 children (35.8%). MRI was normal in 15 (28.3%), mildly abnormal in 26 (49%), and moderately to severely abnormal in 12 (22.6%). Auditory and language outcomes improved significantly post-CI (<i>p</i> < 0.001), though the outcomes varied widely. Twenty-five children (47%) reached CAP level ≥ 6, and thirteen (23%) reached Bates Level 6. Symptomatic status at birth correlated weakly with worse CAP (ρ = −0.291, <i>p</i> = 0.038) and Bates (ρ = −0.310, <i>p</i> = 0.028) scores. Higher Alarcón scores were significantly associated with neurodevelopmental comorbidities, though not directly with post-CI auditory and language outcomes. Finally, the presence of neurodevelopmental disabilities was generally associated with lower results, even if without statistical significance. <b>Conclusions</b>: CI provides substantial auditory and language benefit in children with cCMV, even in cases of severe neurodevelopmental comorbidities. MRI and developmental assessments, as well as perinatal history for clinical signs and symptoms, are helpful in guiding expectations and personalizing post-implantation support. |
| format | Article |
| id | doaj-art-d9e85fde0cbf41a3bbdaca7c80d70ff8 |
| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
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| spelling | doaj-art-d9e85fde0cbf41a3bbdaca7c80d70ff82025-08-20T03:58:30ZengMDPI AGChildren2227-90672025-07-0112790810.3390/children12070908Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric StudyFrancesca Forli0Silvia Capobianco1Stefano Berrettini2Francesco Lazzerini3Rita Malesci4Anna Rita Fetoni5Serena Salomè6Davide Brotto7Patrizia Trevisi8Leonardo Franz9Elisabetta Genovese10Andrea Ciorba11Silvia Palma12Otolaryngology, Audiology, and Phoniatrics Unit, University of Pisa, 56124 Pisa, ItalyOtolaryngology, Audiology, and Phoniatrics Unit, University of Pisa, 56124 Pisa, ItalyOtolaryngology, Audiology, and Phoniatrics Unit, University of Pisa, 56124 Pisa, ItalyOtolaryngology, Audiology, and Phoniatrics Unit, University of Pisa, 56124 Pisa, ItalyDepartment of Neuroscience, Reproductive Sciences and Dentistry-Audiology Section, Università degli Studi di Napoli Federico II, 80131 Naples, ItalyDepartment of Neuroscience, Reproductive Sciences and Dentistry-Audiology Section, Università degli Studi di Napoli Federico II, 80131 Naples, ItalyDivision of Neonatology, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, ItalySection of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, Azienda Ospedale Università di Padova, University of Padua, 35122 Padua, ItalySection of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, Azienda Ospedale Università di Padova, University of Padua, 35122 Padua, ItalyAudiology Unit, Department of Neuroscience, University of Padova, 31100 Treviso, ItalyOtolaryngology and Audiology Unit, University of Modena and Reggio Emilia, 41100 Modena, ItalyENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, ItalyAudiology, Primary Care Department, AUSL of Modena, 41100 Modena, Italy<b>Background/Objectives</b>: Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL) in children. In cases of severe-to-profound SNHL, cochlear implantation (CI) is a widely used intervention, but outcomes remain variable due to possible neurodevelopmental comorbidities. This study aimed to evaluate the long-term auditory and language outcomes in children with cCMV after CI and to explore clinical and radiological predictors of post-CI performance. <b>Methods</b>: Fifty-three children with cCMV and bilateral severe-to-profound SNHL who underwent CI at five tertiary referral centers in Italy were included in the study. Auditory and language outcomes were assessed pre- and post-implantation using the Categories of Auditory Performance II (CAP-II) scale, the Nottingham 3-Level Classification, and the Bates Language Development Scale. Brain MRI abnormalities were classified according to the Alarcón classification. Correlations were explored between outcome scores and symptomatic status at birth, MRI findings, and neurodevelopmental comorbidities. <b>Results</b>: At birth, 40 children (75.5%) were symptomatic and 13 (24.5%) asymptomatic. Neurodevelopmental comorbidities were present in 19 children (35.8%). MRI was normal in 15 (28.3%), mildly abnormal in 26 (49%), and moderately to severely abnormal in 12 (22.6%). Auditory and language outcomes improved significantly post-CI (<i>p</i> < 0.001), though the outcomes varied widely. Twenty-five children (47%) reached CAP level ≥ 6, and thirteen (23%) reached Bates Level 6. Symptomatic status at birth correlated weakly with worse CAP (ρ = −0.291, <i>p</i> = 0.038) and Bates (ρ = −0.310, <i>p</i> = 0.028) scores. Higher Alarcón scores were significantly associated with neurodevelopmental comorbidities, though not directly with post-CI auditory and language outcomes. Finally, the presence of neurodevelopmental disabilities was generally associated with lower results, even if without statistical significance. <b>Conclusions</b>: CI provides substantial auditory and language benefit in children with cCMV, even in cases of severe neurodevelopmental comorbidities. MRI and developmental assessments, as well as perinatal history for clinical signs and symptoms, are helpful in guiding expectations and personalizing post-implantation support.https://www.mdpi.com/2227-9067/12/7/908congenital cytomegaloviruscochlear implantationhearing losslanguage developmentspeech perception |
| spellingShingle | Francesca Forli Silvia Capobianco Stefano Berrettini Francesco Lazzerini Rita Malesci Anna Rita Fetoni Serena Salomè Davide Brotto Patrizia Trevisi Leonardo Franz Elisabetta Genovese Andrea Ciorba Silvia Palma Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric Study Children congenital cytomegalovirus cochlear implantation hearing loss language development speech perception |
| title | Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric Study |
| title_full | Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric Study |
| title_fullStr | Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric Study |
| title_full_unstemmed | Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric Study |
| title_short | Cochlear Implant in Children with Congenital CMV Infection: Long-Term Results from an Italian Multicentric Study |
| title_sort | cochlear implant in children with congenital cmv infection long term results from an italian multicentric study |
| topic | congenital cytomegalovirus cochlear implantation hearing loss language development speech perception |
| url | https://www.mdpi.com/2227-9067/12/7/908 |
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