Research: Late-onset, progressive sensorineural hearing loss in the paediatric population: a systematic review

Eur Arch Otorhinolaryngol

. 2024 Feb 27.

 doi: 10.1007/s00405-024-08527-x. Online ahead of print.

Late-onset, progressive sensorineural hearing loss in the paediatric population: a systematic review

Virginia Corazzi # 1Surina Fordington # 2Tamsin Holland Brown 3Neil Donnelly 4Jessica Bewick 4Diana Ehsani 1Stefano Pelucchi 1Chiara Bianchini 1Andrea Ciorba # 5Daniele Borsetto # 4

Affiliations expand


Purpose: To review possible risk factors for permanent delayed-onset, progressive sensorineural hearing loss (SNHL) in the paediatric population to recommend follow-up protocols for early detection.

Methods: PRISMA-compliant systematic review was performed, including observational studies on the paediatric population up to 16 years old who have passed the newborn hearing screening programme (NHSP), investigating the development of late-onset, progressive SNHL. Electronic searches were performed through Medline, Embase, Cochrane, and Emcare.

Results: 37 studies were included. 21 showed an association between late-onset SNHL and congenital cytomegalovirus (cCMV) infection (age at hearing loss diagnosis 0.75 to 204 months, mean 45.6 ± 43.9), while 16 between late-onset SNHL and other congenital or perinatal factors, namely Neonatal Intensive Care Unit (NICU) stay, prematurity, neonatal respiratory failure, mechanical ventilation, extracorporeal membrane oxygenation (ECMO) support, hypocapnia, hypoxia, alkalosis, seizure activity, congenital diaphragmatic hernia (CDH), inner ear malformation, and gene mutations (age at hearing loss diagnosis 2.5 to 156 months, mean 38.7 ± 40.7).

Conclusions: cCMV infection may cause late-onset SNHL, which can be missed on standard NHSP. There is, therefore, evidence to support universal screening programmes to enable detection in even asymptomatic neonates. Ongoing audiological follow-up for all children with cCMV is advisable, to enable timely treatment. In the paediatric population presenting conditions such as NICU stay > 5 days, prematurity ≤ 34 weeks gestation, severe neonatal respiratory failure, mechanical ventilation, ECMO support, and CDH surgery, an audiological follow-up from 3 months of age up to at least 3-4 years of age, and at least annually, should be recommended.

Keywords: Children; Congenital cytomegalovirus infection; Late-onset sensorineural hearing loss; Neonatal intensive care unit; Perinatal risk factors; Progressive hearing loss.

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