Impaired Sensorineural Hearing Development in Infectious Disease: Congenital and Pediatric Infections

Abstract

Permanent bilateral sensorineural hearing loss affects 1 out of every 1000 live births at a level sufficient to cause significant delays in speech and language development. If diagnosed and managed early, the effects on language and educational attainment can be minimized. Although aggressive management of maternal infections and widespread use of immunizations have reduced the incidence of many infections, a significant proportion of pediatric sensorineural hearing loss continues to occur as sequelae of pediatric infection either passed on transplacentally during pregnancy or due to postnatal exposure. This chapter reviews the infectious etiologies that can adversely affect neonatal and pediatric hearing development. Rubella, cytomegalovirus, measles, herpes simplex type 2, toxoplasmosis, syphilis, and human immunodeficiency virus are common infectious diseases that can occur during pregnancy and potentially cause significant morbidity for the pregnant mother and unborn child. Bacterial meningitis, mumps, and measles are the common pediatric (postnatal) infectious diseases that can cause significant hearing loss as sequelae of infection. The clinical characteristics, diagnostic and treatment strategies, and impact on hearing of each infectious etiology are reviewed, including the role of maternal or pediatric vaccination as a preventative measure. A general strategy for the evaluation and treatment of pediatric hearing loss is reviewed, including the indications for pediatric hearing screening, audiometric tests appropriate for pediatric hearing evaluation, appropriate hearing interventions for maximizing speech and language development, and the role of routine immunizations.