目的:回顾永久性延迟发作的可能危险因素,儿科人群中的进行性感觉神经性听力损失(SNHL),以推荐早期发现的随访方案。
方法:进行符合PRISMA的系统评价,包括对通过新生儿听力筛查计划(NHSP)的16岁以下儿科人群的观察性研究,调查迟发性的发展,渐进式SNHL。电子搜索是通过Medline进行的,Embase,科克伦,和Emcare。
结果:纳入了37项研究。21显示迟发性SNHL与先天性巨细胞病毒(cCMV)感染之间存在关联(听力损失诊断年龄为0.75至204个月,平均45.6±43.9),而16在迟发性SNHL和其他先天性或围产期因素之间,即新生儿重症监护病房(NICU)住院,早产,新生儿呼吸衰竭,机械通气,体外膜氧合(ECMO)支持,低碳酸血症,缺氧,碱中毒,癫痫发作活动,先天性膈疝(CDH),内耳畸形,和基因突变(听力损失诊断年龄2.5到156个月,平均38.7±40.7)。
结论:cCMV感染可能导致迟发性SNHL,标准NHSP可能会错过。有,因此,支持普遍筛查计划的证据,即使无症状的新生儿也能被检测到。建议对所有患有cCMV的儿童进行持续的听力学随访,以便及时治疗。在出现NICU住院>5天等情况的儿科人群中,早产≤妊娠34周,严重的新生儿呼吸衰竭,机械通气,ECMO支持,和CDH手术,从3个月到至少3-4岁的听力学随访,至少每年一次,应该推荐。
OBJECTIVE: 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.