Ep. 281 Expert Insight on Congenital CMV & Pediatric Hearing Loss with Dr. Albert Park

Did you know that congenital CMV-related hearing loss can develop several years after birth? On the BackTable ENT & Allergy Podcast, hosts Dr. Gopi Shah and Dr. Jeff Hyzer interview pediatric otolaryngologist Dr. Albert Park about the latest evidence on congenital CMV and its role in pediatric sensorineural hearing loss. The discussion covers diagnosis, risk factors, screening protocols, testing strategies, antiviral treatment, genetic workup, long-term surveillance, and future directions for early detection and prevention. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:47 - Basics of CMV Infections and Hearing Loss Presentation 07:57 - CMV Screening Workflow 11:33 - Saliva vs. Urine Based Screening 14:00 - Early Workup and Communication 19:37 - Late Onset Workup and Use of Antivirals 24:39 - Treatment with Antiviral Medications 27:22 - Head Ultrasound vs. MRI 30:06 - Role of Genetic Testing 32:47 - Surveillance and Progression Risk37:29 - CI Outcomes and Predictors42:18 - BAHA and Older Candidates45:44 - Awareness, Prevention Efforts, and Education 54:25 - Vaccines and Universal Screening Pitfalls 57:40 - Advocacy and Closing Thoughts --- More about this episode Dr. Park explains the differences between congenital and acquired CMV, reviews epidemiology and, and highlights that hearing loss may be present at birth or develop later in childhood. He discusses Utah’s evolution from hearing-targeted CMV testing to universal NICU screening, emphasizing the importance of diagnosis within the first 21 days of life. The conversation covers saliva versus urine testing, dried blood spot testing, and the role of a multidisciplinary team in evaluation and management. Dr. Park also reviews antiviral treatment strategies, imaging and genetic testing considerations, audiologic surveillance, and cochlear implantation outcomes. Finally, he discusses ongoing advocacy efforts, emerging prenatal screening technologies, and future directions and challenges for CMV prevention and early detection. --- Resources Nance & Morton NEJM Paper Cited - 20% of Congenital SNHL linked to Congenital CMV https://www.nejm.org/doi/full/10.1056/NEJMra050700 Dr.Kimberlin’s work supporting antiviral treatment for 6 months https://www.nejm.org/doi/full/10.1056/NEJMoa1404599?utm_source=openevidence Dr.Vossen’s antiviral therapy research https://pubmed.ncbi.nlm.nih.gov/38336204/ AAP Red Book https://publications.aap.org/redbook Dr. Smith’s Research - Genetic Testing for Congenital Bilateral Hearing Loss in the Context of Targeted Cytomegalovirus Screeninghttps://pubmed.ncbi.nlm.nih.gov/31985074/ Dr.Park’s Research Congenital Cytomegalovirus Testing Outcomes From the ValEAR Trialhttps://pubmed.ncbi.nlm.nih.gov/38415855/ Dr.Park’s Research - Analysis of an Expanded Targeted Early Cytomegalovirus Testing Programhttps://pubmed.ncbi.nlm.nih.gov/36884018/ Dr.Foulon - Hearing Loss With Congenital Cytomegalovirus Infectionhttps://pubmed.ncbi.nlm.nih.gov/31266824/ Research about the use of Vaclovir to reduce vertical transmissionhttps://pubmed.ncbi.nlm.nih.gov/32919517/ Dr.Gantt’s research on the Ping-Pong Effecthttps://pubmed.ncbi.nlm.nih.gov/29889809/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app