Question: A 7 year old male with congenital CMV presents for evaluation of hearing loss. Behavioral audiometry is suggestive of profound right hearing loss and normal left sided hearing. The parents aren’t sure when the hearing loss was first identified though there was some suggestion that he failed his newborn screen in one ear. Imaging shows normal 8th nerves bilaterally and only mild parenchymal changes from CMV. The child’s parents inquire about a cochlear implant for the right ear. Which of the following is most accurate?

a) Since it is likely that the child was congenitally deaf in the right ear, the implant will provide sound awareness only.

b) Central involvement from CMV is likely to have resulted in auditory neuropathy on the right side; a hearing aid is the best first step.

c) Sound localization and hearing in noise are unlikely to improve following implantation.

d) As central auditory pathways are likely developed, implantation will likely result in open-set speech understanding in the implanted ear.

[Answer will be posted with next week's new question]

Answer to last week's question, “Voice Crack” (March 8, 2023)

C - Vocal fold hemorrhage.