CONGENITAL CYTOMEGALOVIRUS: ENT EVALUATION

Abstract

Congenital cytomegalovirus (CMV) infection is a significant health concern as it can lead to various abnormalities and developmental disabilities. CMV is the most common viral cause of congenital infections worldwide, affecting a considerable number of babies. This infection can result in serious consequences, including sensorineural hearing loss (SNHL), which often goes unnoticed until later infancy or early childhood. ENT evaluation plays a crucial role in the early detection and management of SNHL in infants with congenital CMV infection, offering an opportunity for timely intervention and better outcomes. Objective: to comprehensively evaluate the role of otorhinolaryngological evaluation in cases of congenital CMV infection. Methodology: This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A detailed search was conducted in PubMed, Scielo and Web of Science databases to identify relevant scientific articles, studies and books related to otorhinolaryngological evaluation in cases of congenital CMV infection. The search included articles published in the last 10 years. Descriptors used in the search: “Congenital cytomegalovirus infection”, “Sensorineural hearing loss”, “Otorhinolaryngology”, “Newborn screening” and “Early intervention”. Data were extracted from selected studies, covering information on study design, participant characteristics, otorhinolaryngological assessment methods, diagnostic tools used, and reported outcomes. The quality of the included studies was assessed using tools appropriate for different types of studies. This evaluation aimed to guarantee the reliability and validity of the results. The extracted data were synthesized to highlight key findings, methodologies and trends in the otorhinolaryngological evaluation of cases of congenital CMV infection. Results: 15 articles were selected. The systematic review revealed a substantial body of literature emphasizing the importance of early otorhinolaryngological evaluation in infants with congenital CMV infection. Studies have consistently reported that a significant proportion of infants with congenital CMV have varying degrees of sensorineural hearing loss. Early detection through ENT assessments allows for timely interventions such as hearing aids or cochlear implants, leading to better developmental outcomes. The review also highlighted the various diagnostic tools employed, including brainstem auditory evoked potentials (BAEP), otoacoustic emissions (OAEs) and steady state auditory evoked potentials (ASSR). The studies discussed the sensitivity and specificity of these tests in detecting hearing loss associated with CMV infection. Conclusion: Otorhinolaryngological evaluation plays a key role in the comprehensive management of congenital CMV infection. The systematic review highlights the importance of early detection of sensorineural hearing loss through various diagnostic tools, facilitating timely interventions that can significantly improve the developmental trajectories of affected infants. The synthesis of evidence from several studies emphasizes the need for a multidisciplinary approach involving health professionals specialized in otolaryngology, infectious diseases and developmental pediatrics to optimize outcomes for infants with congenital CMV infection.