Banca de DEFESA: KARINE CHRISTINE GUSMÃO DE FREITAS CALHEIROS

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : KARINE CHRISTINE GUSMÃO DE FREITAS CALHEIROS
DATE: 17/06/2025
TIME: 14:00
LOCAL: Plataforma Google Meet
TITLE:

Vestibular dysfunction and postural changes in the pediatric population with congenital cytomegalovirus: a systematic review

KEY WORDS:

cytomegalovirus; cytomegalovirus infection; vestibular diseases; postural balance; dizziness.

PAGES: 94
BIG AREA: Ciências da Saúde
AREA: Fonoaudiologia
SUMMARY:

Congenital cytomegalovirus (CMV) is considered the most common etiology of congenital infection and its main sequela is sensorineural hearing loss. Considering the prevalence of sensorineural hearing loss in this population and the anatomical proximity of the cochlear and vestibular organs in the inner ear, vestibular disorders may also occur in children affected by congenital CMV infection. This study aimed to verify the presence of vestibular alterations and postural balance disorders in the pediatric population with congenital CMV infection. This is a systematic review conducted and reported according to PRISMA and registered in the International prospective register of systematic reviews- PROSPERO, under registration CRD42024549387. Five electronic databases (Embase, LILACS, PubMed/MEDLINE, Scopus and Web of Science) were searched, in addition to the gray literature (Google Scholar and ProQuest Dissertations and Theses). The following inclusion criteria were used: studies conducted in children aged 0 to 12 years, diagnosed with congenital CMV infection, performed through urine or saliva samples in the first 21 days of life, neonatal blood samples, serological tests or molecular tests; articles that addressed the assessment of vestibular function and body balance, and that compared symptomatic groups with asymptomatic groups and/or with healthy children. A metaanalysis was performed to estimate the association between vestibular alterations and cytomegalovirus, as well as the combined proportion of these alterations. A randomeffects model was used and subgroup analyses were performed according to the presence of symptoms. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and the certainty of the evidence was assessed using the GRADE tool. Only articles from randomized clinical trials and observational studies were selected. The search in the databases resulted in the identification of 2,840 studies and, subsequently, eight observational articles were considered eligible for qualitative synthesis. All included articles reported vestibular and/or body balance alterations in the group with congenital CMV infection. The meta-analysis indicated an approximately ten-fold higher risk of manifestation of vestibular alterations in this group compared to the control group (95% CI: 2.42–40.29). The analysis of the risk of bias identified that most of the studies were of moderate/high quality. The certainty of the evidence was considered very low according to the GRADE tool. In addition, there was a higher frequency of alterations in children with symptomatic than asymptomatic congenital CMV infection. Among the included studies, 50% were cohort studies and 50% were case-control studies; 100% were published in English; the sample size ranged from 24 to 185 children with congenital CMV infection, aged between zero and 11 years. The most commonly used tests were VEMP and vHIT. It is concluded that there is an approximately ten-fold higher risk of children with congenital CMV infection presenting vestibular alterations, compared to the control group. Furthermore, the estimate of the combined proportion of vestibular alterations was higher in symptomatic individuals. Similarly, children with symptomatic congenital CMV infection showed higher rates of alteration in postural balance tasks, compared to the groups with asymptomatic congenital CMV infection and the control group, in the included studies.

COMMITTEE MEMBERS:
Externa à Instituição - ADRIANA RIBEIRO TAVARES ANASTASIO - FMRP
Presidente - 2322959 - ERIKA BARIONI MANTELLO
Interna - 1573810 - KARINNA VERISSIMO MEIRA TAVEIRA
Interna - 1804274 - SHEILA ANDREOLI BALEN