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Audiological and Vestibular Follow-Up for Children with Congenital Cytomegalovirus Infection: From Current
Mirko Aldè1,2, Virginia Fancello3, Paola Di Mauro4
1Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
Insights
Current guidelines for congenital cytomegalovirus (CMV) follow-up lack detail. Personalized audiological and vestibular testing protocols are needed for better outcomes in children with congenital CMV.
Area of Science:
- Pediatrics
- Audiology
- Neurology
Background:
- Congenital cytomegalovirus (CMV) can cause hearing and balance problems in children.
- Current follow-up guidelines for audiological and vestibular issues in congenital CMV are not well-defined.
- Existing protocols lack personalization, potentially leading to suboptimal care and resource allocation.
Purpose of the Study:
- To critically evaluate current audiological and vestibular follow-up approaches for children with congenital CMV.
- To highlight the need for personalized follow-up protocols.
- To propose a risk-factor-based approach for tailored assessments.
Main Methods:
- This study is a narrative review of existing literature and guidelines.
- It critically analyzes current audiological and vestibular assessment methods.
- It discusses the potential benefits of personalized follow-up strategies.
Main Results:
- Current follow-up schedules for hearing and vestibular function in congenital CMV are generalized.
- There is a lack of universally accepted protocols for vestibular assessment.
- Personalized protocols, considering maternal infection trimester, amniotic fluid PCR, and antiviral treatment, are proposed.
Conclusions:
- Personalized audiological and vestibular follow-up protocols are crucial for children with congenital CMV.
- Tailoring assessments based on individual risk factors can lead to more precise evaluations and timely interventions.
- This approach optimizes resource allocation and reduces burdens on families.
Abstract:
Currently, the guidelines for audiological and vestibular follow-up in children with congenital cytomegalovirus (CMV) are not well-defined. The general recommendation is to evaluate hearing in all children with congenital CMV at the same intervals: once every 3-6 months up to 1 year of age, once every 6 months from 1 to 3 years of age, and once a year from 3 to 6 years of age. Additionally, there are no universally accepted protocols for the vestibular follow-up of children with congenital CMV, although video head impulse test (v-HIT) and cervical vestibular-evoked myogenic potentials (cVEMPs) are sometimes used. This narrative review critically evaluates existing audiological and vestibular follow-up approaches for children with congenital CMV, highlighting the need for personalized protocols. Tailoring follow-up schedules with different timing and methods based on risk factors, such as the trimester of maternal infection, CMV PCR results in amniotic fluid, and valganciclovir use, would indeed allow for more precise evaluations, timely interventions, and optimized resource allocation. This strategy would also alleviate the logistical and emotional burdens on families by ensuring that high-risk children receive more frequent and appropriate assessments and early interventions, while lower-risk children avoid unnecessary testing.
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