Acompanhamento audiológico de crianças com síndrome congênita associada à infecção pelo vírus zika

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Congenital Zika Syndrome (CZS) is characterized by congenital malformations found in children infected with Zika virus (ZIKV) during pregnancy and, although its clinical spectrum is not yet fully established, it is associated with microcephaly, neurological disorders, ophthalmological and orthopedic manifestations and also sensorineural hearing loss (SNHL). The aim of this study was to characterize the behavior of the auditory function of children with CZS in the first three years of life. We evaluated 139 children with CZS and laboratory confirmation of the virus in the cerebrospinal fluid. Children exposed to other risk factors for congenital or perinatal hearing loss, such as family history of congenital or late deafness, congenital infections known as STORCH (syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex), use of ototoxic medications, mechanical ventilation, severe perinatal hypoxia, among others. Auditory evaluation was performed by means of automated auditory brainstem response with use of the Click stimulus annually and, when failure was detected, the children were referred for complementary audiological evaluation for diagnostic definition. From 139 children with confirmed CZS, nine had confirmed SNHL, which was maintained until the last evaluation. One of them was excluded, due to the use of ototoxic drugs, resulting in an occurrence of eight of the 138 children in the study (5.8%), confirming a higher occurrence of hearing loss at birth in children with SCZ than in the general population. However, no child with normal hearing at the first assessment developed any impairment in subsequent tests. Likewise, no affected children showed progressive worsening of hearing function. Thus, PANS resulting from SCZ does not appear to show any progressive or late-onset behavior. However, further studies are still needed to better clarify the topography of hearing loss, using imaging and electrophysiological assessment of the auditory pathways and auditory cortex, such as research on long-latency potential and central auditory processing. No child with normal hearing at the first evaluation developed any impairment in subsequent tests. As well as, no affected children showed progressive worsening of auditory function. The SNHL resulting from CZS does not appear to have any progressive or late-onset behavior. However, further studies are needed to better clarify the topography of hearing loss, using image evaluation and electrophysiological evaluation of the auditory pathways and the auditory cortex, such as the investigation of the long latency auditory evoked potentials and central auditory processing.

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