Infezione congenita da cmv. Studio del riflesso vestibolo-oculomotore con video head impulse test.

Aim: Congenital cytomegalovirus (cCMV) infection is the leading cause of nongenetic sensorineural deafness. The present study aims to investigate whether this may affect the canal structures of the vestibule correlating with hearing impairment and possible delay in motor development. Methods: A single-center, retrospective observational study was conducted. A total of 45 pediatric patients aged 6 months to 10 years, with congenital CMV infection confirmed by PCR on urine within the first three weeks of life, symptomatic or asymptomatic for neurological impairment, normoacusic or with mono- or bilateral hearing loss, with and without indication for antiviral therapy, were evaluated. Vestibulo-ocular reflex (VOR) gain results for the semicircular canals, obtained by the vestibular examination with video Head Impulse Test (vHIT ), were compared with the mean tonal audiometric threshold (PTA) for frequencies 0.5 -1 - 2 and 4 KHz, with neuropsychomotor development, with the administration or not of antiviral therapy, and asymmetry values were calculated. Results: There is statistical significance between VOR deficiency at the VHIT study and elevation of THA values and neuropsychomotor developmental delay. There is a correlation between the presence of VOR gain asymmetry and developmental delay. Conclusions: it emerges that congenital CMV infection affects not only cochlear structures, but also vestibular structures, and vestibular alteration can occur with both normal and unstructured acoustic pathway.