Hearing Disorders in Congenital Toxoplasmosis: A Literature Review

Corrêa, Camila de Castro; Maximino, Luciana Paula; Weber, Silke Anna Theresa

doi:10.1055/s-0037-1605377

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International Archives of Otorhinolaryngology

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Systematic Review • Int. Arch. Otorhinolaryngol. 22 (03) • Jul-Sep 2018 • https://doi.org/10.1055/s-0037-1605377 copy

Hearing Disorders in Congenital Toxoplasmosis: A Literature Review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Several studies show correlations between congenital toxoplasmosis and hearing loss, with a broad diversity of levels of hearing loss and specifications of hearing disorders.

Objective

To describe the studies found in the literature regarding hearing disorders in congenital toxoplasmosis.

Data

Synthesis A literature review was conducted on the Lilacs, SciELO, PubMed and Scopus databases by combining the following keywords: congenital toxoplasmosis and hearing. Based on this search strategy, 152 papers were found, the majority published on the Scopus and PubMed databases from1958 to 2015. After theapplication of the inclusion criteria, 8 articles published between 1980 and 2015 were included in the present study.

Conclusion

This review showed a moderate evidence of the association between hearing disorders and congenital toxoplasmosis, which is characterized by sensorineural hearing loss. However, there are gaps in the description of the specific characteristics of the type and level of hearing loss, or of other possible disorders involved in the auditory processing.

Keywords:
speech, language and hearing sciences; toxoplasmosis; toxoplasmosis, congenital; hearing; hearing disorders

Author, year	Filiation of main author, country	Study design	Casuistry	Methods of performing the hearing evaluation	Results on hearing disorders
Wilson et al, 1980¹¹11 Wilson CB, Remington JS, Stagno S, Reynolds DW. Development of adverse sequelae in children born with subclinical congenital Toxoplasma infection. Pediatrics 1980;66(05):767-774	Stanford University School of Medicine, US	CSS	24 children (follow-up) with congenital toxoplasmosis	Pure-tone and speech reception threshold audiometry.	The incidence of SNHL ranged from 22 to 30%.
McGee et al, 1992¹⁴14 McGee T, Wolters C, Stein L, et al. Absence of sensorineural hearing loss in treated infants and children with congenital toxoplasmosis. Otolaryngol Head Neck Surg 1992;106(01): 75-80	University of Chicago, US	CSS	30 infants within 2 months of birth	ABR.	A total of 6 (20%) of the 30 infants were diagnosed with mild to moderate conductive hearing loss associated with otitis media. Sensorineural hearing loss was not described.
McLeod et al, 2006¹⁵15 McLeod R, Boyer K, Karrison T, et al; Toxoplasmosis Study Group. Outcome of treatment for congenital toxoplasmosis, 1981-2004: the National Collaborative Chicago-Based, Congenital Toxoplasmosis Study. Clin Infect Dis 2006;42(10): 1383-1394	University of Chicago, US	CS	131 infants (follow-up) with congenital toxoplasmosis	Not described.	None had SNHL.
Andrade et al, 2008¹²12 Andrade GM, Resende LM, Goulart EMA, Siqueira AL, Vitor RWA, Januario JN. Hearing loss in congenital toxoplasmosis detected by newborn screening. Rev Bras Otorrinolaringol (Engl Ed) 2008; 74(01):21-28	University of Minas Gerais, Brazil	CSS	30,808 newborns. Among them, 19 newborns diagnosed with congenital toxoplasmosis	Hearing test battery: behavioral observation audiometry, audiometric, transient and distortion product otoacoustic emission, ABR and tympanometry.	Out of the children with congenital toxoplasmosis, 4 were diagnosed with SNHL and 2 with conductive loss. Considering the SNHL, 2 children had mild, 1 had moderate. and 1 had profound hearing loss. Two properly-treated children persisted with hearing loss.
Noorbakhsh et al 2008¹⁶16 Noorbakhsh S, Memari F, Farhadi M, Tabatabaei A. Sensorineural hearing loss due to Toxoplasma gondii in children: a case-control study. Clin Otolaryngol 2008;33(03):269-273	University of Medical Sciences, Iran	CCS	95 infants with SNHL and 63 healthy infants were compared	Audiologic screening with ABR, EOAE, and PTA	Antibodies were found in 12% SNHL children (children aged 3–5 years old) and in 21.2% (children younger than 1-year-old), whereas in healthy children
Austeng et al, 2010¹⁷17 Austeng ME, Eskild A, Jacobsen M, Jenum PA,Whitelaw A, Engdahl B. Maternal infection with toxoplasma gondii in pregnancy and the risk of hearing loss in the offspring. Int J Audiol 2010;49(01): 65-68	Fredrikstad Hospital Trust, Norway	CSS	27,727 children born in Norway between 1992–1994	Otoscopy, immittance audiometry, otoacoustic emissions and play audiometry, behavioral audiometry in free field, or ABR.	40 women had primary Toxoplasma gondii infection in pregnancy and none of their neonates had hearing loss; 22 children were diagnosed with hearing loss of other origins.
Resende et al, 2010¹³13 Resende LM, Andrade GMQ, Azevedo MF, Perissinoto J, Vieira ABC. Congenital toxoplasmosis: Auditory and language outcomes in early diagnosed and treated children. Sci Med (Porto Alegre) 2010;20(01):13-19	University of Minas Gerais, Brazil	CSS	106 children diagnosed with congenital toxoplasmosis in the neonatal screening program during 6 months	Hearing test battery: behavioral observation audiometry, ABR, transient and distortion product otoacoustic emission, and tympanometry.	They found normal hearing in 60 children (56.6%), conductive hearing loss in 13 (12.3%), SNHL in 4 (3.8%), and central hearing disorders in 29 (27.4%). There was no difference between children with additional risks for hearing loss and children who only had only toxoplasmosis.
Silva et al, 2015¹⁸18 Silva DP, Lopez PS, Ribeiro GE, Luna MO, Lyra JC, Montovani JC. The importance of retesting the hearing screening as an indicator of the real early hearing disorder. Rev BrasOtorrinolaringol (Engl Ed) 2015;81(04):363-367	São Paulo State University, Brazil	CS	565 newborns	Transient EOAE	65 (11%) newborns had risk factors for hearing disorders, and congenital toxoplasmosis was found in 1 newborn; 13 infants presented hearing loss at retest.

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[1] Address for correspondence Camila de Castro Corrêa, SL, MS, PhD student, Distrito de Rubião Júnior s/n, Botucatu, SP, 18618-970, Brazil (e-mail: camila.ccorrea@hotmail.com).