Banca de QUALIFICAÇÃO: LUCAS ALVES TEIXEIRA OLIVEIRA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : LUCAS ALVES TEIXEIRA OLIVEIRA
DATE: 29/01/2025
TIME: 16:00
LOCAL: Auditório FS
TITLE:

“Early otopathological findings in fatal pediatric acute meningitis”

KEY WORDS:

“Meningitis; otopathology; cochlea; spiral ganglion”

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

“Introduction: Acute meningitis is a severe condition, particularly in neonates and infants, with a high fatality rate and neurological complications in survivors, including permanent hearing loss in up to 35% of cases. Hearing loss typically occurs early in the disease and is associated with inflammatory labyrinthitis, which can cause irreversible damage to the inner ear, leading to cochlear ossification (ossifying labyrinthitis). This condition can be assessed through Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), but temporal bone biopsy is the gold standard for diagnosis. While studies on late otopathological changes exist, there is a lack of data on the early stages of the pathology in children, which motivates this study to investigate early histopathological changes in the inner ear of pediatric patients with fatal acute meningitis. Objectives: The aim of this study was to evaluate the early histopathological changes in the temporal bone of pediatric patients with fatal acute meningitis, characterizing the location of inflammatory cells, cochlear alterations (such as hydrops, fibrosis, and ossification), and the survival of spiral ganglion cells (quantitatively). The study also aimed to establish a timeline for neuronal damage and compare otogenic versus non-otogenic disseminations. Methods: This study included 43 temporal bones from 24 neonates or infants, ages ranging from birth to 13 years, from the Costa Rica collection, analyzed at the Otopathology Laboratory of Massachusetts Eye and Ear Infirmary (MEEI). Ten of the ears were from controls who died from other causes, while the cause of death in the other 33 samples was meningitis. Results: The presence of inflammatory infiltrate in the endolymphatic duct and sac was a significant correlate with the cases (p-value: 0.007). The presence of hydrops in meningitis cases was a notable factor (p-value: 0.026). A higher density of inflammatory cells in the mastoid and middle ear was associated with more seizures (p-value: 0.020). The presence of inflammatory infiltrate in the endolymphatic duct and sac was a significant correlate with the cases (p-value: 0.007). More spiral ganglion cells may be associated with higher fever (p-value: 0.015). Strong evidence of an association between fever and greater inflammatory cell density in the internal auditory canal (IAC) (p-value: 0.0000804). The higher the cellular density in the cochlea, the greater the density of inflammatory cells in the IAC (p-value: 0.0475). Higher inflammatory cell density in the IAC may be associated with a greater number of spiral ganglia (p-value: 0.015). For every 6 days of hospitalization, there is a loss of 1000 spiral ganglion cells (p-value: 0.01). Gram-positive subanalysis (p-value: 0.0003). Otogenic subanalysis (p-value: 0.013).

COMMITTEE MEMBERS:
Externa à Instituição - THAIS ABRAHÃO GOMES ELIAS - UNIFESP
Externo à Instituição - SADY SELAIMEN DA COSTA - UFRGS
Presidente - ***.299.221-** - FAYEZ BAHMAD JUNIOR - HUB
Externa à Instituição - FERNANDA FERREIRA CALDAS - IBO
Externa à Instituição - PAULIANA LAMOUNIER E SILVA DUARTE - UnB