Ana Cláudia Mirândola Barbosa Reis

Avaliação da satisfação do usuário de aparelho de amplificação sonora

PURPOSE: assess satisfaction with hearing aids (HA) by applying the self-assessment questionnaire IOI-HA (International Outcome Inventory for Hearing Aids) and to correlate the characteristics of hearing loss and HA fitting process. METHOD: 98 patients from a healthy public service were assessed, of both genders, with sensorineural hearing loss, and using the HA in a systematic way for at least 3 months. The IOI-HA questionnaire was used as a guide directed structured interview with the patient. Correlated these variables with the level of user satisfaction analyzed by IOI-HA by a factor (which reflects the interaction of the patient with his HA), the second factor (related to the patients experience with other people in their environment), and the total score for each patient. RESULTS: there was no significant correlation between these variables and user satisfaction. However, it is important to note that the averages obtained were positive and therefore the analyzes of the total sum of the IOI-HA, Factors 1 and 2, were also positive and approached the maximum score for each factor. CONCLUSION: this study found that in the studied group of HA users were satisfied with the adaptation of their HA and there were no correlations between variables and the degree of satisfaction with HA through the IOI-HA questionnaire.

Auditory Speech Perception Tests in Relation to the Coding Strategy in Cochlear Implant

Introduction  The objective of the evaluation of auditory perception of cochlear implant users is to determine how the acoustic signal is processed, leading to the recognition and understanding of sound. Objective  To investigate the differences in the process of auditory speech perception in individuals with postlingual hearing loss wearing a cochlear implant, using two different speech coding strategies, and to analyze speech perception and handicap perception in relation to the strategy used. Methods  This study is prospective cross-sectional cohort study of a descriptive character. We selected ten cochlear implant users that were characterized by hearing threshold by the application of speech perception tests and of the Hearing Handicap Inventory for Adults. Results  There was no significant difference when comparing the variables subject age, age at acquisition of hearing loss, etiology, time of hearing deprivation, time of cochlear implant use and mean hearing threshold with the cochlear implant with the shift in speech coding strategy. There was no relationship between lack of handicap perception and improvement in speech perception in both speech coding strategies used. Conclusion  There was no significant difference between the strategies evaluated and no relation was observed between them and the variables studied.

Variabilidade do registro de latência e amplitude do potencial evocado auditivo de Longa Latência (P3) na condição teste e reteste

Purpose To analyze the variability of the amplitude and latency of the P3 cognitive potential in normal individuals, the condition test and retest, in the period of 7 days. Methods We evaluated 32 subjects, with ages between 18 and 25 years, 20 females and 12 males, without hearing complaints. Were submitted to audiologic evaluation and cortical potential. Results The mean values of latency and amplitude for the P3 obtained in this study were of 314.78 ms and 312.40 ms for latency and 5.04 μV and 4.58 μV, for amplitude, in positions Cz and Fz, respectively. No significant difference was found when compared to the latency and amplitude, in the test-retest reliability, with the fixing of the electrodes in Cz and Fz. There was no difference for the latency and amplitude of P3 in all the modalities studied: gender, fixation of the electrodes (Cz and Fz) and condition test and retest. For the latency of the P3 in the female gender and condition of test and retest, there was significant difference. Conclusion The mean values of latency and amplitude found in this study were 313.6 ms and 4.81 μV, respectively. The values of latency and amplitude did not vary according to the position of the electrodes (Cz and Fz) and regarding the condition test as retest. There was a significant difference for the female gender when compared in condition test and retest.The mean difference of the latency of P3 in condition of reassessment was 10.50 ms (Fz) and 15.25 ms (Cz) for the female gender and of 6.00 ms (Fz) and 5.83 ms (Cz) for the male gender.

Construção e aplicabilidade de um teste de percepção de fala com figuras

Purpose To prepare and apply support material for responses to the Speech Recognition Percentage Index (SRPI) test in children. Methods This is a descriptive, exploratory study conducted in two phases: in the first phase, 31 speech-language pathologists (referees) prepared material composed of regular, frequently used monosyllabic and disyllabic words belonging to the vocabulary of children and figures that could represent these words; the second phase consisted in the application of this material to 30 normal-hearing children aged 2 to 4 years and 11 months. Results The material consisted of 25 words and six boards with six figures each. The word selection criterion adopted by the referees included the initial phoneme and real, colorful figures familiar to the children. The mean scores of the children in the SRPI test were 93% (SD ± 8%) with the support of figures and 64% (SD ± 25%) without figure support. Comparison between the results obtained with and without the support of figures showed significant difference for 15 of the 25 test words, with higher scores with the use of supporting figures. Comparison between correct and incorrect responses using the support of figures showed significant difference only for the word “dog” (“cao”) (p=0.0079). Conclusion There was agreement among the referees with respect to the words and figures. The SRPI test can be rapidly and easily applied, allowing evaluation and systematic monitoring of speech perception ability regardless of child verbalization capacity.

Relationship between Speech Perception and Level of Satisfaction of Hearing Aid Users

Introduction Hearing difficulties can be minimized by the use of hearing aids. Objective The objective of this study is to assess the speech perception and satisfaction of hearing aids users before and after aid adaptation and to determine whether these measures are correlated. Methods The study was conducted on 65 individuals, 54% females and 46% males aged 63 years on average, after the systematic use of hearing aids for at least three months. We characterized subjectś personal identification data, the degree, and configuration of hearing loss, as well as aspects related to adaptation. We then applied a satisfaction questionnaire and a speech perception test (words and sentences), with and without the use of the hearing aids. Results Mean speech recognition with words and sentences was 69% and 79%, respectively, with hearing aids use; whereas, without hearing aids use the figures were 43% and 53%. Mean questionnaire score was 30.1 points. Regarding hearing loss characteristics, 78.5% of the subjects had a sensorineural loss, 20% a mixed loss, and 1.5% a conductive loss. Hearing loss of moderate degree was present in 60.5% of cases, loss of descending configuration in 47%, and plain loss in 37.5%. There was no correlation between individual satisfaction and the percentages of the speech perception tests applied. Conclusion Word and sentence recognition was significantly better with the use of the hearing aids. The users showed a high degree of satisfaction. In the present study, there was no correlation observed between the levels of speech perception and levels of user satisfaction measured with the questionnaire.

Cochlear implant revision surgeries in children

INTRODUCTION The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. OBJECTIVE To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. METHODS A retrospective study of patients under 18 years submitted to cochlear implant surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after cochlear implant surgery and any need for surgical revision and the reason for it. RESULTS Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. CONCLUSION The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subjects hearing and language performance, indicating that these surgeries are valid in most cases.

Cochlear Implant in a Patient with Arnold-Chiari Syndrome

Objective: To verify the efficacy of cochlear implantation in a patient with Arnold-Chiari syndrome. Design: Review of a medical chart from a patient with Arnold-Chiari syndrome that underwent to cochlear implant surgery. Case report: A 6 year-old female, with meningomyelocele and congenital hydrocephalus, deaf in the past 3 years, after meningitis. At that time, she used oral language with adequate speech development. Tone audiometry revealed bilateral profound sensorineural hearing loss. The MRI was compatible with the Arnold-Chiari syndrome. Cochlear implantation was performed on the left ear with MED-EL? Implant (model SONATATi100). Currently, the child is 12 year-old, performs speech therapy three times a week, with good hearing and language development. Conclusion: Despite the presence of Arnold-Chiari syndrome (Chiari type II) with neurological disorders and with ventriculoperitoneal shunt, patient had good hearing results after cochlear implant surgery.

Long Latency Auditory Potential (P300) Outcomes in a Patient with Vestibular Schwannoma after Cochlear Implant Surgery

Background: Neurofibromatosis type 2 (NF2) is a rare syndrome and it is usually presented with bilateral vestibular schwannomas (VS), multiple meningiomas, and other types of tumors associated to peripheral nerves. Hearing loss is one of its leading manifestations, and surgery for removal of the tumor is often required. Cochlear implant (CI) surgery is an option for auditory rehabilitation and long latency auditory potentials (P300) are becoming a very useful tool to assess hearing outcomes. Objective: To verify the presence of P300 waves during auditory and cortical function assessment in a patient submitted to VS removal and CI surgery. Design: Retrospective chart review. Case Report: A 62 years old male patient, presented at the clinic with a bilateral severe to profound hearing loss, worst at the right side. MRI scan revealed bilateral expansive tumor within the internal auditory canal expanding to cerebellopontine angle, suggestive of VS. Tumor was removed at the right side, and CI surgery was indicated for the left ear. P300 tests were performed pre-operatively, at the moment of activation, and 6 months post-operatively. After CI activation, P300 waves appeared, and presented reduced latency and increased amplitude after 6 months of CI use. Conclusion: P300 waves appear to be dependent on the auditory stimulus to be generated, showing that it can be a useful tool to estimate improvement in cortical cognitive function after restoring hearing through CI surgery after VS removal.

Teste de percepção de fala com figuras: aplicabilidade em crianças com deficiência auditiva

Objetivo: verificar a aplicabilidade do teste de percepcao de fala com figuras, desenvolvido por Souza e Reis (2015), em criancas com deficiencia auditiva. Metodos: estudo descritivo exploratorio. Participaram 40 criancas, de ambos os sexos, na faixa etaria entre 2 e 11 anos, sendo 20 normo ouvintes (GC) e 20 com deficiencia auditiva (GE), equiparadas por tempo de estimulacao sensorial auditiva com audicao normal. Os grupos foram subdivididos de acordo com tempo de estimulacao sensorial auditiva, sendo GC1 (2 anos de idade), GC2 (3 anos de idade), GC3 (4 anos de idade), GE1 (2 anos de estimulacao auditiva), GE2 (3 anos de estimulacao auditiva), GE3 (4 anos de estimulacao auditiva). Resultados: os grupos apresentaram as seguintes porcentagens de acertos: GC1 87.33%, GC2 85.6% e GC3 98.67%. O grupo estudo, composto pelas criancas com deficiencia auditiva, os resultados foram, GE1 61.33%, GE2 76.8% e GE3 88% de acertos. Houve diferenca significante para seis das 25 palavras (gelo, faca, rato, trem, cao, flor), quando associados acertos e erros. Conclusao: o teste e viavel para a avaliacao e monitoramento da percepcao de fala em criancas com deficiencia auditiva, independente da capacidade de verbalizacao das mesmas.

Is there a best side for cochlear implants in post-lingual patients?

INTRODUCTION Cochlear Implant is a sensory prosthesis capable of restoring hearing in patients with severe or profound bilateral sensorineural hearing loss. OBJECTIVE To evaluate if there is a better side to be implanted in post-lingual patients. METHODS Retrospective longitudinal study. Participants were 40 subjects, of both sex, mean age of 47 years, with post-lingual hearing loss, users of unilateral cochlear implant for more than 12 months and less than 24 months, with asymmetric auditor reserve between the ears (difference of 10dBNA, In at least one of the frequencies with a response, between the ears), divided into two groups. Group A was composed of individuals with cochlear implant in the ear with better auditory reserve and Group B with auditory reserve lower in relation to the contralateral side. RESULTS There was no statistical difference for the tonal auditory threshold before and after cochlear implant. A better speech perception in pre-cochlear implant tests was present in B (20%), but the final results are similar in both groups. CONCLUSION The cochlear implant in the ear with the worst auditory residue favors a bimodal hearing, which would allow the binaural summation, without compromising the improvement of the audiometric threshold and the speech perception.