Isabela Freixo Côrtes-Andrade

Emissões Otoacústicas Evocadas por Estímulo Transiente: protocolos de Triagem Auditiva Neonatal

Purpose: to describe the results of three TEOE protocols obtained from automatic equipment used in a Newborn Hearing Screening Program. Method: during two months, TEOEs of 287 neonates in Sao Paulo were studied. To register them, we used a three-protocol, set up with different pass/fail criteria. The following protocols were registered: Protocol A: to pass in four frequency bands, not necessarily consecutive-; Protocol B: to pass in three frequency bands, not necessarily consecutive – and Protocol C: to pass in two frequency bands, not necessarily consecutive, as well. The parameters that we used to consider these answers were: reproducibility above 50%, as well as signal/noise ratio > 3dB at 1.0 and 1.5 kHz and > 6dB at 2.0, 3.0 and 4.0 kHz. Results: TEOEs of 574 ears were analyzed and the 2.0, 3.0 and 4.0 frequencies showed the highest pass percentages (94.1, 95.8 and 92.7% for protocols A, B and C respectively). Protocol C showed the highest pass percentage, achieving 96,9%. Nevertheless, the results obtained in Protocol B, which had the presence of three bands, showed a similar percentage to Protocol C (96,2%). Therefore, there was a not statistically significant difference between Protocols B and C. 1.0 kHz frequency achieved a percentage of only 9.9 in the tested ears. Conclusions: one has to research Protocols A, B and C with gold standard in order to verify which one suits best in terms of sensibility and specificity, even though the three protocols studied showed similar results in pass criteria for two or three frequency bands.

Triagem auditiva neonatal com potencial evocado auditivo de tronco encefálico automático: a utilização de diferentes tecnologias

Objetivo : Analisar os resultados da Triagem Auditiva Neonatal com Potencial Evocado Auditivo de Tronco Encefalico Automatico, com diferentes tecnologias, estudando a sensibilidade, a especificidade e o tempo de exame. Metodos : Foram avaliados 200 neonatos, por meio do Potencial Evocado Auditivo de Tronco Encefalico Automatico utilizando metodo de deteccao no dominio da frequencia e taxa de repeticao do estimulo a 93 Hz. Todos os neonatos foram submetidos ao Potencial Evocado Auditivo de Tronco Encefalico como padrao ouro, para garantir os resultados encontrados. Durante a realizacao da triagem, os neonatos foram classificados de acordo com a Escala Neonatal de Avaliacao Comportamental, conhecida como Escala de Brazelton, como variavel para analise do tempo de exame. Resultados : Dois dos 200 neonatos triados falharam no Potencial Evocado Auditivo de Tronco Encefalico Automatico e no Potencial Evocado Auditivo de Tronco Encefalico Diagnostico e 198 passaram nos dois exames realizados. A sensibilidade encontrada foi de 100% e a especificidade, de 100%. O tempo medio de exame foi de 32,9 segundos. Os neonatos foram dividido em tres grupos, de acordo com o estado de consciencia, segundo a Escala de Brazelton. O Grupo 1 apresentou media de exame de 18,94 segundos, o Grupo 2, de 33,43 segundos e o Grupo 3, de 49,24 segundos. Conclusao : O Potencial Evocado Auditivo de Tronco Encefalico Automatico com diferentes tecnologias apresenta alta sensibilidade e especificidade, com tempo consideravelmente curto para a determinacao da presenca ou ausencia de resposta e o estado de consciencia do neonato influencia no tempo de deteccao da resposta auditiva.

Estudo das emissões otoacústicas - produto de distorção durante a prática esportiva associada à exposição à música

PURPOSE: to study the hearing of individuals in a fitness gym while exercising, analyzing their distortion product evoked otoacustic emissions (DPOAE) test after and before exposure to electronically amplified music. METHODS: a questionnaire was applied to 20 individuals and evaluated through DPOAE test after and before physical exercises with electronically amplified music exposure. RESULTS: most of the individuals (65%) had extra-occupational exposure. The most frequent complaints were headache and insomnia (40%); hearing difficulty (35%); aural fullness (25%); irritability and nervousness (25%); dizziness (20%); and tinnitus (15%) after exercises. Although DPOAE occurred in 100% of the ears before the exposure (moment 1 - M1), 25% failed on the second test, after the exercises (moment 2 - M2). The frequencies that most failed in the DPOAE test were 3 KHz, 4KHz and 5KHz. CONCLUSION: this study shows that individuals exposed to electronic amplified music, may have hearing loss complaints and have signs of such loss.

Triagem auditiva neonatal com emissão otoacústica transiente utilizando estímulo de banda estreita

ABSTRACT Purpose: to assess the sensitivity and specificity of an automated Transient Evoked Otoacoustic Emissions equipment using narrow band stimulus. Methods: the hearing screening results of 300 newborns were analyzed. A portable automated equipment was used with narrow band stimulus to conduct the Transient Evoked Otoacoustic Emissions. All newborns were also submitted to the Brainstem Auditory Evoked Potentials using 100μs-duration click stimuli, which was considered the gold standard test. Results: the proportion of “pass” results in the neonatal hearing screening was 90.7%. Considering the gold standard results, it was observed a false-positive rate of 9%. The Transient Evoked Otoacoustic Emissions with narrow band stimulus presented sensitivity of 100% and specificity of 92%. Conclusion: the narrow band stimulus was efficient enough to be used in neonatal hearing screening programs. KEYWORDS: Infant, Newborn; Hearing Tests; Otoacoustic Emissions, Spontaneous; Evoked Potentials, Auditory; Hearing Loss