Luzia Maria Pozzobom Ventura

Maturação do sistema auditivo central em crianças ouvintes normais

BACKGROUND: the long latency auditory evoked potentials (LLAEP) provide objective data about the function of hearing cortical structures. AIM: to characterize the maturation of the central hearing system in normally hearing children. METHOD: record of LLAEP of fifty-six subjects with hearing tresholds within normal limits, of both genders, being 46 children and 10 adults. With the availability of two recording channels, one was directed to register the LLAEP and the other, to record the artifact generated by ocular movement, aiming at its control. The potentials were recorded with subjects in an alert state, through electrodes positioned in Cz (active) and A2 (reference), and the ocular movements, through electrodes in the left supra and infra-orbital positions; the ground electrode was placed in A1. The morphology and the values of latency and of amplitude for components P1, N1 and P2, according to age, were analyzed. In order to verify the reproducibility of the recorded potentials, a double blind study was carried out, by introducing the analysis of another evaluator. RESULTS: the double blind study did not present statistically significant differences between the analyses. With the increase in age there was an improvement in the morphology and a decrease in the latency values of components P1, N1 and P2. Also there was a decrease in the amplitude of component P1 and no variation in the amplitude values was observed for components N1 and P2. No statistically significant difference was observed between genders. CONCLUSION: the maturational process of the central hearing system occurs gradually, being the greatest changes observed when comparing children and adults.

Development of P1 cortical auditory evoked potential in children presented with sensorineural hearing loss following cochlear implantation: a longitudinal study

PURPOSE To assess the characteristics of P1 component in children presented with pre-lingual hearing loss, users of cochlear implants, and correlate them with speech perception performance. METHODS Ten children presented with pre-lingual sensory neural hearing loss using cochlear implants participated in this research. The cortical auditory evoked potential research was carried out with the /da/ speech stimulus, presented in free field, in three moments: at cochlear implant activation, with three and six months following activation. The Infant-Toddler Meaningful Auditory Integration Scale was used to verify the speech perception. RESULTS The correlation of the three moments of the test with the latency and the amplitude of P1 component through analysis of variance were observed. The comparison of latency and amplitude of P1 in each assessment moment was performed with Tukeys test. Wilcoxon and t-test showed that the score on the Infant-Toddler Meaningful Auditory Integration Scale increased significantly with the time of cochlear implant use, nevertheless with no correlation with the latency and amplitude of P1 component in the moments assessed, as demonstrated by Spearmans and Pearsons correlations. CONCLUSION The latency and amplitude of P1 component diminish as the time of cochlear implant use increases. However, there was no correlation between its development and speech perception performance.PURPOSE To identify risk groups for oropharyngeal dysphagia in hospitalized patients in a university hospital. METHODS The study was design as an exploratory cross-sectional with quantitative data analysis. The researched population consisted of 32 patients admitted to the medical clinic at the university hospital. Patient history data were collected, followed by a universal swallowing screening which included functional feeding assessment, to observe clinical signs and symptoms of dysphagia, and assessment of nutritional status through anthropometric data and laboratory tests. RESULTS Of the total sample, the majority of patients was male over 60 years. The most common comorbidities related to patients with signs and symptoms of dysphagia were chronic obstructive pulmonary disease, systemic arterial hypertension, congestive heart failure, diabetes mellitus and acute myocardial infarction. The food consistency that showed higher presence of clinical signs of aspiration was pudding and the predominant sign was wet voice. CONCLUSION There is a high incidence of risk for oropharyngeal dysphagia in hospitalized patients and an even higher rate of hospitalized patients with nutritional deficits or already malnourished. Hospitalized patients with respiratory diseases, chronic obstructive pulmonary disease, congestive heart failure and patients with xerostomia were indicated as risk group for oropharyngeal dysphagia.Objetivo: Identificar os grupos de risco para disfagia orofaringea em pacientes internados em um hospital universitario. Metodos: O estudo foi transversal do tipo exploratorio com analise quantitativa dos resultados. A populacao pesquisada foi formada por 32 pacientes internados nas clinicas medicas do hospital. Foram coletados dados da historia do paciente e realizada a triagem universal de degluticao, avaliacao funcional da alimentacao para observacao de sinais e sintomas de disfagia e avaliacao do estado nutricional por dados antropometricos e exames laboratoriais. Resultados: Da amostra total, a maioria dos pacientes era homens acima de 60 anos. As comorbidades mais associadas a pacientes com sintomas e sinais de disfagia foram doenca pulmonar obstrutiva cronica, hipertensao arterial sistemica, insuficiencia cardiaca congestiva, diabetes melitus e infarto agudo do miocardio. A consistencia alimentar em que foi observada a maior presenca de sinal clinico de aspiracao foi o pudim, e o sinal predominante, a voz molhada. Conclusao: Ha grande incidencia de risco para disfagia orofaringea nos pacientes internados e um indice ainda maior de pacientes internados em comprometimento nutricional ou ja desnutridos. Pacientes internados com doencas respiratorias, doenca pulmonar obstrutiva cronica, insuficiencia cardiaca congestiva e pacientes com xerostomia foram apontados como grupo de risco para disfagia orofaringea.

Protocolo para captação dos potenciais evocados auditivos de longa latência

Long Latency Auditory Evoked Potentials (LLAEP) represents a number of electrical changes occurring in the central nervous system, resulting from stimulation of the auditory sensorial pathways. Many studies approach the use of these potentials controlling the artifact created by eye movement with the use of equipment with a large number of channels. However, what happens is very different in Brazilian clinical practice, where the equipment used has a very limited number of channels. AIM: to compare the two methods used to control the artifacts created by eye movements during LLAEP capture using two recording channels. MATERIALS AND METHODS: this is a prospective study with the application of two LLAEP capturing methods (eye artifact subtraction and rejection limit control) in 10 normal hearing individuals. RESULTS: we did not observe statistically significant differences concerning the latency values obtained with the use of both methods, only concerning amplitude values. CONCLUSION: both methods were efficient to capture the LLAEP and to control the eye movement artifact. The rejection limit control method produced greater amplitude values.

Protocol to collect late latency auditory evoked potentials

UNLABELLED Long Latency Auditory Evoked Potentials (LLAEP) represents a number of electrical changes occurring in the central nervous system, resulting from stimulation of the auditory sensorial pathways. Many studies approach the use of these potentials controlling the artifact created by eye movement with the use of equipment with a large number of channels. However, what happens is very different in Brazilian clinical practice, where the equipment used has a very limited number of channels. AIM to compare the two methods used to control the artifacts created by eye movements during LLAEP capture using two recording channels. MATERIALS AND METHODS this is a prospective study with the application of two LLAEP capturing methods (eye artifact subtraction and rejection limit control) in 10 normal hearing individuals. RESULTS we did not observe statistically significant differences concerning the latency values obtained with the use of both methods, only concerning amplitude values. CONCLUSION both methods were efficient to capture the LLAEP and to control the eye movement artifact. The rejection limit control method produced greater amplitude values.

Ocorrência de perda auditiva unilateral em pacientes com fissura labiopalatina

Purpose: to investigate the occurrence of unilateral hearing loss in individuals with cleft palate. Methods: a retrospective study of 500 medical records of patients with cleft palate. Results: 55 subjects have been raised with unilateral hearing loss, 27 (49.1%) were male and 28 (50.9%) were female, mean age of 14.6 years. Eighteen (32.73%) had hearing loss in right ear and 37 (67.27%) in the left ear. Being 72.73% (40 subjects) with conductive hearing loss, 18.18% (10 subjects) sensorineural and 9.09% (5 subjects) of mixed type. Regarding the degree of hearing loss was found higher incidence of mild hearing loss. Conclusion: a unilateral hearing loss was more frequent in subjects aged 0-11 years, with equal gender ratio. A unilateral hearing loss may affect social and emotional aspects of the subject, leading him to need an intervention.

Desenvolvimento do potencial evocado auditivo cortical P1 em crianças com perda auditiva sensorioneural após o implante coclear: estudo longitudinal

PURPOSE To assess the characteristics of P1 component in children presented with pre-lingual hearing loss, users of cochlear implants, and correlate them with speech perception performance. METHODS Ten children presented with pre-lingual sensory neural hearing loss using cochlear implants participated in this research. The cortical auditory evoked potential research was carried out with the /da/ speech stimulus, presented in free field, in three moments: at cochlear implant activation, with three and six months following activation. The Infant-Toddler Meaningful Auditory Integration Scale was used to verify the speech perception. RESULTS The correlation of the three moments of the test with the latency and the amplitude of P1 component through analysis of variance were observed. The comparison of latency and amplitude of P1 in each assessment moment was performed with Tukeys test. Wilcoxon and t-test showed that the score on the Infant-Toddler Meaningful Auditory Integration Scale increased significantly with the time of cochlear implant use, nevertheless with no correlation with the latency and amplitude of P1 component in the moments assessed, as demonstrated by Spearmans and Pearsons correlations. CONCLUSION The latency and amplitude of P1 component diminish as the time of cochlear implant use increases. However, there was no correlation between its development and speech perception performance.PURPOSE To identify risk groups for oropharyngeal dysphagia in hospitalized patients in a university hospital. METHODS The study was design as an exploratory cross-sectional with quantitative data analysis. The researched population consisted of 32 patients admitted to the medical clinic at the university hospital. Patient history data were collected, followed by a universal swallowing screening which included functional feeding assessment, to observe clinical signs and symptoms of dysphagia, and assessment of nutritional status through anthropometric data and laboratory tests. RESULTS Of the total sample, the majority of patients was male over 60 years. The most common comorbidities related to patients with signs and symptoms of dysphagia were chronic obstructive pulmonary disease, systemic arterial hypertension, congestive heart failure, diabetes mellitus and acute myocardial infarction. The food consistency that showed higher presence of clinical signs of aspiration was pudding and the predominant sign was wet voice. CONCLUSION There is a high incidence of risk for oropharyngeal dysphagia in hospitalized patients and an even higher rate of hospitalized patients with nutritional deficits or already malnourished. Hospitalized patients with respiratory diseases, chronic obstructive pulmonary disease, congestive heart failure and patients with xerostomia were indicated as risk group for oropharyngeal dysphagia.Objetivo: Identificar os grupos de risco para disfagia orofaringea em pacientes internados em um hospital universitario. Metodos: O estudo foi transversal do tipo exploratorio com analise quantitativa dos resultados. A populacao pesquisada foi formada por 32 pacientes internados nas clinicas medicas do hospital. Foram coletados dados da historia do paciente e realizada a triagem universal de degluticao, avaliacao funcional da alimentacao para observacao de sinais e sintomas de disfagia e avaliacao do estado nutricional por dados antropometricos e exames laboratoriais. Resultados: Da amostra total, a maioria dos pacientes era homens acima de 60 anos. As comorbidades mais associadas a pacientes com sintomas e sinais de disfagia foram doenca pulmonar obstrutiva cronica, hipertensao arterial sistemica, insuficiencia cardiaca congestiva, diabetes melitus e infarto agudo do miocardio. A consistencia alimentar em que foi observada a maior presenca de sinal clinico de aspiracao foi o pudim, e o sinal predominante, a voz molhada. Conclusao: Ha grande incidencia de risco para disfagia orofaringea nos pacientes internados e um indice ainda maior de pacientes internados em comprometimento nutricional ou ja desnutridos. Pacientes internados com doencas respiratorias, doenca pulmonar obstrutiva cronica, insuficiencia cardiaca congestiva e pacientes com xerostomia foram apontados como grupo de risco para disfagia orofaringea.