Maristela Julio Costa

Limiares de reconhecimento de sentenças no ruído, em campo livre: valores de referência para adultos normo-ouvintes

Nas clinicas de audiologia, as queixas de dificuldade de compreensao da fala em ambientes ruidosos sao frequentes, mesmo para individuos normo-ouvintes. Assim, o audiologista deve nao so identificar uma perda auditiva, mas tambem analisar a compreensao da fala, em condicoes de comunicacao proximas as encontradas no cotidiano. OBJETIVO: Determinar o valor de referencia para os limiares de reconhecimento de sentencas no ruido, em campo livre, para individuos adultos normo-ouvintes. MATERIAL E METODO: O experimento foi realizado nos anos de 2005 e 2006. Participaram da pesquisa 150 individuos adultos normo-ouvintes, com idade entre 18 e 64 anos, avaliados em cabine acusticamente tratada. Realizou-se a avaliacao a partir da aplicacao do teste Listas de Sentencas em Portugues. As listas de sentencas foram apresentadas em campo livre, na presenca de um ruido competitivo, na intensidade fixa de 65 dB A. O ângulo de incidencia de ambos os estimulos foi de 0o- 0o azimute. RESULTADOS E CONCLUSAO: Os limiares de reconhecimento de sentencas em campo-livre foram obtidos na relacao sinal-ruido de -8,14 dB A, sendo este o valor de referencia para individuos normo-ouvintes.

Satisfação de usuários de próteses auditivas, com perda auditiva de graus severo e profundo

To analyze the satisfaction of adults and elders, users of hearing aids with hearing loss of severe and deep degree, using a questionnaire and searching factors that can difficult the adaptation. Method: A retrospective study of 56 patients, with age group between 18 and 86 years old, hearing loss of severe and deep degree and users of HA by a program of concession of hearing aids, submitted to the questionnaire: “Satisfaction with Amplification in Daily Life”. The global average was calculated by sub scale and by question and it was given emphasis to the questions that resulted in best and worse averages. Results: 58,9% were women and 41,1% men, about of 55% of the patients presented hearing loss of severe degree and 45% deep degree. 87,5% referred use major than 8 hours daily. The users believe that the acquisition of the hearing aid was the best option and this aid very much in the speech understanding. They feel themselves trustful and able with the sounding amplification and refer a good service by professionals of the service. The performance to the telephone was the problem found. Conclusion: It was demonstrated high degree of satisfaction in the studied population. The hearing loss degree, as well as the incompatibility of systems between telephone and telecoils and the difficulty in the placement of telephone ate factors that difficult the good performance to the telephone. The accentuated hearing loss collaborate for the hearing aid be an integral part of the daily life and essential in the aid to the communication. ACTRN12610000424000

Estudo da equivalência entre as listas de sentenças em Português

PURPOSE: to investigate the equivalence among of sentence lists of the test: Lists of Sentences, in Portuguese, proposed by Costa in 1998. METHODS: the information was taken from a database of a research project. 240 individuals with at least complete high-school, 18 to 30-year old and having normal audibility thresholds, were studied. The Sentence Recognition Thresholds under Silence and under Noise were separately searched in each ear through earphones. In The Sentence Recognition Thresholds under the Noise, speech and noise were presented at the same ear. RESULTS: comparing the results among the lists, we find average difference of 0.03 dB NA to 0.86 dB NA under silence and 0.04 dB NA to 1.06 dB NA under noise. The minimum and maximum values in the six lists were very close. CONCLUSION: it was observed that in the application of the test Lists of Sentences in Portuguese, through earphones, both under silence as well as under noise, similar results were obtained in the lists 1B, 2B, 3B, 4B, 5B and 6B, showing equivalence among the lists.

A satisfação e o desempenho de usuários de próteses auditivas atendidos em um programa de atenção à saúde auditiva

RESUMOObjetivo: avaliar o desempenho e a satisfacao com o uso das proteses auditivas nos pacientes aten-didos no convenio APAC-UFSM, apos um ano de adaptacao. Metodos: analisou-se 49 sujeitos, com perda auditiva do tipo neurossensorial ou mista, de grau leve a severo na melhor orelha, divididos em adultos e idosos. Realizou-se a pesquisa dos Limiares e Indices Percentuais de Reconhecimento de Sentencas no Silencio e no Ruido, em campo livre, por meio do teste Listas de Sentencas em Portugues; e aplicou-se o questionario de satisfacao, International Outcome Inventory for Hearing Aids. Realizaram-se os testes na mesma sessao, em dois momentos distintos, sendo o primeiro, sem o uso das proteses auditivas e o segundo, usando as mesmas.Resultados: houve diferenca signi-ficante no desempenho dos individuos em ambos os grupos, no procedimento realizado no silencio. Apesar de o desempenho com proteses auditivas nao ter apresentado melhora significante no ruido, os pacientes apresentaram respostas satisfatorias no questionario. Na comparacao entre os grupos, nao se observou diferenca significante quanto ao desempenho e satisfacao. Conclusao: a melhora significante do desempenho no silencio vai ao encontro do relato dos pacientes. O questionario evi-denciou que a maioria referiu fazer uso efetivo das proteses auditivas e considerou ter um beneficio muito satisfatorio. Apesar de uma parcela significativa referir moderada ou bastante dificuldade resi-dual, a maioria considerou que o uso das proteses auditivas vale muito ou bastante a pena.DESCRITORES: Auxiliares de Audicao; Testes de Discriminacao da Fala; Questionarios; Perda Auditiva

Limiares de reconhecimento de sentenças no silêncio em campo livre versus limiares tonais em fone em indivíduos com perda auditiva coclear

PURPOSE: to investigate the existent correlation among pure tone thresholds and Sentence Recognition Thresholds in Silence (TRSS) and to check if it is possible, through the audiogram, to set up a prognostic of the patients about their communication ability. METHODS: 42 individuals with moderate cochlear hearing loss, 18 females and 24 males, 41 to 76-year old were studied. Firstly, a basic audiologic evaluation was carried out, then a search of TRSS in free field, through the Portuguese Sentence List Test (PSLT) (Costa, 1998). RESULTS: The statistical analysis showed significant correlation between the sentence recognition thresholds in silence and the average of frequencies of 0.5, 1 and 2 kHz. However, when correlating with the average frequencies of 3, 4 e 6 kHz, there was no significant correlation. CONCLUSION: the probable prognostic concerning the ability for recognizing sentences in silence can be carried through just with the frequency thresholds of 0.5, 1 and 2 kHz in cochlear hearing loss.

Reconhecimento de sentenças no silêncio e no ruído em fones auriculares: valores de referência de normalidade

OBJETIVO: determinar os limiares de reconhecimento de sentencas no silencio (LRSS) e no ruido (LRSR), a fim de estimar os valores de referencia para jovens adultos normo-ouvintes. METODOLOGIA: foram avaliados 240 individuos, de ambos os sexos, com idades entre 18 e 30 anos, com no minimo o ensino medio completo. As medidas foram obtidas utilizando o teste Listas de Sentencas em Portugues (LSP, Costa, 1998), em fones auriculares. Para a obtencao dos LRSR foi usado um ruido fixo a 65 dB NA, ipsilateralmente, cujos resultados foram expressos por meio das relacoes S/R. RESULTADOS: com base nos valores encontrados a partir da avaliacao de 480 orelhas, o LRSS medio encontrado foi de 6,20 dB NA, com valores minimos e maximos de 2,44 dB NA e 9,66 dB NA, respectivamente, e um desvio-padrao medio de 1,33; enquanto que a relacao S/R media foi de -5,29 dB, com valores minimos e maximos de -2,55 dB e -9,22 dB, e um desvio-padrao medio de 1,13. CONCLUSAO: o LRSS medio, 6,20 dB NA, foi compativel com a media dos limiares tonais, 7,22 dB NA, nas frequencias de 0,5, 1 e 2 kHz. O LRSR medio -5,29 dB pode ser usado como referencia para avaliar o desempenho de individuos com e sem perda auditiva. Os LRSR obtidos em relacoes S/R de -3,03 a -7,55 dB podem indicar um bom desempenho no reconhecimento de fala no ruido.

Efeitos da reabilitação auditiva na habilidade de ordenação temporal em idosos usuários de próteses auditivas

PURPOSE To analyze the effects of an auditory rehabilitation program for the temporal ordering ability, of duration and pitch patterns of sounds, in elderly hearing aids users. METHODS Participants were 17 elderly people, with ages between 60 and 84 years, divided into Control Group (CG), which only used hearing aids, and Study Group (SG), which were submitted to an auditory rehabilitation program that included auditory counseling and training. All subjects were assessed at the beginning and at the end of the study, through the Duration Pattern Sequence and Pitch Pattern Sequence tests. The period between assessments was seven weeks. RESULTS In the Duration Pattern Sequence test, CG subjects showed mean values of accuracy in the murmured condition of 48.64 and 54.43%, for initial and final assessments, respectively; SG subjects, presented 60.39 and 76.28%. In the named condition, CG presented 51.93 and 52.43%, and SG, 63.94 and 77.44% for initial and final assessments, respectively. In the Pitch Pattern Sequence test, CG subjects showed mean values of accuracy in the murmured condition of 80.62 and 79.94%, and SG subjects, of 79.78 and 90.39%, for initial and final assessments, respectively. In the named the condition, CG presented 82.64 and 84.21%, and SG, 82.94 and 85.89%, for initial and final assessments. There was a difference only for SG subjects in the murmured and named conditions of the Duration Pattern Sequence test, in the named condition of the Pitch Pattern Sequence test, indicating higher mean values in the final assessment. CONCLUSION The auditory rehabilitation program to elderly hearing aid users provide satisfactory improvement in recognition, temporal ordering, and naming of duration and pitch patterns of sounds.

Limiares de reconhecimento de sentenças em indivíduos normo-ouvintes na presença de ruído incidente de diferentes ângulos

ABSTRACT Purpose: To determine and compare the sentence recognition thresholds in the noise, in sound field, in the presence of incident noise from different angles, and to verify the most unfavorable hearing condition, in normal-hearing individuals. Methods: The Portuguese Sentences Lists test was carried out in 38 young adults, evaluated in acoustic booth. The sentences were presented at 0o - 0o azimuth, and the competitive noise at 0o - 0°, 0° - 90°, 0° - 180°, and 0° - 270° azimuth, in a fixed loudness of 65 dB NPS (A). Results: The signal-to-noise ratios in which the sentence recognition thresholds were obtained for these incidence angles were, respectively: -7.56, -11.11, -9.45, and -10.43 dB. Differences were found between the results in the conditions: 0o - 0o and 0o - 90o; 0o - 0o and 0o - 180o; -0o - 0o and 0o - 270o. Conclusion: The following sentence recognition thresholds in the noise, in sound field, were obtained for these signal-to-noise ratios: 0° - 0° = -7.56 dB; -0o - 90o = -11.11 dB; -0o - 180° = -9.75 dB; 0o - 270o = -10.43 dB. The better thresholds were obtained with the incidence angles of 0o - 90o and 0o - 270o, followed by the 0o - 180o condition, and, finally, by the 0o - 0o condition. The most unfavorable hearing condition was that in which the noise was in the same incidence angle of the speech, in front of the evaluated subject.

Reconhecimento de fala em indivíduos com e sem queixa clínica de dificuldade para entender a fala no ruído

INTRODUCTION: Clinical and experimental study. Individuals with a normal hearing can be jeopardized in adverse communication situations, what negatively interferes with speech clearness. OBJECTIVE: check and compare the performance of normal hearing young adults who have a difficulty in understanding speech during noise or not, by making use of sentences as stimuli. METHOD: 50 normal hearing individuals, 21 of whom were male and 29 were female, aged between 19 and 32, were evaluated and divided into two groups: with and without a clinical complaint about understanding speech during noise. By using Portuguese Sentence Lists test, the Recognition Threshold of Sentences during Noise research was performed, through which the signal-to-noise (SN) ratios were obtained. The contrasting noise was introduced at 65 dB NA. RESULTS: the average values achieved for SN ratios in the left ear, for the group without a complaint and the group with a complaint, were respectively 6. 26 dB and 3. 62 dB. For the left ear, the values were -7. 12 dB and -4. 12 dB. A statistically significant difference was noticed in both right and left ears of the two groups. CONCLUSION: normal hearing individuals showing a clinical complaint about understanding speech at noisy places have more difficulty in the task to recognize sentences during noise, in comparison with the people who do not face such a difficulty. Accordingly, the customary audiologic evaluation must include tests using sentences during a contrasting noise, with a view to evaluating the speech recognition performance more reliably and efficiently.

Efeito da aclimatização no reconhecimento de fala: avaliação sem as próteses auditivas

Background: after the adaptation of hearing aids, an improvement in speech understanding is expected to occur, called acclimatization. Aim: to determine the effect of acclimatization in sentences recognition threshold, for the conditions of silence (SRTQ) and noise (SRTN), in new users of hearing aids, evaluated prior to and after acclimatization, without the use of the hearing aids. Method: participants were 40 individuals, aged between 28 and 78 years, with mild to moderate sensorineural hearing loss. Tests were conducted in three sessions: prior to the adaptation of the hearing aids, fourteen days and three months later.The Portuguese Sentences Lists test in free field was used for testing, and the SRTQ and SRTN were obtained (with noise level settled at 65 dB A). Results were expressed through the signal/noise ratios. Results: the mean values for the SRTQ in the 1st, 2nd and 3rd sessions were 54.43, 51.71 and 52.22 dB A respectively,. The mean signal/noise ratios for the 1st, 2nd and 3rd sessions were 1.67, 0.30 and -0.03 dB A. When comparing the results obtained between the testing sessions, a statistically significant difference was observed between the 1st and 2nd sessions, and between the 1st and 3rd sessions for the values obtained in the testing conditions of silence and noise. Conclusion: There was a progressive reduction of sentences recognition thresholds and signal/noise ratios indicating an improvement in performance even when assessing the individuals without the hearing aids. This improvement can be related to the effect of acclimatization.