Michele Vargas Garcia

Medidas de imitância acústica em lactentes com 226hz e 1000hz: correlação com as emissões otoacústicas e o exame otoscópico

A avaliacao audiologica do lactente deve ser composta pela verificacao das condicoes de orelha media (medidas de imitância acustica e otoscopia) e pela avaliacao coclear (Emissoes Otoacusticas). OBJETIVO: Verificar qual tom teste da timpanometria (226Hz ou 1000Hz) tem maior correlacao com o exame otoscopico e com o resultado das Emissoes Otoacusticas por estimulo transiente. METODO: Realizou-se emissoes otoacusticas nos 60 lactentes da amostra, com idade entre de zero e quatro meses. Foram distribuidos em dois grupos, sendo o grupo I 30 lactentes com EOA presente e o grupo II 30 lactentes com EOA ausente. Foram submetidos a timpanometria de multiplas frequencias, com tom teste de 226Hz e 1000Hz e avaliacao otoscopica. RESULTADOS: Na timpanometria, o tom teste de 1000Hz apresentou mais sensibilidade para identificar as alteracoes de orelha media. Nas criancas com curva timpanometrica dentro da normalidade, ambos os tons-teste (226 e 1000Hz) apresentaram alta especificidade. Todas as correlacoes foram significantes com o tom teste de 1000Hz. CONCLUSAO: O tom teste de 1000Hz apresentou maior correlacao estatisticamente significante com as EOA e com a avaliacao otoscopica para lactentes de zero a quatro meses.

Memory Networks in Tinnitus: A Functional Brain Image Study

Tinnitus is characterized by the perception of sound in the absence of an external auditory stimulus. The network connectivity of auditory and non-auditory brain structures associated with emotion, memory and attention are functionally altered in debilitating tinnitus. Current studies suggest that tinnitus results from neuroplastic changes in the frontal and limbic temporal regions. The objective of this study was to use Single-Photon Emission Computed Tomography (SPECT) to evaluate changes in the cerebral blood flow in tinnitus patients with normal hearing compared with healthy controls. Methods: Twenty tinnitus patients with normal hearing and 17 healthy controls, matched for sex, age and years of education, were subjected to Single Photon Emission Computed Tomography using the radiotracer ethylenedicysteine diethyl ester, labeled with Technetium 99 m (99 mTc-ECD SPECT). The severity of tinnitus was assessed using the “Tinnitus Handicap Inventory” (THI). The images were processed and analyzed using “Statistical Parametric Mapping” (SPM8). Results: A significant increase in cerebral perfusion in the left parahippocampal gyrus (pFWE <0.05) was observed in patients with tinnitus compared with healthy controls. The average total THI score was 50.8+18.24, classified as moderate tinnitus. Conclusion: It was possible to identify significant changes in the limbic system of the brain perfusion in tinnitus patients with normal hearing, suggesting that central mechanisms, not specific to the auditory pathway, are involved in the pathophysiology of symptoms, even in the absence of clinically diagnosed peripheral changes.

Portadores de vitiligo: estudo das emissões otoacústicas e efeito de supressão

Vitiligo e uma doenca cutânea, caracterizada pela ausencia da melanina, por destruicao de melanocitos. OBJETIVO: Verificar a ocorrencia de alteracao auditiva em individuos com vitiligo. METODO: Avaliacao audiologica, pesquisa das emissoes otoacusticas evocadas transientes e do efeito de supressao em estudo prospectivo de 24 pacientes com vitiligo. A faixa etaria variou de 15 a 45 anos. RESULTADOS: 21 pacientes (87.5%) apresentaram audiometria normal; dois apresentaram perda auditiva unilateral em frequencias altas e um apresentou perda coclear de grau moderado a esquerda. Destes 21 sujeitos, 66,7% tiveram ausencia de emissoes, sugerindo disfuncao coclear. As emissoes estiveram presentes em todas as bandas de frequencia em apenas 7 pacientes (29,2%) e ausentes em 17 (70,8%), com maior ocorrencia de falha no sexo masculino, na orelha direita. Na pesquisa da supressao, seis individuos falharam, todos do sexo feminino, sendo a orelha esquerda a mais afetada. CONCLUSAO: Pela analise das emissoes otoacusticas verificou-se que os portadores de vitiligo possuem maior predisposicao a disfuncao coclear, com maior ocorrencia no sexo masculino na orelha direita. Quanto ao efeito de supressao, houve maior alteracao no sistema eferente em mulheres, com maior ausencia a esquerda. As alteracoes auditivas nao diferiram quanto a idade, tipo de vitiligo e tempo de evolucao da doenca.

Accoustic immitance measures in infants with 226 and 1000 hz probes: correlation with otoacoustic emissions and otoscopy examination

UNLABELLED Audiological evaluation in infants should include the middle ear (immitance measures and otoscopy) and also a cochlear evaluation. AIM To check which tympanometry tone test (226 Hz or 1000 Hz), transient otoacoustic emissions and otoscopy. METHODS Transient otoacoustic emissions were taken from sixty infants ranging from zero to four months of age. The babies were assigned to two groups of 30 infants each, according to the presence or absence of otoacoustic emissions (OAE). All babies have undergone tympanometry with probe tones of 226 and 1000 Hz and ENT evaluation. RESULTS Tests performed with 1000 Hz probe tone were more sensitive in identifying middle ear disorders. In children with normal tympanograms, both probe tones (226 and 1000 Hz) showed high specificity. All correlations were significant when the 1000 Hz probe tone was used. CONCLUSION The high frequency probe tone (1000 Hz) presented the most significant correlation with OAE and otoscopy in infants from zero to four months of age.

A study on otoacoustic emissions and supression effects in patients with vitiligo

UNLABELLED Vitiligo is a skin disease characterized by absence of melanin due to melanocytes destruction. AIM to study the incidence of hearing alterations in patients with vitiligo. METHOD prospective audiological evaluation, transient-evoked otoacoustic emission recordings and study the effects of suppression in 24 patients with vitiligo. Their ages ranged from 15 to 45 years. RESULTS 21 patients (87.5%) had normal audiometry; 2 had unilateral hearing loss in the high frequencies and 1 had cochlear moderate hearing loss in the left ear. Of these 21 subjects, 66.7% had no otoacoustic emissions, suggesting cochlear dysfunction. Only 7 patients had otoacoustic emissions present in all frequencies (29.2%) and 17 (70.8%) did not have them, and the highest rate of no otoacoustic emissions happened in the right ear of males. Regarding the suppression study, 6 subjects failed, all of them were females, and their left ears were the most affected. CONCLUSION the findings show that patients with vitiligo, particularly males, have a greater predisposition to cochlear dysfunction, especially in the right ear. As far as the suppression effect was concerned, there was a greater alteration in the female efferent system, particularly in the left ear. Hearing alterations did not vary as far as age is concerned, type of vitiligo and time of disease progression.

Bilingualism and auditory processing abilities: performance of adults in dichotic listening tests

PURPOSE To evaluate and compare the dichotic listening abilities in non-hearing-impaired adults monolingual speakers of the Brazilian Portuguese language (CG) and simultaneous Brazilian Portuguese-German (GG) bilingual speakers or successive Brazilian Portuguese-Italian bilingual speakers (IG). METHODS This is about an observational, descriptive, transverse and quantitative research. The sample consisted of 87 subjects aged between 18 and 55 years, divided into: Control Group (CG), of 30 monolingual speakers of Brazilian Portuguese; Study Group A (SGA), of 31 simultaneous Brazilian Portuguese-German bilingual speakers; and Study Group I (SGI), of 26 successive Brazilian Portuguese-Italian speakers. The individuals were submitted to the Dichotic digits test (DDT) and to Staggered Spondaic Words (SSW). RESULTS The DTT results showed difference in right ear and total scores when comparing SGA to CG. Comparing the CG and the SGI, it was observed difference in right and left ears and total scores. Comparing the SGA and the SGI, no difference was observed between the groups. Results of SSW showed that both bilingual groups were significantly better in the right and left ears scores and even in total one when compared to CG. Comparing the SGA and the SGI, the SGI showed better significant scores in the right ear and total. CONCLUSION Bilingual experiences seem to influence positively the ability of high predictability dichotic listening, evaluated by DDT, and the low predictability dichotic listening, evaluated by SSW test. The SSW results also showed statistically significantly better results for successive Brazilian Portuguese-Italian bilingual speakers when compared to simultaneous Brazilian Portuguese-German speakers.

The influence of the type of breastfeeding on middle ear conditions in infants

UNLABELLED Infants should be submitted to hearing screening upon birth, and for the results to be complete, it is necessary to assess middle ear conditions. OBJECTIVE To check whether the type of breastfeeding in infants between zero and four months can impact middle ear conditions my means an ENT assessment and acoustic immittance comparing neonates who were submitted to hearing screening with those who failed it. MATERIALS AND METHODS Otoacoustic emissions (OAE) was carried out in 60 infants between zero and four months. They were distributed in two groups; group I had the infants with OAE and those infants in group II did not have OAE. They were submitted to tympanometry with a 1000 Hz test tone and ENT assessment. RESULTS Bottle fed infants or those who were fed in a mixed way had more changes to their audiometry and ENT assessment, with a statistically significant difference. The breastfed infants had a higher occasion of normal tympanometries and normal otorhinolaryngological assessment, with statistically significant difference. CONCLUSION We then concluded that those breastfed implants had less ENT changes and as well as less acoustic immittance change, thus enabling OAEs. Breastfeeding alone can be considered a protection factor against middle ear changes.

Intensive care unit: results of the Newborn Hearing Screening

INTRODUCTION Procedures for extending the life of newborns are closely related to potential causes of hearing loss, justifying the identification and understanding of risk factors for this deficiency. OBJECTIVE To characterize the population, analyze the frequency of risk factors for hearing loss, and assess the audiological status of infants attended in a Newborn Hearing Screening program (NHS). METHODS This was a retrospective study that analyzed medical records of 140 patients from a neonatal intensive care unit, identifying the frequency of risk factors for hearing loss and audiological status, utilizing transient otoacoustic emissions and brainstem auditory evoked potential (BAEP). RESULTS Prematurity was present in 78.87% of cases; 45% of the infants were underweight and 73% received ototoxic medication. Audiologically, 11.42% failed the NHS, and 5% of cases failed retest; of these, one had results compatible with hearing loss on BAEP. CONCLUSION A higher rate of low birth weight, and prematurity was observed in infants who underwent screening and had an audiological diagnosis by the third month of life. Only one newborn presented a change in audiological status. The authors emphasize the importance of auditory monitoring for all infants, considering this as a high-risk sample for hearing loss.

Long-latency auditory evoked potentials with verbal and nonverbal stimuli,

INTRODUCTION Long-latency auditory evoked potentials represent the cortical activity related to attention, memory, and auditory discrimination skills. Acoustic signal processing occurs differently between verbal and nonverbal stimuli, influencing the latency and amplitude patterns. OBJECTIVE To describe the latencies of the cortical potentials P1, N1, P2, N2, and P3, as well as P3 amplitude, with different speech stimuli and tone bursts, and to classify them in the presence and absence of these data. METHODS A total of 30 subjects with normal hearing were assessed, aged 18-32 years old, matched by gender. Nonverbal stimuli were used (tone burst; 1000Hz - frequent and 4000Hz - rare); and verbal (/ba/ - frequent; /ga/, /da/, and /di/ - rare). RESULTS Considering the component N2 for tone burst, the lowest latency found was 217.45ms for the BA/DI stimulus; the highest latency found was 256.5ms. For the P3 component, the shortest latency with tone burst stimuli was 298.7 with BA/GA stimuli, the highest, was 340ms. For the P3 amplitude, there was no statistically significant difference among the different stimuli. For latencies of components P1, N1, P2, N2, P3, there were no statistical differences among them, regardless of the stimuli used. CONCLUSION There was a difference in the latency of potentials N2 and P3 among the stimuli employed but no difference was observed for the P3 amplitude.

Diagnosing cochlear "dead" regions and its importance in the auditory rehabilitation process.

UNLABELLED A good audiologic diagnosis is increasingly more important in the practice of audiology, in order to understand patients needs for selection and fitting of hearing aid devices. AIM Show recent literature that mention the concept of cochlear dead regions, diagnostic strategies and its relevance in the process of selection and fitting of hearing aids. METHODS to carry out a bibliographical survey on dead cochlear regions. Dead cochlear regions were described as regions where inner hair cells and/or adjacent neurons do not work. Therefore, in these regions, the information generated by basilar membrane vibration is not transmitted to the central nervous system. However, a tone at a frequency correspondent to that of dead regions, provided it being sufficiently intense, can be perceived in regions near this zone where inner hair cells and/or nervous fibers still work. CONCLUSION The identification of dead regions in the cochlea is used to obtain better results in the process of selection and fitting of hearing aids because the pieces of information generated by inner hair cells to the auditory nerve are important to better identify sounds, mainly those related to speech.