Orozimbo Alves Costa

Implante coclear: audição e linguagem em crianças deficientes auditivas pré-linguais

BACKGROUND Cochlear implant in children, speech perception and oral language, hearing and oral language performance in children with pre-lingual profound sensory-neural hearing impairment, users of cochlear implant. AIM To study the hearing and oral language performance of children with pre-lingual bilateral profound sensory neural hearing impairment, users of multi-channel cochlear implant considering the following aspects: age of the child when the research was carried out, time of hearing sensorial privation, time of cochlear implant use, type of cochlear implant, type of speech coding strategy used, familial permeability level in relation to the therapeutic process and cognitive style of the child. METHOD Participants of this study were 60 children who were assessed according to hearing and language categories. All of the variables were statistically analyzed. Psycho-social aspects, considering the childs cognitive style and the familys permeability level were also assessed. RESULTS Regarding the hearing and language performance with the use of cochlear implant, the intermediate and advanced hearing categories were accomplished by more than half of the children. The statistically significant aspects in the performance of hearing and oral language were: the age of the child upon evaluation, time of hearing sensorial privation, time of cochlear implant use, type of implant, speech sounds coding strategy and familial permeability. CONCLUSION The cochlear implant as a treatment for children with pre-lingual sensory-neural hearing impairment is highly effective, although complex, owing to the interaction of variables which interfere in the implanted childs performance. Further studies are needed for the understanding of the implantation complexity in young children.

The universal newborn hearing screening in Brazil: From identification to intervention

OBJECTIVE The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. METHODS A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, São Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of São Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. RESULTS 11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US

Potencial cognitivo P300 em indivíduos com diabetes mellitus

7.00 and the annual cost of the universal newborn hearing screening program was US

Análise crítica de três protocolos de triagem auditiva neonatal

26,940.47. CONCLUSION The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System.

Emissões otoacústicas - produto de distorção em indivíduos expostos ao chumbo e ao ruído

Diabetes Mellitus pode acarretar complicacoes nos olhos, rins, nervos cranianos, nervos perifericos, ouvidos, etc. A funcao cognitiva tambem parece estar prejudicada em individuos portadores de Diabetes Mellitus, visto que as estruturas corticais e subcorticais responsaveis por esta funcao estao prejudicadas em alguns pacientes dependentes de insulina. O potencial cognitivo P300 tem sido usado como um procedimento objetivo para avaliar a funcao cognitiva cerebral. OBJETIVO: Analisar a sensibilidade do potencial cognitivo P300 para detectar alteracoes no cortex auditivo decorrentes do Diabetes Mellitus. FORMA DE ESTUDO: coorte transversal. MATERIAL E METODO: Participaram deste estudo 16 individuos diabeticos de ambos os sexos, com idade variando de 7 a 71 anos, e 17 individuos nao-diabeticos equiparados quanto ao sexo, idade e limiar auditivo. Os procedimentos de avaliacao foram: Audiometria Tonal Liminar (ATL) e potencial cognitivo P300. No grupo diabetico foi realizada a medida do valor glicemico antes da realizacao do P300. RESULTADOS: Os resultados obtidos na ATL nao mostraram diferenca estatisticamente significante. Foi observado diferenca estatisticamente significante entre os grupos, quando analisado a latencia do componente P3, medido em Fz. Houve correlacao entre a glicemia e a latencia e amplitude do P300. CONCLUSAO: A pesquisa do potencial cognitivo P300 e um importante procedimento para prevenir e diagnosticar precocemente de alteracoes neurologicas em individuos com Diabetes Mellitus.

Potencial cognitivo P300 realizado em campo livre: aplicabilidade do teste

BACKGROUND: having knowledge about the validity of procedures for newborn hearing screening (NHS) is fundamental, once the purpose of these programs is to identify all newborns with hearing loss at an acceptable cost. AIM: to estimate the specificity and the false-positive rate of NHS protocols using transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR). METHOD: participants were 200 newborns who were submitted to a hearing screening test between March and July 2006. Three protocols were analyzed: protocol 1, NHS was carried out in two steps using TEOAE; protocol 2, NHS was carried out in two steps using AABR; and protocol 3, NHS was carried out in one step, using the two procedures - testing with TEOAE followed by a retest with AABR for all the newborns who did not pass the TEOAE testing. RESULTS: although there was no statistically significant difference when comparing the referral rates to audiological diagnosis obtained in protocols using TEOAE and AABR, the protocol using TEOAE referred four times more newborns. Protocol 3 presented the highest referral rate, with a statistically significant difference when compared to protocols 1 and 2. CONCLUSIONS: the false-positive rate and consequently specificity were better for the protocol using AABR, followed respectively by the protocol using TEOAE and using both TEOAE and AABR.

Longitudinal study of the ecap measured in children with cochlear implants

Currently, legislations concerning workers health only require periodic monitoring of individuals who are noise-exposed at work, and exposure to chemicals are not taken into consideration. However, the scientific literature indicates a very clear concern regarding the effects of lead on the auditory system, demonstrating that there are negative effects to the auditory system following occupational exposure to this metal. AIM: The aim of this study was to evaluate the amplitude of distortion product otoacoustic emissions (DPOAEs) among individuals with a history of exposure to lead and noise. STUDY DESIGN: Transversal Cohort. MATERIAL AND METHOD: We evaluated 69 individuals divided in 3 groups: Group I (GI): composed by 29 workers occupationally exposed to both lead and noise; Group II (GII): composed by 11 noise-exposed workers with no other exposure to ototraumatic, and Group III (GIII): composed by 11 individuals with normal hearing and no history of exposure to noise or lead. RESULTS: The results showed no effect of lead exposure on the otoacoustic emission results, since the smaller EOEPD amplitudes were observed in the noise-exposed group, despite the fact that the lead and noise exposed workers had a long history of lead exposure, and a wide variability in blood lead levels.

Desempenho de crianças normais em testes temporais auditivos em campo livre

Avaliar a funcao auditiva em usuarios de dispositivos eletronicos aplicados a surdez e muito importante para o processo de reabilitacao. Entretanto, nestes individuos os procedimentos devem ser realizados em campo livre. OBJETIVO: Analisar a aplicabilidade do potencial cognitivo P300 pesquisado em campo livre. FORMA DE ESTUDO: Clinico prospectivo. MATERIAL E METODO: Foram avaliados 33 individuos de ambos os sexos com idade entre 7 e 34 anos, com audicao normal e sem fator de risco para problemas mentais. O potencial cognitivo P300 foi realizado por meio do equipamento Biologics Evoked Potential System (EP), com fones de insercao (3A) e em campo livre (0o Azimute e 45o Azimute). RESULTADOS: Nao houve diferenca estatisticamente significante para a latencia do N2 e P300 e amplitude do P300 quando analisado o sexo e o modo de realizacao do teste (fone e campo livre), assim como nao houve diferenca ao comparar as medidas em campo livre a 0o e 45o Azimute. CONCLUSAO: A pesquisa do potencial cognitivo P300 em campo livre e um procedimento viavel de ser realizado.

Programação remota dos sistemas de implante coclear

UNLABELLED In children with cochlear implant (CI), the recording of the electrically evoked compound action potential (ECAP) of the auditory nerve represents an option to assess changes in auditory nerve responses and the interaction between the electrode bundle and the neural tissue over time. AIM To study ECAP in children during the first year of CI use. MATERIALS AND METHODS The ECAP characteristics have been analyzed in 13 children implanted younger than three years of age. Series study. RESULTS During the first year of CI use there was a significant statistical raise in the N1 peak amplitude, in basal electrodes, between the second and third return visits. There were not any significant differences obtained for N1 peak, latency, slope, p-NRT or recovery time, in the return visits. CONCLUSION During the first year of CI use, the electrical stimulation provided by the intracochlear electrodes did not cause significant changes to ECAP characteristics, except for an increase in N1 peak amplitude.

Cognitive P300 potential in subjects with diabetes mellitus

TEMA: processamento temporal auditivo. OBJETIVO: determinar o perfil de desempenho de criancas com audicao normal nas tarefas de deteccao e identificacao da ordem e sequencia temporal em campo livre. METODO: avaliou-se 43 criancas com idade entre 7 anos e 11 anos e 5 meses em dois testes comportamentais -Teste de Padroes de Frequencia (TPF) e Teste de Padroes de Duracao (TPD) - versao infantil da Auditec. Os testes foram aplicados em campo livre a 60 dBNA. Foram solicitados dois tipos de respostas: nao verbal (NV) sendo o murmurio para o TPF e manual para o TPD, e verbal (V), nomeacao pra TPF e TPD. Para ambos os testes (TPF e TPD) foram apresentadas 10 repeticoes dos 6 padroes sequenciais, totalizando 60 estimulos para cada crianca. RESULTADOS: o desempenho no TPF com resposta NV foi significativamente superior a resposta V para todos os sujeitos. Constatou-se melhora significativa do desempenho com a idade para o TPFV, TPDNV e TPDV. O desempenho no TPF foi superior ao TPD. Os resultados deste estudo demonstraram semelhante desempenho nas tarefas de deteccao e identificacao da ordem e sequencia temporal quando comparados com outros estudos realizados na populacao brasileira, nos quais estas tarefas foram aplicadas com fones supra-aurais. CONCLUSAO: os valores obtidos para o TPF e TPD podem ser considerados como referencia de normalidade para a versao infantil da Auditec em campo livre em criancas de 7 anos a 11 anos e 5 meses.