Rosanna Mariangela Giaffredo Angrisani

PEATE automático em recém nascidos de risco: estudo da sensibilidade e especificidade

OBJETIVO: verificar a sensibilidade e especificidade do teste de potencial evocado auditivo de tronco encefalico em equipamento automatico (PEATEa), comparando-o ao teste de potencial evocado auditivo de tronco encefalico em equipamento diagnostico (PEATE) em um programa de triagem auditiva neonatal em neonatos de risco. METODO: foram avaliados 186 neonatos, 83 nascidos a termo e 103 pre-termo, sendo 88 do sexo masculino e 98 feminino. A triagem constou de emissoes otoacusticas evocadas por estimulos transientes (EOAT), PEATEa e ao PEATE na mesma semana. RESULTADOS: dos 186 neonatos avaliados, 156 (83,9%) apresentaram audicao normal. A perda condutiva foi encontrada em 9 neonatos (4,8%),sendo 7 bilaterais e 2 unilaterais. A perda auditiva coclear foi observada em 5 neonatos (2,7%) sendo um unilateral. Alteracao central foi obtida em 11 neonatos (5,9%) e um neonato foi diagnosticado como espectro da neuropatia auditiva -ENA(0,5%).Em 4 casos houve atraso maturacional na avaliacao inicial com normalizacao das respostas no mes seguinte Comparando-se os resultados do PEATEa com o PEATE, observou-se alta sensibilidade ( superior a 99%) para identificacao de perda coclear,condutiva, central, atraso maturacional e ENA .A especificidade do PEATEa foi de 100% para ENA, mediana para perda coclear (75% na OD e 60% na OE), e para alteracoes centrais (54,5%OD e 63,6% OE). Para identificacao de perdas condutivas (inferior a 43%). CONCLUSAO: o PEATEa foi eficaz na identificacao das neuropatias auditivas com elevada especificidade e sensibilidade. Contudo, falsos negativos foram observados para perdas cocleares, condutivas, para alteracoes centrais e atraso maturacional.

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.

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.

Auditory brainstem response in neonates: influence of gender and weight/gestational age ratio

Objective: To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR) in preterm (PT) and term (T) newb...

Avaliação do sistema nervoso auditivo central em neonatos com Hemorragia peri intraventricular

Purpose: to verify the occurrence of Intracranial hemorrhage in preterm infants undergoing neonatal intensive care, characterizing the occurrence of central hearing impairment in this population and its variation depending on the degree of hemorrhage. Methods: a longitudinal retrospective study. Of the 719 premature infants, 46 (6.4%) had peri-intraventricular hemorrhage. 84 patients were selected, and divided into two groups: a study group, consisted of 42 with hemorrhage, and a control group, consisted of 42 without peri-intraventricular hemorrhage. All had transient evoked otoacoustic emissions present, and underwent brainstem auditory evoked potential investigation during hospitalization and were followed for two years, through behavioral assessment of hearing. Results: there was a higher incidence of central alteration in the study group (33.4%) compared to the control group (4.8%), characterized by increased latency of waves III and V and interpeak interval IV. The auditory central alteration was higher in preterm infants with hemorrhage grade II, III and IV in the degree I, being significant. Conclusion: The occurrence of peri-intraventricular hemorrhage was 6.4%. The occurrence of central alteration was 33.4% and varied with the hemorrhage degree: children with hemorrhage grades II, III and IV showed higher occurrence of central alteration in relation to the ones with hemorrhage grade I. In audiological follow-up, central hearing impairment remained at 51.85% of children who already had this alteration since birth.

Efeito de supressão das emissões otoacústicas em lactentes termo e pré-termo

PURPOSE This research aims at verifying the occurrence and magnitude of suppression effect of otoacoustic emissions evoked by transient stimulus in term and preterm infants, setting a benchmark for clinical use. METHODS The study sample consisted of 40 infants, with a rage of age from five days to four months, without any risk indicators for hearing loss and otoacoustic emissions present at birth: the 20 term and 20 preterm infants spent more than five days in the Neonatal Intensive Care Unit. Linear click was presented at 65 dB Sound Pressure Level, in blocks of 15 seconds without noise, and with contralateral noise at 60 dB Sound Pressure Level. The reduced response in the presence of noise indicates positive suppression effect. Mean values of suppression were established and the comparison between the groups was analyzed statistically. RESULTS Suppression occurred in 100% of the children and did not vary as a function of ear side and between the groups. CONCLUSION All children presented suppression regardless of the group. The average suppression obtained on the total population was 0.85 dB. The minimum recommended criterion for clinical use was a reduction of 0.20 dB in the overall response.

Avaliação audiológica em lactentes com agenesia de corpo caloso

Purpose to assess the occurrence of hearing loss in infants with corpus callosum agenesis comparing them to children without such malformation. Methods a cohort study in two parts: a retrospective from 2008 to 2011, and prospective from 2011 to 2012. The study group consisted of 12 infants diagnosed with agenesis of the corpus callosum and the control group of 12 infants, matched for sex and post conceptional age. All patients underwent otoacoustic emissions transient stimulus, Auditory Evoked Potential (analysis of the average latencies of waves I, III and V and interpeak I-III, III-V and IV 80dBnNA) and behavioral auditory tests. Results the analysis of the occurrence of hearing impairment evaluationotoacoustic emissions transient stimulusand Auditory Evoked Potential showed differences in both groups, withhighest percentage of normal results in the control group. There was significant difference between the ears, the latencies of wave III and I-III interpeak interval, and lower right in the control group. In behavioral assessment, there was significant difference between the groups in relation to normal and abnormal results, with higher prevalence of central alteration in the study group. Also in this group, the second assessment showed a statistically significant higher rate of abnormal results when compared to the first assessment. Conclusion hearing disorders in infants with corpus callosum agenesis were not identified at birth, but within the first six months of life. Most of the changes occurred in the central auditory pathway in the brainstem.

Potencial evocado auditivo de tronco encefálico em recém-nascido: influência do sexo e da relação peso e idade gestacional

Objective: To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR) in preterm (PT) and term (T) newb...

Potencial evocado auditivo de tronco encefálico en recién nacidos: influencia del sexo y de la relación peso y edad gestacional

Objective: To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR) in preterm (PT) and term (T) newb...

Triagem auditiva neonatal com emissões otoacusticas e reflexo cocleo-palpebral: estudo da sensibilidade e especificidade

ABSTRACTPurpose : to study the specificity and sensitivity of NHS with otoacoustic emissions transient stimulus (TEOAE) associated with cochlear-palpebral reflex (CPR), and comparing the results of Auditory Evoked Potential (BAEP). Method : three hundred and sixty-nine neonates under risk of hearing loss were evaluated. Evaluation procedures consisted of transient otocoustic emissions(TOAEs), cochlear-palpebral reflex (CPR), and ABR diagnostic carried out in the same week. Results : the incidence in the general population was 4 neonates (1.1%) with cochlear hearing loss, 22 (5.9%) with conductive hearing loss, 2 (0.5%) with auditory neuropathy, 14 (3.8%) with central abnormalities and 15 (4.1%) with delayed maturation of the auditory pathway. The TAN showed 100% sensitivity and 94.6% specificity in detecting the spectrum of cochlear and auditory neuropathy, 77.3% sensitivity and 94.6% specificity in detecting conductive and 42.9% and 94.6% specificity while detecting central abnormalities. All findings showed statistically significant differences when compared to normal auditory neonates.