Silvana Frota

Consciência fonológica e o processo de aprendizagem de leitura e escrita: implicações teóricas para o embasamento da prática fonoaudiológica

TEMA: consciencia fonologica e o aprendizado da leitura e escrita. OBJETIVO: realizar uma revisao de literatura acerca do tema com o objetivo de retomar conceitos dispostos recentemente na literatura e oferecer ao Fonoaudiologo a possibilidade de revisao de suas praticas para (re)formulacao de estrategias terapeuticas. CONCLUSAO: e possivel observar que os estudos convergem para a importante relacao no desenvolvimento das habilidades de consciencia fonologica com o desenvolvimento da leitura e escrita. Tal fato reforca a necessidade de revisao de nossa pratica clinica e cientifica para a criacao e difusao de estrategias preventivas e/ou de remediacao envolvendo atividades ludicas que englobam a consciencia da crianca na manipulacao dos sons da fala. Uma importante area de pesquisa na Fonoaudiologia do Brasil deveria convergir para o estudo e criacao de ferramentas facilitadoras ao Fonoaudiologo.

Estudo comparativo de exames audiométricos de metalúrgicos expostos a ruído e ruído associado a produtos químicos

A exposicao a produtos quimicos ototoxicos na presenca ou nao do ruido pode provocar danos irreversiveis na audicao dos trabalhadores em um periodo significativamente menor de exposicao. OBJETIVO: Realizar um estudo comparativo, atraves de exames audiometricos, em trabalhadores expostos somente a ruido e ruido associado a produtos quimicos. METODOS: 155 metalurgicos (18 - 50 anos) expostos a ruido (grupo I) e a ruido e produtos quimicos (grupo II) por um periodo que varia de 3 a 20 anos. RESULTADOS: diferenca significativa na proporcao de perda auditiva ocupacional da orelha direita entre os grupos I (3,6%) e II (15,5%). Proporcao de perda auditiva ocupacional no profissional significativamente maior no grupo II (18,3%) em relacao ao grupo I (6%). Com respeito ao tempo medio de exposicao aos agentes agressores, o grupo I esteve exposto por tempo significativamente maior. Estudo retrospectivo. DISCUSSAO: O fato de ter havido maior comprometimento da orelha direita no grupo II e controverso e merece ser pesquisado futuramente, pois alguns estudos revelam que a orelha esquerda seria mais suscetivel a lesao por ruido. CONCLUSAO: O grupo II apresentou proporcionalmente maior prevalencia de perda auditiva quando comparado ao grupo I, mesmo tendo estado exposto aos agentes agressores por um menor tempo medio.

Envelhecimento e ordenação temporal auditiva

OBJETIVO: avaliar o processamento auditivo em idosos atraves do teste de ordenacao temporal (Padrao de Duracao) e verificar se a presenca de perda auditiva influencia no desempenho deste teste. METODOS: 65 idosos foram avaliados (46 mulheres e 19 homens), entre 60 e 79 anos. Os participantes responderam a uma anamnese, realizaram mini-exame do estado mental e avaliacao audiologica basica. Os participantes foram alocados e estudados em um grupo unico e tambem divididos em tres grupos denominados G1, G2 e G3. De acordo com os resultados audiometricos, classificou-se o G1 (audicao normal para as medias de 0,5/1/2 kHz e de 3/4/6 kHz), o G2 (audicao normal ou perda auditiva de grau leve para a media de 0,5/1/2 kHz e grau leve para a media de3/4/6 kHz ) e o G3 (audicao normal ou perda auditiva de grau leve para a media de 0,5/1/2 kHz e grau moderado para a media de3/4/6 kHz). Foi realizado o teste Padrao de Duracao, que avalia a ordenacao temporal, a 50dBNS. Para a analise dos resultados foi utilizado o teste estatistico nao-parametrico de Kruskal-Wallis e o teste do qui-quadrado, sendo considerado como significante um p < 0,05. RESULTADOS: em toda a amostra a media de porcentagem de acertos foi de 63,1%. Nos grupos, as medias de acertos foram de 57,5%, 69% e 63,9% para o G1, G2 e G3, respectivamente. CONCLUSAO: a presenca de perda auditiva nao influenciou nos resultados do teste padrao de duracao.

Resolução temporal auditiva em idosos

PURPOSE: To assess the auditory processing of elderly patients using the temporal resolution Gaps-in-Noise test, and to verify if the presence of hearing loss influences the performance on this test. METHODS: Sixty-five elderly listeners, with ages between 60 and 79 years, were assessed with the Gaps-in-Noise test. To meet the inclusion criteria, the following procedures were carried out: anamnesis, mini-mental state examination, and basic audiological evaluation. The participants were allocated and studied as a group, and then were divided into three groups, according to audiometric results for the frequencies of 500 Hz, 1, 2, 3, 4 and 6 kHz. Thus, subjects in G1 had normal hearing, participants in G2 were classified with mild hearing loss, and those in G3 had moderate hearing loss. RESULTS: In the entire sample, the mean gap detection threshold and the mean percentage of correct responses were, respectively, 8.1 ms and 52.6% for the right ear, and 8.2 ms and 52.2% for the left ear. In G1, these measures were 7.3 ms and 57.6% for the right ear, and 7.7 ms and 55.8% for the left ear. In G2, these measures were 8.2 ms and 52.5% for the right ear, and 7.9 ms and 53.2% for the left ear. In G3, the measures were 9.2 ms and 45.2% for the right and left ears. CONCLUSION: The presence of hearing loss increased the gap detection thresholds and lowered the percentage of correct responses on the Gaps-in-Noise test.

Audiometria de altas frequências em bombeiros militares com audiometria normal expostos ao ruído

UNLABELLED The study of high frequencies has proven its importance for detecting inner ear damage. In some cases, conventional frequencies are not sensitive enough to pick up early changes to the inner ear. AIM To analyze the results of threshold high frequency analysis of individuals exposed to noise with normal conventional audiometry. MATERIALS AND METHODS This was a retrospective cross-sectional cohort study, in which we studied 47 firefighters of the Fire Department of Rio de Janeiro, based on Santos Dumont airport and 33 military men without noise exposure. They were broken down into two age groups: 30-39years and 40-49years. The high frequencies were studied immediately after conventional audiometry. RESULTS The results were most significant in the 40 to 49 years of age range, where the experimental group showed significantly higher threshold values than the control group 14000Hz (p = 0.008) and 16,000Hz (p = 0.0001). CONCLUSIONS We concluded that noise interfered with high frequency thresholds, where all the mean values found in the experimental group were higher than those in the control group. We suggest that these data reinforce the importance of studying high frequencies, even with normal conventional audiometry in the early detection of noise-induced hearing loss.

Avaliação dos limiares de audibilidade das altas freqüências em indivíduos entre 18 e 29 anos sem queixas otológicas

Estudos recentes que avaliaram os limiares auditivos em altas frequencias trouxeram novas perspectivas a investigacao de danos auditivos. Contudo, as pesquisas desenvolvidas ainda nao estabeleceram um consenso para os padroes de normalidade dos limiares de audicao nessas frequencias. OBJETIVO: Analisar os resultados dos limiares de audibilidade das altas frequencias, em nivel de audicao, de individuos entre 18 e 29 anos sem queixas otologicas. FORMA DE ESTUDO: Tipo seccional transversal. MATERIAL E METODOS: Foram realizadas 60 audiometrias convencionais, sendo 51 exames com resultados normais, em individuos entre 18 e 29 anos. Esses individuos foram submetidos a audiometria de altas frequencias utilizando o aparelho AMPLAID 460 e fones de orelha Sennheiser HD 520 II, sendo os limiares obtidos em dBNA. RESULTADOS: Observou-se nao existir diferenca significativa nos limiares de audibilidade entre o sexo masculino e feminino. Foram obtidos os limiares de audicao em dBNA nas altas frequencias para individuos sem queixas otologicas, entre 18 e 29 anos. CONCLUSAO: Sugeriu-se que esses dados poderiam ser utilizados como referencia de normalidade para estudos posteriores com equipamento de mesmo padrao, que tivessem como objetivo avaliar alteracoes auditivas apresentadas em individuos jovens.

Acompanhamento da adaptação de próteses auditivas em crianças surdas

PURPOSE: to describe the compliance and attitudes of hearing-impaired children towards the treatment and support offered by the Hearing Health Program, a public health endeavor, and assessing patients’ returns for follow-ups. METHODS: participants consisted of fifty children aged from 0 to 8 years, with a diagnosis of mild to severe sensorineural hearing loss. The children received the hearing aids from the Hearing Health Program, in Vila Velha, in the state of Espirito Santo, Brazil. The research protocol was completed using both medical records and a socio-economical profile survey of the affected children, including the behavioral adaptation as for hearing aids. RESULTS: the requirement of patient return for follow-ups facilitated the attendance of nearly half the population (44%); results indicate that there seems to be an association between compliance with the program and school routine. CONCLUSION: the aforementioned program mostly affects families with a monthly income from one to two minimum wages. Hearing loss is diagnosed between the chronological ages of two and three years in this study. The first adaptation with hearing aids at the age of six is quite late. The contact with the parents promoted by the social workers facilitates the proposed evaluation. School attendance also proved to have a positive influence on the evaluation.

Emissões otoacústicas por produto de distorção e audiometria tonal liminar: estudo da mudança temporária do limiar

Introduction: Noise-induced hearing loss is one of the most common causes for sensorineural hearing impairment. Objective: The purpose of this study was to evaluate pure tone and distortion product otoacoustic emissions (DPOAE) pre and post white noise exposition at high levels (100 dB SPL for 10 minutes), considering gender and ear variables, aiming at investigating pure tone audiometry and DPOAE efficiency in detecting subtle temporary threshold shifts (TTS). Study design: prospectivo clinical randomized. Material and method: Forty subjects, 20 male and 20 female ranging from 18 to 36 years old with no otological complaints were evaluated. Pure tone audiometry and DPOAE were carried out pre and post white noise exposure. Results: Pure tone audiometry was sensitive in detecting temporary threshold shifts after white noise exposition in 2, 3 and 4 kHz, with no significant differences concerning gender and ear, whereas DPOAE revealed temporary shifts in audibility evidenced by amplitude reduction, in 2588 and 3614 in female subjects and in 932, 1304, 2588 and 5128 Hz in male subjects. Conclusion: We could conclude that either pure tone audiometry or DPOAE were sensitive in determining significant temporary shifts in hearing thresholds and amplitude, respectively, after white noise exposition, according to the involved frequency range

Intercorrência audiológica em músicas após um show de rock

PURPOSE: verifying the temporary threshold shift in musicians after a high sound pressure level music exposure in a rock concert. METHODS: the sample has been made up of six bands musicians, who underwent an occupational anamnesis, pure tone audiometry and acoustic reflex measurements, before and after the rock concert. The noise levels of the room and the stage were determined by means of a dosimeter. The results were compared and statically analyzed using the t Student test with significance criterion of p> 0.05. the noise level found in the room and stage during the concert was 98.5 dB. As for the behavioral aspects related to the noise, tinnitus was the most prevalent complaint among the subjects. In pure tone audiometry, statistically significant differences were found in the hearing thresholds, before and after exposure, mostly in the right ear for the high frequencies. The results were also statistically significant at the frequencies between 2000Hz and 6000Hz, for the right ear (p=2.7; p=2.59; p=3.7 e p=2.86), and at the frequency of 4000Hz, for the left ear (p=2.87). The right ears acoustic reflex has shown the highest index of absence (40%); however, we found statistically significant differences in the presence of the acoustic reflex, before and after exposure, only for the left ear (p=3.64). CONCLUSION: musicians exposed to high sound pressure levels in rock concerts have shown temporary threshold shift at the pure tone audiometry and acoustic reflex measurements.

Comparative study of audiometrics tests on metallurgical workers exposed to noise only as well as noise associated to the handling of chemical products

UNLABELLED Exposure to ototoxic chemical products in the presence or absence of noise can cause irreversible injury to the hearing of workers for a significantly short period of exposure period. AIM to perform a comparative study, through audiometric tests, in workers exposed to noise only and noise associated with chemical products. MATERIALS AND METHODS 155 steel workers (18 - 50 years) exposed to noise (group I), and exposed to noise and chemical products (group II) for a period that varies from 3 to 20 years. RESULTS significant difference in the rate of occupational hearing loss in the right ear between groups I (3.6%) and II (15.5%). A significantly higher rate of occupational hearing loss in group II (18.3%) and I (6%). With respect to the average time of exposure to aggressive agents, group I was exposed by a significantly higher time. Retrospective study. DISCUSSION The fact that the right ear was more affected in group II is controversial and should be better investigated in the future, since some studies show that the left ear would be more prone to noise-induced hearing loss. CONCLUSION group II had proportionally a higher rate of hearing loss when compared with group I, even after having been exposed to aggressive agents for a lower average time.