Sirley Alves da Silva Carvalho

Frequency specificity of distortion-product otoacoustic emissions produced by high-level tones despite inefficient cochlear electromechanical feedback

Distortion product otoacoustic emissions (DPOAEs) are thought to stem from the outer hair cells (OHCs) around the normally narrow place tuned to the primary tone stimuli. They are thus said to be frequency-specific: their local absence should accurately pinpoint local OHC damage. Yet the influence of impaired tuning on DPOAE frequency specificity is poorly documented. Mice with local damage to OHCs were examined. Their DPOAEs were frequency-specific in that audiometric notches were accurately tracked. The same cochleae were further impaired by ischemia or furosemide injection inducing strial dysfunction with flat loss of sensitivity and tuning, while the preexisting pattern of damaged OHCs remained unaltered. Despite the loss of cochlear activity, DPOAEs produced by high-level (> or =70 dB SPL) primaries remained large in about the same interval where they had been initially normal, i.e., that with nondamaged OHCs, albeit with a slight frequency shift, of -1.1 kHz on average. Thus, the ability of DPOAEs to map structurally intact OHCs cannot be a mere consequence of cochlear tuning as it largely persists in its absence. The key element for this correct mapping is likely part of intact OHC structures (e.g., stereocilia bundles) and must have some tuning of its own.

Increased prevalence of early cochlear damage in young patients with type 1 diabetes detected by distortion product otoacoustic emissions

Abstract Objective: To evaluate the hearing of adolescents with diabetes mellitus type 1(DM1) by otoacoustic emissions (OAEs), and by comparing different tests with pure-tone audiometry to identify potential early cochlear impairments. Design: Pure-tone audiometry, transient evoked otoacoustic emissions (TEOAEs), and distortion product otoacoustic emissions (DPOAEs) were performed in a group of adolescents with and without DM1. Clinical characteristics, disease duration, and glycated haemoglobin levels were studied. Study sample: Participants were 40 adolescents with DM1 and 40 healthy subjects. Results: Sensorineural hearing loss, affecting frequencies of 6000 and 8000 Hz, was found only in DM1 subjects when compared to the controls (7.7% vs. 0%, p < 0.05). A higher prevalence of cochlear damage was detected by DPOAE responses, 32% belonging from the diabetic group, vs. 3.7% in the control group. Absent TEOAE responses were observed in only three individuals, all from the diabetic group (5.1% of the tests performed in the diabetic group). Additionally, hearing thresholds were better in diabetic subjects with good control when compared to ones with regular or poor control (p = 0.00). Hearing thresholds were higher in poorly controlled diabetics when compared to subjects with good (p = 0.000) or regular control (p = 0.006). Conclusion: Early evidence of cochlear damage was detected in adolescents with DM1 leading to hearing loss at high frequencies. Abnormal DPOAEs responses were found more frequently than the alterations in TEOAEs and pure-tone audiometry, suggesting that DPOAEs evaluation is the most sensitive and it could be used for monitoring the progression of cochlear damage during the early stages of hearing impairment.

Conhecimentos e práticas de professores de educação infantil sobre crianças com alterações auditivas

PURPOSE: To investigate the knowledge, perceptions and practices of preschool teachers regarding children with hearing alterations. METHODS: A descriptive cross-sectional study was carried out through structured interviews with 45 preschool teachers from the public education system of Belo Horizonte (MG, Brazil). Interviews were recorded, transcribed and later analyzed. RESULTS: The majority of the subjects showed little knowledge, at times vague and of common-sense, regarding hearing loss. However, conscience of the necessity of learning more about the subject for a better professional performance is clear. Despite the lack of information, teachers demonstrated knowing some characteristics of children with hearing loss, and explicit conducts to be carried out in the classroom. Almost all subjects claimed not to know the school hearing screening. CONCLUSION: The knowledge, practices and perceptions displayed by the subjects revealed wide variation of concepts, attitudes and strategies. However, much is based on common-sense or intuition, due to lack of experience and training of teachers to deal with children with hearing loss.

Audição, zumbido e qualidade de vida: um estudo piloto

OBJETIVOS: analisar a influencia do zumbido na qualidade de vida dos pacientes; verificar a relacao entre grau de incomodo do zumbido e presenca de perda auditiva concomitante. METODO: estudo observacional transversal com amostra de conveniencia. Foram aplicados anamnese e questionario com enfoque das caracteristicas clinicas do zumbido em 22 pacientes. Para analise dos dados, foi aplicado o Teste exato de Fisher, com nivel de significância de 5% (p < 0,05). RESULTADOS: dos 22 pacientes, 7 ( 31,8%) apresentaram audicao normal e 15 (68,2%) apresentaram algum tipo de perda auditiva. Dos pacientes possuidores de perda auditiva, 12 apresentaram perda auditiva neurossensorial em pelo menos uma das orelhas e 3 perda mista uni ou bilateral. Quanto ao grau de incomodo, utilizando a escala analogo-visual, 17 (77,27%) dos pacientes relataram incomodo intenso, ao passo que 5 (22,72%) consideraram grau reduzido de incomodo gerado por esse sintoma. Foi evidenciado que o zumbido impacta mais as emocoes e o sono dos pacientes, do que a concentracao e realizacao de atividades sociais. CONCLUSOES: dos 22 pacientes com zumbido, encaminhados para realizacao do PEATE, 70% apresentam zumbido e perda auditiva associada. No entanto, nao houve relacao entre a presenca de zumbido e presenca de perda. Nao houve ainda relacao entre o grau de incomodo e presenca de perda.

Relação entre o benefício do aparelho de amplificação sonora individual e desempenho cognitivo em usuário idoso

OBJECTIVES: To verify the effective use of hearing aids by the elderly, its social and personal benefits and its relation to cognitive performance. METHOD: An observational, cross-sectional study carried out at Hospital das Clinicas - UFMG, with 15 individuals aged over 65 years and users of hearing aids for four months. We used the IOI-HA, speech recognition threshold and Mini Mental State Examination - Mini Mental. For comparison of results, users of hearing aids were divided in two groups: normal Mini Mental (NM) and altered Mini Mental (AM). RESULTS: When compared to an average value of the threshold for speech recognition, both groups showed benefit with the use of hearing aids. In all variables studied by means of IOI-HA, we observed better results in the NM group, without statistical significance. As for daily use, 50% of the elderly from NM group and 40% of the AM group use it for over 8 hours/day. Regarding satisfaction, 80% of those in NM group believe that the quality of life improved through the use of hearing aids, while 100% of subjects in the AM group reported little or no improvement in the quality of life. CONCLUSIONS: The results showed that the use of hearing aids provided effective, social and personal benefits to all elderly, regardless of the results of the Mini Mental, and allowed them to return to communicative relations and reduce the perception of hearing handicap. However, it was observed a trend of improved performance with hearing aids in subjects with no change in the Mini Mental.

Correlação entre perda auditiva e indicadores de risco em um serviço de referência em triagem auditiva neonatal

PURPOSE: To investigate the correlation between risk indicators and hearing impairment in infants of a Newborn hearing screening program METHODS: A retrospective study with 3151 newborn records with and without risk indicator for hearing loss, followed-up by a Newborn hearing screening program at a Public Hospital in the city of Belo Horizonte (MG). RESULTS: In the group without risk indicators, the incidence of hearing loss was 1.04%: 0.04% were sensorineural and 0.99% were conductive. In the group with risk indicators, the incidence of hearing loss was 8.38% (5.27% conductive and 3.1% sensorineural). In the high risk group one child (0.33%), who passed the screening, was diagnosed during the follow up with bilateral sensorineural mild hearing. The most common risk indicators were neonatal intensive care of >5 days (43.47%) followed by use of ototoxic drugs, (29.81%) and mechanical ventilation (28.88%). It was observed that children with suspected syndromes have 18 times more chance of acquiring sensorineural hearing loss. CONCLUSION: The risk indicator which correlated to hearing loss was suspicion of syndromes. Health promotion actions are necessary to reduce the presence of risk indicators found in the served population.

Perfil e satisfação com o trabalho de profissionais da rede de atenção à saúde auditiva

Objetivo Verificar o perfil e a satisfacao com a estrutura do servico, politica de recursos humanos e rotina de trabalho de profissionais que integram equipes de uma Rede de Atencao a Saude Auditiva. Metodos Trata-se de um estudo realizado com 34 profissionais pertencentes a Rede de Atencao a Saude Auditiva de duas microrregioes de Minas Gerais. A pesquisa se deu por meio da aplicacao de um questionario estruturado, composto por seis eixos (caracterizacao do profissional, dados do atendimento/perfil do servico, conhecimento do profissional quanto ao perfil da populacao atendida, caracterizacao do trabalho em equipe, satisfacao do profissional e comunicacao e trabalho. Foi realizada analise descritiva da distribuicao de frequencia de todas as variaveis categoricas e analise das medidas de tendencia central e de dispersao das variaveis continuas. Resultados A maioria dos profissionais pertencia a categoria fonoaudiologo, eram contratados e recebiam entre R

Investigação do reconhecimento do próprio nome em bebês de 4 a 5 meses: estudo piloto

1.091,00 e R

Indicadores de saúde auditiva em Minas Gerais : um estudo por macrorregião

2.180,00. Metade deles relatou haver discussao dos casos clinicos e planejamento de acoes, pelas equipes. A maioria referiu nao haver demanda administrativa e discussao dos resultados alcancados. Todas as equipes possuiam fonoaudiologos que se manifestaram satisfeitos com a maior parte dos aspectos do servico no qual estavam inseridos. Como itens de insatisfacao foram citados: “politica de recursos humanos”, “equipamentos para diagnostico” e “politica salarial”. Conclusao O instrumento utilizado permitiu realizar o delineamento do perfil dos profissionais pertencentes a Rede de Atencao a Saude Auditiva e verificar que estes estao satisfeitos com a maioria dos aspectos analisados.

Timpanometria com sonda de 226 e 1000 hertz em bebês

PURPOSE: to verify that children aged between four and five months recognize their own names. METHOD: it is a cross-sectional study with 16 infants aged between four and five months, assessed by the Newborn Hearing Screening State Program (NHSP) in the Speech and Language Therapy Clinic of Hospital das Clinicas of Universidade Federal de Minas Gerais (HC - UFMG). In addition to the recognition test of the name, it was realized hearing and language assessment. A descriptive analysis of the variables of the study was held and the statistical analysis. Continuous variables were compared using the paired T test and it was considered a significance level of 5% and confidence coefficient of 95%. RESULTS: it was verified a predominance of responses to recall the name itself, in most infants evaluated. CONCLUSIONS: on the basis of the criteria set out in this study, infants aged between four and five months are capable of recognize their own names.