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Chiari Malformation Type I (CMI) is a prevalent neurosurgical condition characterized by the descent of cerebellar tonsils below the foramen magnum. Surgery, aimed at reducing symptomatology and syrinx size, presents risks, making intraoperative neuromonitoring (IONM) a potentially vital tool. Despite its widespread use in cervical spine surgery, the utility of IONM in CMI surgery remains controversial, with concerns over increased operative time, cost, restricted anesthetic techniques and tongue lacerations. This systematic review and meta-analysis followed the Cochrane Group standards and PRISMA framework. It encompassed an extensive search through PubMed, Embase, and Web of Science up to December 2023, focusing on clinical and surgical outcomes of IONM in CMI surgery. Primary outcomes included the use of various IONM techniques, complication rates, clinical improvement, reoperation, and mortality. The review, registered at PROSPERO (CRD42024498996), included both prospective and retrospective studies, with rigorous selection and data extraction processes. Statistical analysis was conducted using R software. The review included 16 studies, comprising 1358 patients. It revealed that IONM techniques predominantly involved somatosensory evoked potentials (SSEPs), followed by motor evoked potentials (MEPs) and Brainstem auditory evoked potentials (BAEPs). The estimated risk of complications with IONM was 6% (95% CI: 2-11%; I2 = 89%), lower than previously reported rates without IONM. Notably, the clinical improvement rate post-surgery was high at 99% (95% CI: 98-100%; I2 = 56%). The analysis also showed lower reoperation rates in surgeries with IONM compared to those without. Interestingly, no mortality was observed in the included studies. This systematic review and meta-analysis indicate that intraoperative neuromonitoring in Chiari I malformation surgery is associated with favorable clinical outcomes, including lower complication and reoperation rates, and high rates of clinical improvement.

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PURPOSE: The purpose of this study was to investigate the peripheral and central auditory pathways in adult individuals after COVID-19 infection. METHOD: A total of 44 individuals aged between 19 and 58 years, of both genders, post-COVID-19 infection, confirmed by serological tests, with no previous hearing complaints and no risk factors for hearing loss, were assessed. All the participants underwent the following procedures: pure tone audiometry, logoaudiometry, immitanciometry, and Brainstem Auditory Evoked Potentials (BAEP), in addition to answering a questionnaire about auditory symptoms. RESULTS: Thirteen individuals (29.5 %) had some hearing threshold impairment, mainly sensorineural hearing loss. In the BAEP, 18 individuals (40.9 %) presented longer latencies, mainly in waves III and V. According to the questionnaire answers, 3 individuals (9.1 %) reported worsened hearing and 7 (15.9 %) tinnitus that emerged after the infection. As for the use of ototoxic drugs during treatment, 7 individuals (15.9 %) reported their use, of which 5 showed abnormalities in peripheral and/or central auditory assessments. CONCLUSION: Considering the self-reported hearing complaints after COVID-19 infection and the high rate of abnormalities found in both peripheral and central audiological assessments, it is suggested that the new COVID-19 may compromise the auditory system. Due to the many variables involved in this study, the results should be considered with caution. However, it is essential that audiological evaluations are carried out on post-COVID-19 patients in order to assess the effects of the infection in the short, medium, and long term. Future longitudinal investigations are important for a better understanding of the auditory consequences of COVID-19.

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OBJECTIVES: Research focusing on changes in the clinical practice of audiological diagnosis has become increasingly necessary, particularly in pediatric audiology. The pursuit of accurate and reliable examinations has intensified given the importance of early detection and intervention in cases of childhood hearing loss. Thus, this study aims to investigate the correlation between electrophysiological auditory thresholds, as obtained through frequency-specific auditory brainstem responses with two distinct chirp stimuli (narrow-band CE-Chirp Level Specific and narrow-band iChirp), in children with hearing impairments. In addition, this research set out to correlate these thresholds with behavioral responses while simultaneously comparing the examination durations relative to the type of stimuli and the degree of hearing loss. DESIGN: A cohort of 20 children (aged 6 months to 12 years) with varying degrees of hearing impairment (ranging from mild to profound) were recruited. The participants underwent bilateral measurement of their electrophysiological thresholds via auditory brainstem responses across different frequencies (500, 1000, 2000, and 4000 Hz), and the timeframe for determining these thresholds was carefully recorded. Subsequently, behavioral thresholds were ascertained using pure-tone audiometry or visual reinforcement audiometry based on the child's age. The data collected was subsequently analyzed using Pearson and Spearman correlation coefficients. To compare examination times, the Student t test and the Kruskal-Wallis test were used. RESULTS: There was a pronounced correlation between the thresholds obtained through both narrow-band chirp stimuli. Moreover, a substantial correlation was found between electrophysiological and behavioral thresholds at 1000, 2000, and 4000 Hz, especially when compared with pure-tone audiometry. The mean differences between the electrophysiological and behavioral thresholds were below 6 dB nHL, and the exam duration was relatively consistent across both devices, averaging 47.63 (±19.41) min for the narrow-band CE-Chirp Level Specific and 52.42 (±26) min for the narrow-band iChirp. Notably, variations in exam duration did not relate to varying degrees of hearing loss when using the narrow-band CE-Chirp Level Specific. Nevertheless, the narrow-band iChirp indicated significantly shorter durations in instances of profound degree measurements, demonstrating a statistically significant difference. CONCLUSIONS: The narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli provided similar estimates of electrophysiological auditory thresholds in children with hearing impairments, giving accurate estimations of behavioral thresholds. The time it took to complete the assessment is comparable between both stimuli. For the narrow-band iChirp, the degree of hearing loss was shown to impact the testing time, and children with profound hearing loss underwent faster exams. Ultimately, this study exhibits significant clinical implications as it reveals that the narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli could be remarkably promising for clinically exploring electrophysiological thresholds in children with hearing impairments.

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AIMS: Very Low Birthweight (VLBW) infants with neonatal Chronic Lung Disease (CLD) have been found to have functional impairment of the brainstem auditory pathway at term. This study investigated the functional status of the brainstem auditory pathway in VLBW infants with CLD after term for any abnormality. METHODS: Fifty-two VLBW infants were recruited at 50 weeks of Postconceptional Age: 25 with neonatal CLD and 27 without CLD. None had any other major complications to minimize confounding effects. Brainstem Auditory Evoked Responses were studied at 21‒91/s click rates. RESULTS: Compared with those without CLD, VLBW infants with CLD had relatively shorter latencies of BAER waves I and III, associated with a slightly lower BAER threshold. Wave V latency and I‒V interpeak interval did not differ significantly between the two groups of infants. The I‒III interval in infants with CLD was shorter than in those without CLD at 91/s clicks. However, the III‒V interval was significantly longer than in those without CLD at all click rates (all p < 0.05). There were no significant differences in the amplitudes of BAER wave components between the two groups of infants. CONCLUSIONS: The main BAER abnormality in VLBW infants with CLD was a prolonged III‒V interval. Auditory conduction is delayed or impaired at more central regions of the brainstem in CLD infants. After term central auditory function is adversely affected by neonatal CLD. Monitoring post-term change is required to provide valuable information for post-term care of CLD infants.

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OBJECTIVES: Children with microcephaly exhibit neurodevelopmental delays and compromised communicative functioning, yielding challenges for clinical assessment and informed intervention. This study characterized auditory neural function and communication abilities in children with microcephaly due to congenital Zika syndrome (CZS). DESIGN: Click-evoked auditory brainstem responses (ABR) at fast and slow stimulation rates and natural speech-evoked cortical auditory evoked potentials (CAEP) were recorded in 25 Brazilian children with microcephaly related to CZS ( M age: 5.93 ± 0.62 years) and a comparison group of 25 healthy children ( M age: 5.59 ± 0.80 years) matched on age, sex, ethnicity, and socioeconomic status. Communication abilities in daily life were evaluated using caregiver reports on Vineland Adaptive Behavior Scales-3. RESULTS: Caregivers of children with microcephaly reported significantly lower than typical adaptive functioning in the communication and socialization domains. ABR wave I latency did not differ significantly between the groups, suggesting comparable peripheral auditory function. ABR wave V absolute latency and waves I-V interwave latency were significantly shorter in the microcephaly group for both ears and rates. CAEP analyses identified reduced N2 amplitudes in children with microcephaly as well as limited evidence of speech sound differentiation, evidenced mainly by the N2 response latency. Conversely, in the comparison group, speech sound differences were observed for both the P1 and N2 latencies. Exploratory analyses in the microcephaly group indicated that more adaptive communication was associated with greater speech sound differences in the P1 and N2 amplitudes. The trimester of virus exposure did not have an effect on the ABRs or CAEPs. CONCLUSIONS: Microcephaly related to CZS is associated with alterations in subcortical and cortical auditory neural function. Reduced ABR latencies differ from previous reports, possibly due to the older age of this cohort and careful assessment of peripheral auditory function. Cortical speech sound detection and differentiation are present but reduced in children with microcephaly. Associations between communication performance in daily life and CAEPs highlight the value of auditory evoked potentials in assessing clinical populations with significant neurodevelopmental disabilities.

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PURPOSE: To identify the pathophysiological definitions adopted by studies investigating "cochlear synaptopathy" (CS) and "hidden hearing loss" (HHL). RESEARCH STRATEGIES: The combination of keywords "Auditory Synaptopathy" or "Neuronal Synaptopathy" or "Hidden Hearing Loss" with "etiology" or "causality" or "diagnosis" was used in the databases EMBASE, Pubmed (MEDLINE), CINAHL (EBSCO), and Web of Science. SELECTION CRITERIA: Studies that investigated CS or HHL in humans using behavioral and/or electrophysiological procedures were included. DATA ANALYSIS: Data analysis and extraction were performed with regard to terminology, definitions, and population. RESULTS: 49 articles were included. Of these, 61.2% used the CS terminology, 34.7% used both terms, and 4.1% used HHL. The most-studied conditions were exposure to noise and tinnitus. CONCLUSION: CS terminology was used in most studies, referring to the pathophysiological process of deafferentiation between the cochlear nerve fibers and inner hair cells.

OBJETIVO: Identificar as definições fisiopatológicas adotadas pelos estudos que investigaram a "sinaptopatia coclear" (SC) e "perda auditiva oculta" (PAO). ESTRATÉGIA DE PESQUISA: Utilizou-se a combinação de unitermos "Auditory Synaptopathy" or "Neuronal Synaptopathy" or "Hidden Hearing Loss" com "etiology" or "causality" or "diagnosis" nas bases de dados EMBASE, Pubmed (MEDLINE), CINAHL (EBSCO) e Web of Science. CRITÉRIOS DE SELEçÃO: Incluiu-se estudos que investigaram a SC ou PAO em humanos com procedimentos comportamentais e/ou eletrofisiológicos. ANÁLISE DOS DADOS: Realizou-se a análise e extração de dados quanto a terminologia, definição e população estudada. RESULTADOS: Foram incluídos 49 artigos. Destes, 61,2% utilizaram a terminologia SC, 34,7% ambos os termos e 4,1% utilizaram PAO. As condições mais estudadas foram exposição ao ruído e zumbido. CONCLUSÃO: A terminologia SC foi empregada na maioria dos estudos, com referência ao processo fisiopatológico de desaferenciação entre as fibras do nervo coclear e as células ciliadas internas.

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BACKGROUND: Multiple sclerosis (MS) is an inflammatory demyelinating disease. Auditory evoked potential studies have demonstrated conduction and neural processing deficits in adults with MS, but little is known about the electrophysiological responses in children and adolescents. OBJECTIVE: to evaluate the central auditory pathway with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP) in children and adolescents with MS. METHODS: The study comprised 17 individuals with MS, of both sexes, aged 9 to 18 years, and 17 healthy volunteers, matched for age and sex. All individuals had normal hearing and no middle ear impairments. They were assessed with click-BAEP and LLAEP through oddball paradigm and tone-burst stimuli. RESULTS: Abnormal responses were observed in 60% of electrophysiologic assessments of individuals with MS. In BAEP, 58.82% of MS patients had abnormal responses, with longer wave V latency and therefore longer III-V and I-V interpeak latencies than healthy volunteers. In LLAEP, 52.94% of MS patients had abnormal responses. Although statistical differences were found only in P2-N2 amplitude, MS patients had longer latencies and smaller amplitudes than healthy volunteers in all components. CONCLUSION: Children and adolescents with MS had abnormal BAEP responses, with delayed neural conduction between the cochlear nucleus and the lateral lemniscus. Also, abnormal LLAEP results suggest a decrease in neural processing speed and auditory sensory discrimination response.

ANTECEDENTES: A esclerose múltipla (EM) é uma doença inflamatória desmielinizante. Estudos com potenciais evocados auditivos têm demonstrado déficits de condução e processamento neural em adultos com EM, mas pouco se sabe sobre as respostas electrofisiológicas em crianças e adolescentes. OBJETIVO: avaliar a via auditiva central por meio dos potenciais evocados auditivos de tronco encefálico (PEATE) e dos potenciais evocados auditivos de longa latência (PEALL) em crianças e adolescentes com EM. MéTODOS: Foram avaliados17 indivíduos com EM, de ambos os sexos, com idades entre 9 e 18 anos, e 17 voluntários saudáveis, pareados por sexo e idade. Todos os indivíduos tinham audição normal sem alterações de orelha média. Os indivíduos foram avaliados por meio do PEATE com estímulo clique e do PEALL com paradigma de oddball e estímulo tone-burst. RESULTADOS: Foram observadas alteração em 60% das avaliações dos indivíduos com EM. No PEATE, 58,82% dos pacientes com EM apresentaram alteração, com aumento da latência da onda V, e interpicos III-V e I-V aumentados em comparação aos voluntários saudáveis. No PEALL, 52,94% dos pacientes com EM apresentaram alteração. Embora diferenças estatísticas foram observadas apenas na amplitude P2-N2, os pacientes com EM apresentaram latências prolongadas e amplitudes menores em comparação aos voluntários saudáveis para todos os componentes. CONCLUSãO: Crianças e adolescentes com EM apresentaram alteração das respostas do PEATE, com atraso de condução neural entre o núcleo coclear e o lemnisco lateral. Além disso, os resultados alterados do PEALL sugeriram uma diminuição na velocidade de processamento neural e de discriminação sensorial da audição.

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PURPOSE: This study aimed to analyze the auditory processing behavior of children and adolescents diagnosed with stroke and compare it with that of typically developing individuals. METHODS: This was an analytical cross-sectional study involving 48 participants aged between 7 and 17 years with adequate schooling for age and grade, allocated equally to two groups: Stroke (SG) and Control Groups (CG). For the SG, cases identified between 2003 and 2018 were considered. In the CG, school-aged participants with typical development were randomized. After screening for differential audiological assessment and confirmation of auditory pathway integrity at the brainstem level, binaural analyses of the auditory processing behavior were conducted using the Dichotic Digit Test (DDT), Frequency Pattern Test (FPT), and electrophysiological assessment (P300). The Shapiro-Wilk test for normality was conducted, followed by the T and Mann-Whitney tests, with a 95 % confidence level and significance offset at p < 0.05, using the SPSS software (IBM®, v. 22.) RESULTS: The CG performed better in terms of auditory processing. These differences were significant (p < 0.0001) for the binaural integration of DDT, FPT humming and Labeling, and P300 latency. The P300 results were similar; however, with a greater amplitude in the SG. CONCLUSION: This study showed that children and adolescents with stroke performed worse in electrophysiological and behavioral tests of auditory processing assessed using the auditory evoked potentials. These data reinforce the hypothesis that stroke-related lesions compromise the neural mechanisms underlying auditory processing.

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Introdução: Com base na necessidade do diagnóstico audiológico e da intervenção precoce na vida de uma criança com perda auditiva, faz-se necessário a elaboração de protocolos de avaliação auditiva que forneçam o maior número de informações. Objetivo: Analisar um programa de saúde auditiva infantil com relação à adesão à triagem auditiva e procedimentos de diagnóstico. Metodologia: Pesquisa de caráter transversal com análise quantitativa. Realizado em três etapas: 1ª etapa: triagem auditiva de neonatos de alojamento conjunto; 2ª etapa: reteste das falhas; 3ª etapa: diagnóstico audiológico dos lactentes que falharam nas etapas anteriores com a utilização do Potencial Evocado Auditivo de Estado Estável (PEAEE) em conjunto com o Potencial Evocado Auditivo de Tronco Encefálico (PEATE). Resultados: Em 2019, 1.898 neonatos foram triados e destes, 287 (15.2%) falharam na primeira testagem em pelo menos uma orelha. Um total de 197 (10.3%) foram retestados e 14 (0,73%) falharam em pelo menos uma orelha. Dez (0,52%) neonatos retornaram para diagnóstico compondo uma amostra homogênea de neonatos nascidos a termo. Um neonato apresentou perda auditiva unilateral. O tempo necessário para coleta de dados no PEAEE foi de 20 minutos. Conclusão: O PEAEE pode ser considerado uma alternativa a ser utilizado na bateria de testes na avaliação audiológica infantil, juntamente com outros procedimentos, utilizando-se do princípio de verificação cruzada e adicionando uma informação valiosa, especialmente com relação às baixas frequências. (AU)

Introduction: Based on the need for audiological diagnosis and intervention as soon as possible in the life of a child with hearing loss, it is necessary to elaborate of hearing evaluation protocols with high efficiency, which provide the greatest amount of information. Aim: To analyze a pediatric hearing health program regarding their adherence to hearing screening, failure rates, and diagnostic procedures. Method: This is a cross-sectional, descriptive, quantitative study, and consisted of tree stages: Performed in three steps: 1st step: hearing screening of rooming-in neonates; 2nd stage: retest of failures; 3rd stage: audiological diagnosis of infants who failed in the previous stages using the Steady State Response (ASSR) together with the Brainstem Evoked Response Audiometry (BERA). Results: In 2019, 1,898 infants were submitted to the program, of whom 287 (15.2%) failed the screening in at least one of the ears. A total of 197 (10.3%) infants attended the retest and 14 (0.73%) failed the TOAE in at least one of the ears. Ten (0.52%) infants returned for diagnosis. The sample was homogeneously full-term children. One child showed unilateral HL. The average amount of time required to collect information in the ASSR was 20 minutes. Conclusion: For diagnosis, ASSR can be an alternative to be used in the battery of examinations in pediatric hearing assessment along with the other procedures, using the cross-check principle and adding valuable information, especially regarding the low frequencies. (AU)

Introducción: En base a la necesidad de diagnóstico audiológico e intervención lo antes posibles en la vida de un niño con pérdida auditiva, es necesario elaborar protocolos de evaluación auditiva de alta eficiencia, que proporcionan la mayor cantidad de información. Objetivo: Analizar un programa de salud auditiva infantil en cuanto a la adherencia al tamizaje auditivo, tasa de fracaso y procedimientos diagnósticos. Metodología: Investigación transversal con análisis cuantitativo, Realizado en tres pasos: 1er paso: tamizaje auditivo de los neonatos en alojamiento conjunto; 2ª etapa: retest de fallas; 3ª etapa: diagnóstico audiológico de los lactantes que fracasaron en las etapas anteriores utilizando el Potencial Evocado Auditivo de Estado Estacionario junto con el Potencial Evocado Auditivo de Tallo Cerebral. Resultados: Em 2019, se cribaron 1,898 neonatos y de estos, 287 (15,2%) no pasaron la primera prueba en al menos un oído. Un total de 197 (10,3) fueron reevaluados y 14 (0,73%) fallaron en al menos un oído. Diez (0,52%) neonatos regresaron para diagnóstico, conformando una muestra homogénea de neonatos a término, con una edad gestacional media de 39 semanas y dos días. Un neonato tuvo pérdida auditiva unilateral. El tiempo de recogida de los resultados en el ASSR fue de 20 min. Conclusión: Para el diagnóstico, la ASSR puede considerarse una alternativa para ser utilizada en la batería de pruebas en la evaluación audiológica infantil, junto con otros procedimientos, utilizando el principio de verificación cruzada y agregando información valiosa, especialmente en lo que se refiere a las bajas frecuencia. (AU)

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Introducción. Una forma no invasiva y segura de evaluar los parámetros neurofisiológicos en recién nacidos es la evaluación de los potenciales evocados auditivos del tronco encefálico (PEAT). Objetivo. Evaluar las latencias e intervalos de ondas de los PEAT en neonatos sanos nacidos a gran altitud (Cusco, 3399 msnm). Población y métodos. Estudio transversal y prospectivo. Se incluyeron neonatos menores a 14 días de vida, dados de alta a menos de 7 días de nacidos, evaluados para determinar los valores de los PEAT a intensidades sonoras de 70 dB, 80 dB y 90 dB. Se incluyeron las variables edad gestacional, peso al nacer, tipo de parto. Se calcularon las diferencias de las medianas de las latencias e intervalos de las ondas según edad gestacional y peso al nacer. Resultados. Se evaluaron 96 neonatos (17 pretérminos). Las medianas de las latencias de las ondas I a V a 90 dB fueron las siguientes: onda I 1,56 ms; onda II 2,74 ms; onda III 4,37 ms; onda IV 5,62 ms, onda V 6,63 ms. La latencia de la onda I para 80 dB fue de 1,71 ms y para 70 dB de 1,88 ms. Los intervalos para las ondas (I-III), (III-V) y (I-V) fueron de 2,8 ms, 2,2 ms y 5,0 ms respectivamente, sin diferencias entre intensidades (p >0,05). La prematuridad y el bajo peso estuvieron asociados a latencias de la onda I más prolongadas (p <0,05). Conclusiones. Se presentan valores ajustados de latencias e intervalos de los PEAT en neonatos nacidos a gran altitud. Se identificó que, a distintas intensidades sonoras, se ven diferencias en las latencias de las ondas, pero no en los intervalos entre ondas.

Introduction. A non-invasive and safe way to assess neurophysiological parameters in newborn infants is the evaluation of brainstem auditory evoked potentials (BAEPs). Objective. To assess the latencies and wave intervals of BAEPs in healthy newborn infants born in a high-altitude area (Cusco, 3399 MASL). Population and methods. Cross-sectional and prospective study. Newborn infants younger than 14 days of age, discharged less than 7 days after birth, were assessed to determine BAEP values at intensities of 70 dB, 80 dB, and 90 dB. The study variables were gestational age, birth weight, and type of delivery. The median differences in wave latencies and intervals were estimated according to gestational age and birth weight. Results. A total of 96 newborn infants (17 preterm infants) were assessed. The median latencies of waves I­V at 90 dB were for wave I: 1.56 ms, wave II: 2,74 ms, wave III: 4.37 ms, wave IV: 5.62 ms, and wave V: 6.63 ms. The latency of wave I for 80 dB was 1.71 ms and for 70 dB, 1.88 ms. Wave intervals (I­III, III­V, I­V) were 2.8 ms, 2.2 ms, and 5.0 ms, respectively, without differences among intensities (p > 0.05). Prematurity and low birth weight were associated with a longer wave I latency (p < 0.05). Conclusions. Here we describe adjusted BAEP latency and interval values for newborn infants born at high altitude. At different sound intensities, we identified differences in wave latencies, but not in interwave intervals.

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PURPOSE: To verify the occurrence of abnormal auditory evoked potentials (AEP) tests in adult smokers. RESEARCH STRATEGIES: Systematic review of the literature according to the PRISMA guidelines, to answer the question: "Are there any changes in the AEP results in adult smokers?", PECOS strategy. Research carried out on PubMed, Embase, CINAHL, LIVIVO, Scopus, Web of Science, LILACS and Scielo databases. Additional search of gray literature: Google Scholar and ProQuest hand searching of reference lists of the included studies. SELECTION CRITERIA: Cross-sectional studies were selected, without restriction on the year of publication and language. DATA ANALYSIS: First, the titles and abstracts of all the studies were analyzed, followed by the full reading of the eligible studies. RESULTS: 898 articles were collected, after the duplicate studies were removed and after blind analysis by three researchers, 8 studies of the observational type were selected. Most studies have found an association between active smoking and changes in electrophysiological tests. CONCLUSION: Normal hearing adult smokers present alterations in short and long AEP. In the auditory brainstem response, the main altered components were the increase in waves latencies of I and III and in the interpeaks I - III and III - V, as well as a decrease in the amplitude of the waves. In Mismatch Negativity, there was a significant increase in wave amplitude and latency. In the long latency potential, P300, there was an increase in latencies and decreased amplitudes in the components N1 (in Fz) and P3.

OBJETIVO: Verificar a ocorrência de alterações nos exames de potencial evocado (PEA) auditivo em adultos fumantes normo-ouvintes. ESTRATÉGIA DE PESQUISA: Revisão sistemática da literatura de acordo com recomendações do PRISMA, buscando responder à pergunta: "Há alterações nos resultados do exame de PEA em adultos fumantes?", estratégia PECOS. Pesquisa realizada nas bases de dados PubMed, Embase, CINAHL, LIVIVO, Scopus, Web of Science, LILACS e Scielo. Busca adicional da literatura cinzenta: Google Scholar e ProQuest e busca manual das referências dos estudos incluídos. CRITÉRIOS DE SELEçÃO: Foram selecionados estudos com delineamento transversal, sem restrição do ano de publicação e idioma. ANÁLISE DOS DADOS: Primeiramente foram analisados os títulos e resumos de todos os estudos encontrados, seguido da leitura na íntegra dos estudos elegíveis. RESULTADOS: Foram obtidos 898 artigos, que após remoção dos duplicados e análise cega por três pesquisadores, foram selecionados oito trabalhos. Grande parte dos estudos encontrou uma associação entre tabagismo ativo e alterações nos testes eletrofisiológicos. CONCLUSÃO: Adultos fumantes normo-ouvintes apresentam alterações nos exames de PEA de curta e longa latência. No potencial evocado auditivo de tronco encefálico, os principais componentes alterados foram o aumento das latências das ondas I e III e nos interpicos I - III e III - V, bem como diminuição da amplitude das ondas. No Mismatch Negativity, houve aumento significativo da amplitude da onda e da latência. No potencial de longa latência, P300, houve aumento das latências e redução das amplitudes nos componentes N1 (em Fz) e P3.

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INTRODUCTION: The aim of the study was to describe auditory and vestibular findings in Brazilian adults after COVID-19 in a municipality from the outskirts of the São Paulo state. METHODS: This was a transversal and exploratory study comprising sixteen participants infected by the SARS-CoV-2 virus, confirmed through RT-PCR detection, aged 20 to 55 years. Subjects underwent anamnesis, vestibular and auditory testing. Fisher's exact test was used to evaluate medication use, chemical and physical exposure, and occupational risk and McNemar test was used to compare auditory and vestibular symptoms pre- and post-COVID-19. RESULTS: Most patients were women (75%) and had been exposed to the virus over 90 days before testing (50%). 18.8% used hydroxychloroquine, 68.8% used ivermectin, and 87.5% used azithromycin to treat COVID-19. Auditory complaints were reported by 31.2% and vestibular by 18.7%. There was no statistical difference before and after the disease. Other reported symptomatology was hair loss, pain, fatigue, memory loss, difficulty to concentrate, and headache. Auditory findings were relevant in contralateral acoustic reflex, in the distortion-product otoacoustic emissions, and in the brainstem auditory evoked potential, characterizing a neurosensorial compromise. 43.74% of patients had altered vectonystagmography. When comparing both ears, no statistical relevance was found; however, when results were crossed with medication use and exposures, there was statistical relevance in the amplitude of the V wave for medications and absolute latency of the V wave to exposure to physical agents. DISCUSSION/CONCLUSION: This study demonstrated auditory and vestibular findings of neurosensorial nature, considering hearing and of a peripheral vestibulopathy. As it is a study of transversal nature, it is not possible to extend results to general population; yet it may be a finding to future studies.

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OBJECTIVE: To characterize the peripheral and central auditory pathways in individuals with Acute Lymphoid Leukemia (ALL) and compare assessment results before and during chemotherapy. METHOD: The study included 17 subjects with ALL, divided into two age groups: 3 to 6 (11 individuals) and 7 to 16 years old (6 individuals). Each subject was evaluated twice (before and 3 to 6 months after chemotherapy treatment) with the following procedures: medical history survey, otoscopy, Pure-Tone Threshold (PTA) and speech audiometry, acoustic immittance measures, Brainstem Auditory Evoked Potentials (BAEP) and Long-Latency Auditory Evoked Potentials (LLAEP). RESULTS: PTA was normal. Tympanometry was abnormal in the second assessment in 2 individuals aged 3 to 6 years. One subject in each age group had absent ipsilateral acoustic reflexes. In high-frequency audiometry, 1 individual had abnormal results. BAEP was abnormal in 5 (first assessment) and 7 individuals (second assessment) aged 3 to 6 years and 2 (first assessment) and 1 individual (second assessment) aged 7 to 16 years. As for LLAEP, P1 latency was increased in 5 (first assessment) and 7 individuals (second assessment) aged 3 to 6 years. CONCLUSION: No hearing loss was identified in the behavioral audiological assessment. BAEP was more affected in the 3-to-6-year-old group, with greater impairment in the lower brainstem in the first and second assessments. In LLAEP, P1 was the most impaired component in children aged 3 to 6 years, and P2 and N2 were so for those 7 to 16 years old, especially in the second assessment.

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Introduction. A non-invasive and safe way to assess neurophysiological parameters in newborn infants is the evaluation of brainstem auditory evoked potentials (BAEPs). Objective. To assess the latencies and wave intervals of BAEPs in healthy newborn infants born in a high-altitude area (Cusco, 3399 MASL). Population and methods. Cross-sectional and prospective study. Newborn infants younger than 14 days of age, discharged less than 7 days after birth, were assessed to determine BAEP values at intensities of 70 dB, 80 dB, and 90 dB. The study variables were gestational age, birth weight, and type of delivery. The median differences in wave latencies and intervals were estimated according to gestational age and birth weight. Results. A total of 96 newborn infants (17 preterm infants) were assessed. The median latencies of waves I-V at 90 dB were for wave I: 1.56 ms, wave II: 2,74 ms, wave III: 4.37 ms, wave IV: 5.62 ms, and wave V: 6.63 ms. The latency of wave I for 80 dB was 1.71 ms and for 70 dB, 1.88 ms. Wave intervals (I-III, III-V, I-V) were 2.8 ms, 2.2 ms, and 5.0 ms, respectively, without differences among intensities (p > 0.05). Prematurity and low birth weight were associated with a longer wave I latency (p < 0.05). Conclusions. Here we describe adjusted BAEP latency and interval values for newborn infants born at high altitude. At different sound intensities, we identified differences in wave latencies, but not in interwave intervals.

Introducción. Una forma no invasiva y segura de evaluar los parámetros neurofisiológicos en recién nacidos es la evaluación de los potenciales evocados auditivos del tronco encefálico (PEAT). Objetivo. Evaluar las latencias e intervalos de ondas de los PEAT en neonatos sanos nacidos a gran altitud (Cusco, 3399 msnm). Población y métodos. Estudio transversal y prospectivo. Se incluyeron neonatos menores a 14 días de vida, dados de alta a menos de 7 días de nacidos, evaluados para determinar los valores de los PEAT a intensidades sonoras de 70 dB, 80 dB y 90 dB. Se incluyeron las variables edad gestacional, peso al nacer, tipo de parto. Se calcularon las diferencias de las medianas de las latencias e intervalos de las ondas según edad gestacional y peso al nacer. Resultados. Se evaluaron 96 neonatos (17 pretérminos). Las medianas de las latencias de las ondas I a V a 90 dB fueron las siguientes: onda I 1,56 ms; onda II 2,74 ms; onda III 4,37 ms; onda IV 5,62 ms, onda V 6,63 ms. La latencia de la onda I para 80 dB fue de 1,71 ms y para 70 dB de 1,88 ms. Los intervalos para las ondas (I-III), (III-V) y (I-V) fueron de 2,8 ms, 2,2 ms y 5,0 ms respectivamente, sin diferencias entre intensidades (p >0,05). La prematuridad y el bajo peso estuvieron asociados a latencias de la onda I más prolongadas (p <0,05). Conclusiones. Se presentan valores ajustados de latencias e intervalos de los PEAT en neonatos nacidos a gran altitud. Se identificó que, a distintas intensidades sonoras, se ven diferencias en las latencias de las ondas, pero no en los intervalos entre ondas.

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BACKGROUND Learning to read and write depends on the effective functioning of various sensory systems, including the auditory system. Auditory information processing involves behavioral and electrophysiological processes. Electrophysiological procedures are used to investigate activity in the auditory pathway in response to sound stimuli, and the associated cortical activity in discrimination, integration, and attention. The study evaluated electrophysiological testing for an auditory processing disorder and reading performance in 54 school students aged between 8 and 12 years. MATERIAL AND METHODS The study involved 54 public school students aged between 8 and 12 years, who were divided into a study group and control group. All children underwent basic audiological assessment, rating of reading and writing ability, non-verbal intelligence, auditory brainstem response, long-latency auditory-evoked potentials (LLAEP), frequency following responses (FFR), and auditory training (AT). RESULTS The basic audiological evaluation showed a statistically significant difference between groups only for the frequency of 6 kHz. The LLAEP response had a statistically significant difference between groups for N1 latency, P300 latency, and amplitude. Finally, there was a statistically significant difference between pre-AT and post-AT to LLAEP for latencies of P2, N2, and P300 and amplitudes of N2 and P300, and to FFR for latency of wave C. CONCLUSIONS This study showed that electrophysiological tests are sensitive tools for identifying deficits in the auditory pathway. Moreover, latency measures can detect improvements from an auditory training program. In this way, an auditory intervention program might help children with reading and writing difficulties.

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PURPOSE: To investigate the functionalities of the neural pathways through the auditory evoked potentials of the brainstem and the contralateral stapedial acoustic reflexes in normal-hearing individuals with type 1 diabetes mellitus, in order to detect possible alterations in the central auditory pathways. METHODS: This is a cross-sectional study with a comparison group and a convenience sample, consisting of 32 individuals with type 1 diabetes mellitus and 20 controls without the disease. All subjects had hearing thresholds within normal limits and type A tympanometric curves. The acoustic reflex arc and brainstem auditory potentials were investigated. Statistical analyses were performed using the SPSS 17.0. The Chi-square test, Student´s t-test, and Multiple linear regression were used. RESULTS: The auditory thresholds of the acoustic reflex were statistically lower in the group with the disease at frequencies of 0.5 kHz and 1.0 kHz in the left ear (p=0.01 and p=0.01, respectively). The absolute latencies III and V of the auditory potentials of the brainstem in the right ear and V in the left ear were increased in subjects with type 1 diabetes mellitus (p=0.03, p=0.02 and p=0.03, respectively). CONCLUSION: The findings suggest that subjects with type 1 diabetes mellitus are more likely to present alterations in the central auditory pathways, even with auditory thresholds within normal limits.

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MAIN AIM: To electrophysiologically determine the impact of moderate to severe chronic hypoxia (H) resulting from a wide array of CHD (HCHD) conditions on the integrity of brainstem function. MATERIALS AND METHODS: Applying brainstem auditory-evoked response methodology, 30 chronically afflicted HCHD patients, who already had undergone heart surgery, were compared to 28 healthy control children (1-15 yo) matched by age, gender and socioeconomic condition. Blood oxygen saturation was clinically determined and again immediately before brainstem auditory-evoked response testing. RESULTS: Among HCHD children, auditory wave latencies (I, III and V) were significantly longer (medians: I, 2.02 ms; III, 4.12 ms, and; V, 6.30 ms) compared to control (medians: I, 1.67ms; III, 3.72 ms, and; V, 5.65 ms), as well as interpeak intervals (HCHD medians: I-V, 4.25 ms, and; III-V, 2.25ms; control medians: I-V, 3.90 ms and, III-V, 1.80 ms) without significant differences in wave amplitudes between groups. A statistically significant and inverse correlation between average blood oxygen saturation of each group (control, 94%; HCHD, 78%) and their respective wave latencies and interpeak intervals was found. CONCLUSIONS: As determined by brainstem auditory-evoked responses, young HCHD patients manifestly show severely altered neuronal conductivity in the auditory pathway strongly correlated with their hypoxic condition. These observations are strongly supported by different brainstem neurological and image studies showing that alterations, either in microstructure or function, result from the condition of chronic hypoxia in CHD. The non-altered wave amplitudes are indicative of relatively well-preserved neuronal relay nuclei.

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BACKGROUND Auditory brainstem response (ABR) potential is important for audiological diagnosis, reflecting the integrity of the structures of the auditory system up to the brainstem. The click stimulus is the best known and is most used in clinical practice. However, different devices and examiners may yield distinct results, and each institution tends to use its own parameters. We aimed to analyze the latency values of wave I, III, V, and interpeak intervals I-III, III-V, I-V values obtained in assessing ABR using a new device. MATERIAL AND METHODS We performed a cross-sectional study of 73 participants with normal hearing thresholds and no hearing problems. All underwent basic audiological (air and bone conduction, Speech Recognition Threshold, Speech Recognition Index, acoustic reflex, and tympanometry) and electrophysiological evaluation (ABR assessment). RESULTS Absolute latency and interpeak values from ABR showed earlier responses in women, faster than international standards suggest. The responses were similar to other studies carried out previously, with the exception of wave I values, which were a little earlier in females. CONCLUSIONS We assessed normative data from measurement of latency values of wave I, III, V, and interpeak intervals I-III, III-V, and I-V applying 2 standard deviations in the assessment of ABR using the new Neuro-Audio/ABR device created by Neurosoft.

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During childhood, neuronal modifications occur so that typical childhood communicative development occurs. This work aims to contribute to the understanding of differences in the speech encoding of infants and school-age children by assessing the effects of child development, in different phases of early childhood, on the encoding of speech sounds. There were 98 subjects of both sexes, aged from 1 day to 8 years and 9 months who participated in the study. All subjects underwent a Frequency Following Response (FFR) assessment. A regression and linear correlation showed the effects of age in the FFR components, i.e., significant decrease in the latency and increased amplitude of all FFR waves with age. An increase in the slope measure was also observed. Younger infants require more time and show less robust responses when encoding speech than their older counterparts, which were shown to have more stable and well-organized FFR responses.

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PURPOSE: In the present study, a new procedure to perform automatic audiometry using multifrequency Auditory Steady-State Response (ASSR) is proposed. METHODS: The automatic audiometry procedure consists of detecting the presence of multifrequency ASSR in real-time using the sequential test strategy and by adjusting the stimulus intensity independently. The ASSR audiometric thresholds of 18 adult volunteers with normal hearing were determined by automatically (four simultaneous frequencies per ear) at modulation frequencies in the 80 Hz range. The exam time and the difference between ASSR thresholds and pure-tone behavioural hearing thresholds were estimated as performance measures. RESULTS: The results showed that automatic audiometry can reduce the number of intensity levels used to obtain the ASSR threshold by up to 58% when compared to audiometry without using the techniques applied in automatic audiometry. In addition, the average of the difference between ASSR thresholds and Pure-Tone Behavioural Hearing thresholds was around 19 dB, which is similar to the results reported in similar studies. CONCLUSIONS: The audiometric procedure proposed in this study is fully automatic, i.e., does not require any human supervision throughout the exam, and is able to significantly reduce the conventional exam time.

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