RESUMO
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.
Assuntos
Diabetes Mellitus Tipo 1 , Potenciais Evocados Auditivos do Tronco Encefálico , Humanos , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Reflexo Acústico/fisiologia , Vias Auditivas , Estudos Transversais , Potenciais Evocados Auditivos , Testes de Impedância Acústica , Limiar Auditivo/fisiologiaRESUMO
INTRODUCTION: When mapping cochlear implant (CI) patients with limited reporting abilities, the lowest electrical stimulus level that produces a stapedial reflex (i.e., the electrical stapedius reflex threshold [eSRT]) can be measured to estimate the upper bound of stimulation on individual or a subset of CI electrodes. However, eSRTs measured for individual electrodes or a subset of electrodes cannot be used to predict the global adjustment of electrical stimulation levels needed to achieve comfortable loudness sensations that can be readily used in a speech coding strategy. In the present study, eSRTs were measured for 1-, 4-, and 15-electrode stimulation to (1) determine changes in eSRT levels as a function of the electrode stimulation mode and (2) determine which stimulation mode eSRT levels best approximate comfortable loudness levels from patients' clinical maps. METHODS: eSRTs were measured with the 3 different electrical stimulation configurations in 9 CI patients and compared with behaviorally measured, comfortable loudness levels or M-levels from patients' clinical maps. RESULTS: A linear, mixed-effects, repeated-measures analysis revealed significant differences (p < 0.01) between eSRTs measured as a function of the stimulation mode. No significant differences (p = 0.059) were measured between 15-electrode eSRTs and M-levels from patients' clinical maps. The eSRTs measured for 1- and 4-electrode stimulation differed significantly (p < 0.05) from the M-levels on the corresponding electrodes from the patients' clinical map. CONCLUSION: eSRT profiles based on 1- or 4-electrode stimulation can be used to determine comfortable loudness level on either individual or a subset of electrodes, and 15-electrode eSRT profiles can be used to determine the upper bound of electrical stimulation that can be used in a speech coding strategy.
Assuntos
Testes de Impedância Acústica/métodos , Implante Coclear , Implantes Cocleares , Reflexo Acústico/fisiologia , Estapédio/fisiopatologia , Adolescente , Adulto , Estimulação Elétrica/métodos , Humanos , Adulto JovemRESUMO
PURPOSE: this paper aims to identify the most used terminologies to designate the disproportional behavior to sounds in the autism spectrum disorder (ASD) and its relationship with the respective tools for its investigation, as well as its occurrence and outcomes. RESEARCH STRATEGIES: the databases used were PubMed, PsycINFO, Web of Science, Scielo and Lilacs. The keywords used were "autism", "hyperacusis" and "auditory perception", with the following combinations: "autism AND hyperacusis" and "autism AND auditory perception". SELECTION CRITERIA: individuals diagnosed with ASD of any age group; available abstract; papers in English, Spanish and Brazilian Portuguese; case series, prevalence and incidence studies, cohort and clinical trials. DATA ANALYSIS: we analyzed studies with individuals diagnosed with ASD of any age group; reference in the title and/or summary of the occurrence of disproportional behavior to sounds, accepting the terms hyper-responsiveness, hypersensitivity and hyperacusis; summary available; papers in English, Spanish and Brazilian Portuguese; series of cases, prevalence and incidence studies, cohort and clinical trials. RESULTS: Of the 692 studies resulting from the consultation, 13 studies could achieve the established requirements. CONCLUSION: The term auditory hypersensitivity was the most commonly used to designate disproportional behavior to sounds, followed by hyperacusis. There was no relationship between the terms and the respective research tool, and the questionnaires were the most used to designate the referred behavior, whose reported frequency was from 42.1% to 69.0%. The auditory behavior tests when performed showed the involvement of the auditory, afferent and efferent neural pathways.
OBJETIVO: identificar as terminologias mais utilizadas para designar o comportamento desproporcional a determinados sons (CDS) no TEA e sua relação com as respectivas ferramentas para sua investigação, assim como sua ocorrência e desfechos. ESTRATÉGIA DE PESQUISA: Foram utilizadas as bases de dados: PubMed, PsycINFO, Web of Science, Scielo e Lilacs. As palavras-chave utilizadas foram "autism", "hyperacusis" e "auditoryperception", com as seguintes combinações: "autism AND hyperacusis" e "autism AND auditoryperception". CRITÉRIOS DE SELEÇÃO: Foram incluídos os trabalhos com diagnóstico de TEA, de qualquer faixa etária; resumo disponível; Artigos em inglês, espanhol e português brasileiro; série de casos, estudos de prevalência e incidência, coorte e ensaios clínicos. ANÁLISE DOS DADOS: Foram analisados estudos com sujeitos com diagnóstico de TEA de qualquer faixa etária; referência no título e/ou resumo da ocorrência do CDS, aceitando os termos hiper-responsividade, hipersensibilidade e hiperacusia; resumo disponível; artigos em inglês, espanhol e português brasileiro; série de casos, estudos de prevalência e incidência, coorte e ensaios clínicos. RESULTADOS: Dos 692 estudos resultantes da consulta, foram identificados 13 que atendiam aos requisitos estabelecidos. CONCLUSÃO: O termo hipersensibilidade auditiva foi o mais empregado para designar o CDS, seguido da hiperacusia. Não houve relação entre os termos e a respectiva ferramenta de investigação, sendo os questionários os mais utilizados para designar o referido comportamento, cuja frequência relatada foi de 42,1% a 69,0%. Os testes auditivos, quando realizados, mostraram o envolvimento das vias neurais auditivas, aferente e eferente.
Assuntos
Transtorno do Espectro Autista/complicações , Hiperacusia/etiologia , Reflexo Acústico/fisiologia , Terminologia como Assunto , Transtorno do Espectro Autista/fisiopatologia , Humanos , Hiperacusia/fisiopatologiaRESUMO
RESUMO Objetivo Analisar as emissões otoacústicas evocadas produto de distorção (EOAPD) de indivíduos adultos entre 18 e 50 anos, com audição normal, e associar os resultados com os achados à timpanometria. Métodos Foram selecionados 27 prontuários de adultos com audição dentro dos padrões de normalidade, sem queixa auditiva, com curva timpanométrica do tipo A, Ad ou Ar, presença de reflexos acústicos, sem queixa de zumbido e de exposição frequente a níveis de pressão sonora elevados, com repouso auditivo mínimo de 14 horas no momento do exame e que realizaram o exame de emissões otoacústicas evocadas produto de distorção. Os resultados do exame de emissões otoacústicas foram analisados considerando os resultados das curvas timpanométricas apresentadas por estes indivíduos. Para análise dos dados foram aplicados testes não paramétricos e o nível de significância foi de 5%. Resultados foram analisados os resultados das emissões otoacústicas de 54 orelhas. Observou-se maior ocorrência da curva do tipo A em indivíduos sem queixas auditivas. Independente do lado, a maioria das orelhas que apresentou resposta presente ao exame de EOAPD, apresentou, também, curva timpanométrica normal. Observou-se correlação positiva entre a amplitude das EOAPD e o volume da orelha média para as frequências de 6000 Hz e uma tendência à significância em 4000 Hz Conclusão Foi possível concluir que há maior ocorrência de emissões otoacústicas presentes em indivíduos com audição normal e curva timpanométrica do tipo A e que a amplitude das EOAPD em 6000 Hz mostra-se menor nos indivíduos com audição normal e curva timpanométrica do tipo Ar ou Ad.
ABSTRACT Purpose To analyze distortion product evoked otoacoustic emissions in normal-hearing adults aged between 18 and 50 years old, and to associate the results with the findings of tympanometry. Methods 27 medical records were selected of adults with the following conditions: normal hearing; without auditory complaint; with type A, Ad or Ar tympanometric curve; with presence of acoustic reflexes; with no complaint of tinnitus or frequent exposure to high sound pressure levels; with minimal auditory rest of 14 hours at the time of the test, and who had undergone distortion product evoked otoacoustic emission (DPOAE) testing. The results of otoacoustic emissions were analyzed considering the results of the tympanometric curves presented by these individuals. For the data analysis, non-parametric tests were applied, and the level of significance was 5%. Results The results of otoacoustic emissions of 54 ears were analyzed. There was a greater occurrence of the type A curve in individuals without auditory complaints. Regardless of side, most ears whose response was present in the DPOAE test also presented normal tympanometric curve. There was a positive correlation between DPOAE amplitude and middle ear volume for the 6000Hz frequencies (p = 0.048) and a tendency to significance at 4000Hz (p = 0.054). Conclusion There was a higher occurrence of otoacoustic emissions present in normal-hearing individuals and type A tympanometric curve, and the amplitude of DPOAE at 6000Hz was smaller in normal-hearing individuals and type Ar or Ad tympanometric curve.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Reflexo Acústico/fisiologia , Testes de Impedância Acústica , Emissões Otoacústicas Espontâneas/fisiologia , Testes Auditivos , Audiometria , Limiar AuditivoRESUMO
RESUMO Objetivo identificar as terminologias mais utilizadas para designar o comportamento desproporcional a determinados sons (CDS) no TEA e sua relação com as respectivas ferramentas para sua investigação, assim como sua ocorrência e desfechos. Estratégia de pesquisa Foram utilizadas as bases de dados: PubMed, PsycINFO, Web of Science, Scielo e Lilacs. As palavras-chave utilizadas foram "autism", "hyperacusis" e "auditoryperception", com as seguintes combinações: "autism AND hyperacusis" e "autism AND auditoryperception". Critérios de seleção Foram incluídos os trabalhos com diagnóstico de TEA, de qualquer faixa etária; resumo disponível; Artigos em inglês, espanhol e português brasileiro; série de casos, estudos de prevalência e incidência, coorte e ensaios clínicos. Análise dos dados Foram analisados estudos com sujeitos com diagnóstico de TEA de qualquer faixa etária; referência no título e/ou resumo da ocorrência do CDS, aceitando os termos hiper-responsividade, hipersensibilidade e hiperacusia; resumo disponível; artigos em inglês, espanhol e português brasileiro; série de casos, estudos de prevalência e incidência, coorte e ensaios clínicos. Resultados Dos 692 estudos resultantes da consulta, foram identificados 13 que atendiam aos requisitos estabelecidos. Conclusão O termo hipersensibilidade auditiva foi o mais empregado para designar o CDS, seguido da hiperacusia. Não houve relação entre os termos e a respectiva ferramenta de investigação, sendo os questionários os mais utilizados para designar o referido comportamento, cuja frequência relatada foi de 42,1% a 69,0%. Os testes auditivos, quando realizados, mostraram o envolvimento das vias neurais auditivas, aferente e eferente.
ABSTRACT Purpose this paper aims to identify the most used terminologies to designate the disproportional behavior to sounds in the autism spectrum disorder (ASD) and its relationship with the respective tools for its investigation, as well as its occurrence and outcomes. Research strategies the databases used were PubMed, PsycINFO, Web of Science, Scielo and Lilacs. The keywords used were "autism", "hyperacusis" and "auditory perception", with the following combinations: "autism AND hyperacusis" and "autism AND auditory perception". Selection criteria individuals diagnosed with ASD of any age group; available abstract; papers in English, Spanish and Brazilian Portuguese; case series, prevalence and incidence studies, cohort and clinical trials. Data analysis we analyzed studies with individuals diagnosed with ASD of any age group; reference in the title and/or summary of the occurrence of disproportional behavior to sounds, accepting the terms hyper-responsiveness, hypersensitivity and hyperacusis; summary available; papers in English, Spanish and Brazilian Portuguese; series of cases, prevalence and incidence studies, cohort and clinical trials. Results Of the 692 studies resulting from the consultation, 13 studies could achieve the established requirements. Conclusion The term auditory hypersensitivity was the most commonly used to designate disproportional behavior to sounds, followed by hyperacusis. There was no relationship between the terms and the respective research tool, and the questionnaires were the most used to designate the referred behavior, whose reported frequency was from 42.1% to 69.0%. The auditory behavior tests when performed showed the involvement of the auditory, afferent and efferent neural pathways.
Assuntos
Humanos , Hiperacusia/etiologia , Reflexo Acústico/fisiologia , Transtorno do Espectro Autista/complicações , Terminologia como Assunto , Hiperacusia/fisiopatologia , Transtorno do Espectro Autista/fisiopatologiaRESUMO
BACKGROUND: Vestibular migraine (VM) has been recognized as a diagnostic entity over the past three decades. It affects up to 1% of the general population and 7% of patients seen in dizziness clinics. It is still underdiagnosed; consequently, it is important to conduct clinical studies that address diagnostic indicators of VM. The aim of this study was to assess auditory brainstem function in women with vestibular migraine using electrophysiological testing, contralateral acoustic reflex and loudness discomfort level. METHODS: The study group consisted of 29 women with vestibular migraine in the interictal period, and the control group comprised 25 healthy women. Auditory brainstem response, frequency following response, binaural interaction component and assessment of contralateral efferent suppression were performed. The threshold of loudness discomfort and the contralateral acoustic reflex were also investigated. The results were compared between the groups. RESULTS: There was a statistically significant difference between the groups in the frequency following response and the loudness discomfort level. CONCLUSIONS: The current study suggested that temporal auditory processing and loudness discomfort levels are altered in VM patients during the interictal period, indicating that these measures may be useful as diagnostic criteria.
Assuntos
Tronco Encefálico/fisiopatologia , Hiperacusia/etiologia , Hiperacusia/fisiopatologia , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/fisiopatologia , Estimulação Acústica , Adulto , Idoso , Estudos de Casos e Controles , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Reflexo Acústico/fisiologia , Adulto JovemRESUMO
BACKGROUND: One of the most important steps for good user performance with a cochlear implant (CI) is activation and programming, aimed at determining the dynamic range. In adults, current levels are determined by psychophysical measures. In babies, small children, or individuals with multiple disorders, this procedure requires techniques that may provide inconsistent responses because of auditory inexperience or the age of the child, making it a very difficult process that demands the collaboration of both the patient and the family. PURPOSE: To study the relationship between the electrically evoked stapedius reflex threshold (ESRT) and maximum comfort level for stimulating electrodes (C-level) in postoperative CI users. RESEARCH DESIGN: Cross-sectional analytical observational case series study. STUDY SAMPLE: We assessed 24 patients of both sexes, aged between 18 and 68 yr, submitted to CI surgery. INTERVENTION: Otoscopy and immittance. Next, an implant speech processor connected to an Itautec® computer containing the manufacturer's software (custom sound Ep 3-2) was used, as well as an AT 235h probe inserted into the ear contralateral to the CI to capture the stapedius reflex, obtaining electrically evoked stapedius reflex thresholds. DATA COLLECTION AND ANALYSIS: Data from the last programming, defining C-levels for each electrode studied, were extracted from the databank of each patient. The manual decay function of the AT 235h middle ear analyzer was used to observe ESRT response in a same window for a longer response capture time. Electrodes 22, 16, 11, 6, and 1 were tested when active, with the aim of using electrodes over the entire length of the CI, and ESRT was considered present when compliance was ≥0.05 ml. Stimuli, in current units, were always initiated at 20 cu above the C-level. The analysis of variance parametric test, Tukey's honest significant difference test, the t-test, Wilcoxon nonparametric test, and the Kolmogorov-Smirnov test examined whether significant relationships existed between these other factors. RESULTS: The results demonstrate that all the electrodes selected for the study exhibited higher mean reflex threshold values than their mean C-level counterparts. However, there was no significant difference between them, for electrodes 1, 6, 11, and 16. The data provided allow the use of ESRT to define C-level values and make it possible to stipulate a correction factor ranging between 6 and 25.6 electrical units. CONCLUSION: The use of electrically evoked stapedius reflex thresholds can help the team in charge of programming CIs, making the process faster and safer, mainly for infants, small children, or individuals with multiple disorders.
Assuntos
Estimulação Acústica , Implante Coclear/métodos , Implantes Cocleares , Estimulação Elétrica , Reflexo Acústico/fisiologia , Estimulação Acústica/métodos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ajuste de Prótese , Estapédio/fisiologia , Adulto JovemRESUMO
Counter, S. Allen, Leo H. Buchanan, Fernando Ortega, Anthony B. Jacobs, and Göran Laurell. Assessment of the brainstem-mediated stapedius muscle reflex in Andean children living at high altitudes. High Alt Med Biol. 18:37-45, 2017.-This study examined the physiological thresholds, amplitude growth, and contraction duration of the acoustic stapedius reflex (ASR) in Andean children aged 2-17 years living at altitudes of 2850 m (Altitude I Group) and 3973 m (Altitude II Group) as part of a general medical assessment of the health status of the children. The brainstem-mediated ASR reveals the integrity of the neuronal components of the auditory reflex arc, including the cochlea receptors, eight cranial nerves, and brainstem neural projections to the cochlear nuclei, bilateral superior olivary nuclei, facial nerve nuclei, and facial nerve and its stapedius branch. Uncrossed (ipsilateral) and crossed (contralateral) ASR thresholds (ASRT), ASR amplitude growth (ASRG) function, and ASR muscle contraction duration (decay/fatigue) (ASRD) were measured noninvasively with 500, 1000 Hz and broadband (bandwidth = 125-4000 Hz) noise stimulus activators using a middle ear immittance system. Oxygen saturation (SaO2) level and heart rate were measured in a subsample of the study group. Statistical analyses revealed that the Altitude I and Altitude II groups had ASRT, ASRG function, and ASRD rates comparable to children at sea level and that the two groups were not significantly different for any of the ASR measures. No significant association was found between SaO2 or heart rate and ASRT, growth, and muscle fatigue rate. In conclusion, the assessment of the ASR in children in the high-altitude groups revealed normal function. Furthermore, the results indicate no adverse oto-physiological effects of altitude on the brainstem-mediated ASR at elevations between 2850 and 4000 m and suggest normal middle ear and auditory brainstem function.
Assuntos
Altitude , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Reflexo Acústico/fisiologia , Estapédio/fisiologia , Testes de Impedância Acústica/métodos , Adolescente , Criança , Pré-Escolar , Equador/etnologia , Feminino , Voluntários Saudáveis , Humanos , MasculinoRESUMO
ABSTRACT INTRODUCTION: Acoustic reflectance is an important tool in the assessment of middle ear afflictions, and the method is considered advantageous in relation to tympanometry. There has been a growing interest in the study of contralateral acoustic stimulation and its effect on the activation of the efferent auditory pathway. Studies have shown that the introduction of simultaneous stimulation in the contralateral ear generates alterations in auditory response patterns. OBJECTIVE: To investigate the influence of contralateral stimulation on acoustic reflectance measurements. METHODS: Case study of 30 subjects with normal hearing, of both genders, aged 18-30 years. The test and retest acoustic reflectance was conducted in the frequency range 200-6000 Hz. The procedure was repeated with the simultaneous presence of contralateral white noise at 30 dBNS. RESULTS: The analysis of the conditions of test, retest, and test with contralateral noise showed statistical difference at the frequency of 2 kHz (p = 0.011 and p = 0.002 in test and retest, respectively) in the right ear. CONCLUSION: The activation of the auditory efferent pathways through contralateral acoustic stimulation produces alterations in response patterns of acoustic reflectance, increasing sound reflection and modifying middle ear acoustical energy transfer.
RESUMO Introdução: A reflectância acústica é citada como uma importante ferramenta na avaliação das afecções da orelha média, sendo um método considerado vantajoso em relação à timpanometria. Tem havido crescente interesse no estudo da estimulação acústica contralateral e seu efeito na ativação da via eferente auditiva. Estudos têm demonstrado que a introdução de estímulo simultâneo na orelha contralateral gera mudanças no padrão de respostas auditivas. Objetivo: Verificar a influência da estimulação contralateral nas medidas de reflectância acústica. Método: Estudo de casos de 30 sujeitos com audição normal, de os gêneros entre 18 a 30 anos. Foi realizado o teste e reteste de reflectância acústica no intervalo de frequência de 200 a 6000 Hz. O procedimento foi repetido com a presença simultânea de ruído branco contralateral à 30 dBNS. Resultados: A análise entre as condições de teste, reteste e teste com ruído contralateral apresentou diferença estatística na frequência de 2 kHz (p = 0,011 em teste e p = 0,002 em reteste) em orelha direita. Conclusão: A ativação da via auditiva eferente por meio da estimulação acústica contralateral produz mudanças nos padrões de respostas da reflectância acústica, aumentando a reflexão do som e, modificando a transferência de energia sonora da orelha média.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Estimulação Acústica/métodos , Vias Auditivas/fisiologia , Limiar Auditivo/fisiologia , Emissões Otoacústicas Espontâneas/fisiologia , Testes de Impedância Acústica , Audiometria de Tons Puros , Estudos de Coortes , Reflexo Acústico/fisiologiaRESUMO
INTRODUCTION: Acoustic reflectance is an important tool in the assessment of middle ear afflictions, and the method is considered advantageous in relation to tympanometry. There has been a growing interest in the study of contralateral acoustic stimulation and its effect on the activation of the efferent auditory pathway. Studies have shown that the introduction of simultaneous stimulation in the contralateral ear generates alterations in auditory response patterns. OBJECTIVE: To investigate the influence of contralateral stimulation on acoustic reflectance measurements. METHODS: Case study of 30 subjects with normal hearing, of both genders, aged 18-30 years. The test and retest acoustic reflectance was conducted in the frequency range 200-6000Hz. The procedure was repeated with the simultaneous presence of contralateral white noise at 30dBNS. RESULTS: The analysis of the conditions of test, retest, and test with contralateral noise showed statistical difference at the frequency of 2kHz (p=0.011 and p=0.002 in test and retest, respectively) in the right ear. CONCLUSION: The activation of the auditory efferent pathways through contralateral acoustic stimulation produces alterations in response patterns of acoustic reflectance, increasing sound reflection and modifying middle ear acoustical energy transfer.
Assuntos
Estimulação Acústica/métodos , Vias Auditivas/fisiologia , Limiar Auditivo/fisiologia , Emissões Otoacústicas Espontâneas/fisiologia , Testes de Impedância Acústica , Adolescente , Adulto , Audiometria de Tons Puros , Estudos de Coortes , Feminino , Humanos , Masculino , Reflexo Acústico/fisiologia , Adulto JovemRESUMO
INTRODUCTION: The clinical evaluation of subjects with occupational noise exposure has been difficult due to the discrepancy between auditory complaints and auditory test results. This study aimed to evaluate the contralateral acoustic reflex thresholds of workers exposed to high levels of noise, and to compare these results to the subjects' auditory complaints.METHODS: This clinical retrospective study evaluated 364 workers between 1998 and 2005; their contralateral acoustic reflexes were compared to auditory complaints, age, and noise exposure time by chi-squared, Fisher's, and Spearman's tests.RESULTS: The workers' age ranged from 18 to 50 years (mean = 39.6), and noise exposure time from one to 38 years (mean = 17.3). We found that 15.1% (55) of the workers had bilateral hearing loss, 38.5% (140) had bilateral tinnitus, 52.8% (192) had abnormal sensitivity to loud sounds, and 47.2% (172) had speech recognition impairment. The variables hearing loss, speech recognition impairment, tinnitus, age group, and noise exposure time did not show relationship with acoustic reflex thresholds; however, all complaints demonstrated a statistically significant relationship with Metz recruitment at 3000 and 4000 Hz bilaterally.CONCLUSION: There was no significance relationship between auditory complaints and acoustic reflexes.
INTRODUÇÃO: A avaliação clínico-ocupacional de trabalhadores expostos a ruído é dificultada pela discrepância entre queixas auditivas e resultados dos exames audiológicos. Este estudo pretende avaliar limiares dos reflexos estapedianos contralaterais em sujeitos expostos a níveis elevados de pressão sonora, relacionando-os com queixas auditivas.MÉTODO: Estudo clínico retrospectivo que analisou 364 trabalhadores e seus limiares de reflexos estapedianos contralaterais, relacionado-os com queixas auditivas, idades e tempos de exposição ao ruído.RESULTADOS: Dos trabalhadores avaliados, com idades de 18 a 50 anos (média 39,6) e tempos de exposição entre um e 38 anos (média 17,3); 15,1% (55) tinham queixa de perda auditiva bilateral, 38,5% (140) zumbidos bilaterais, 52,8% (192) irritação ao ouvir sons intensos e 47,2% (172) dificuldades para reconhecer a fala. As variáveis: perda auditiva, dificuldade para reconhecimento da fala, zumbidos, faixa etária e tempo de exposição ao ruído não se relacionaram significativamente com limiares dos reflexos estapedianos, mas todas as queixas apresentaram relação estatisticamente significante com o recrutamento de Metz nas frequências de 3000 e 4000 Hz, bilateralmente.CONCLUSÃO: Não houve relações significativas entre limiares dos reflexos estapedianos e queixas auditivas.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Limiar Auditivo/fisiologia , Perda Auditiva Provocada por Ruído/diagnóstico , Ruído Ocupacional/efeitos adversos , Exposição Ocupacional/efeitos adversos , Reflexo Acústico/fisiologia , Perda Auditiva Provocada por Ruído/fisiopatologia , Estudos Retrospectivos , Fatores de TempoRESUMO
PURPOSE: To analyze the occurrence of acoustic reflex and its threshold on newborns using the 226 and 1,000 Hz probes. METHODS: Thirty-six newborns with "PASS" results in newborn hearing screening and tympanogram with one or two peaks for both probe tones were included. Group I comprised 20 full-term newborns without risk indicator for hearing loss, and Group II comprised 16 newborns with at least one risk indicator. The study about ipsilateral acoustic reflex thresholds was conducted in 500, 1,000, 2,000, and 4,000 Hz. RESULTS: The groups presented the acoustic reflex thresholds between 50 and 100 dB for both probe tones. In the comparison between the probes, there were differences in all frequencies evaluated in Group I, with the lowest threshold mean for the 1,000 Hz probe. In Group II, differences were detected at 2,000 Hz. The mean acoustic reflex thresholds were similar in both groups for the 226 Hz probe. There was a difference for the 1,000 Hz probe in all tested frequencies. The percentage of response was higher in both groups for the 1,000 Hz probe. The kappa test showed extremely poor agreement in the comparison of results between both probes. CONCLUSION: The occurrence of acoustic reflex was higher in newborns and its thresholds were lower with the 1,000 Hz probe both for healthy newborns and for newborns at risk.
Assuntos
Testes de Impedância Acústica/instrumentação , Limiar Auditivo/fisiologia , Reflexo Acústico/fisiologia , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Masculino , Fatores de RiscoRESUMO
INTRODUCTION: The clinical evaluation of subjects with occupational noise exposure has been difficult due to the discrepancy between auditory complaints and auditory test results. This study aimed to evaluate the contralateral acoustic reflex thresholds of workers exposed to high levels of noise, and to compare these results to the subjects' auditory complaints. METHODS: This clinical retrospective study evaluated 364 workers between 1998 and 2005; their contralateral acoustic reflexes were compared to auditory complaints, age, and noise exposure time by chi-squared, Fisher's, and Spearman's tests. RESULTS: The workers' age ranged from 18 to 50 years (mean=39.6), and noise exposure time from one to 38 years (mean=17.3). We found that 15.1% (55) of the workers had bilateral hearing loss, 38.5% (140) had bilateral tinnitus, 52.8% (192) had abnormal sensitivity to loud sounds, and 47.2% (172) had speech recognition impairment. The variables hearing loss, speech recognition impairment, tinnitus, age group, and noise exposure time did not show relationship with acoustic reflex thresholds; however, all complaints demonstrated a statistically significant relationship with Metz recruitment at 3000 and 4000Hz bilaterally. CONCLUSION: There was no significance relationship between auditory complaints and acoustic reflexes.
Assuntos
Limiar Auditivo/fisiologia , Perda Auditiva Provocada por Ruído/diagnóstico , Ruído Ocupacional/efeitos adversos , Exposição Ocupacional/efeitos adversos , Reflexo Acústico/fisiologia , Adulto , Feminino , Perda Auditiva Provocada por Ruído/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adulto JovemRESUMO
PURPOSE: To analyze the occurrence of acoustic reflex and its threshold on newborns using the 226 and 1,000 Hz probes. METHODS: Thirty-six newborns with "PASS" results in newborn hearing screening and tympanogram with one or two peaks for both probe tones were included. Group I comprised 20 full-term newborns without risk indicator for hearing loss, and Group II comprised 16 newborns with at least one risk indicator. The study about ipsilateral acoustic reflex thresholds was conducted in 500, 1,000, 2,000, and 4,000 Hz. RESULTS: The groups presented the acoustic reflex thresholds between 50 and 100 dB for both probe tones. In the comparison between the probes, there were differences in all frequencies evaluated in Group I, with the lowest threshold mean for the 1,000 Hz probe. In Group II, differences were detected at 2,000 Hz. The mean acoustic reflex thresholds were similar in both groups for the 226 Hz probe. There was a difference for the 1,000 Hz probe in all tested frequencies. The percentage of response was higher in both groups for the 1,000 Hz probe. The kappa test showed extremely poor agreement in the comparison of results between both probes. CONCLUSION: The occurrence of acoustic reflex was higher in newborns and its thresholds were lower with the 1,000 Hz probe both for healthy newborns and for newborns at risk. .
OBJETIVO: Verificar a ocorrência e o limiar do reflexo acústico em neonatos utilizando a sonda de 226 e 1.000 Hz. MÉTODOS: Trinta e seis neonatos com resultado "PASS" na triagem auditiva neonatal e timpanogramas com um ou dois picos para os dois tons de sonda. O Grupo I foi composto por 20 neonatos a termo sem indicador de risco para deficiência auditiva e o Grupo II, por 16 neonatos com pelo menos um indicador de risco. A pesquisa dos limiares do reflexo acústico ipsilateral foi realizada em 500, 1.000, 2.000 e 4.000 Hz. RESULTADOS: Os grupos apresentaram limiar do reflexo acústico entre 50 e 100 dB para ambos os tons de sonda. Na comparação entre as sondas, houve diferença em todas as frequências avaliadas no Grupo I, com a média de limiares menor com a sonda de 1.000 Hz. No Grupo II, foi detectada diferença em 2.000 Hz. Com a sonda de 226 Hz, os limiares médios do reflexo acústico foram semelhantes nos dois grupos. Com a sonda de 1.000 Hz, houve diferença em todas as frequências avaliadas. A porcentagem de presença de resposta foi maior para ambos os grupos para a sonda de 1.000 Hz. O teste kappa revelou concordância extremamente pobre na comparação dos resultados entre as duas sondas. CONCLUSÃO: A ocorrência de reflexo acústico em neonatos foi maior e os limiares menores com a utilização da sonda de 1.000 Hz, tanto para neonatos saudáveis como para os neonatos de risco. .
Assuntos
Feminino , Humanos , Recém-Nascido , Masculino , Testes de Impedância Acústica/instrumentação , Limiar Auditivo/fisiologia , Reflexo Acústico/fisiologia , Estudos de Casos e Controles , Fatores de RiscoRESUMO
Objective To outline the audiological findings of aphasic patients after cerebrovascular accidents. Methods This is a cross-sectional study performed between March 2011 and August 2012 in the Speech, Language, and Hearing Pathology Department of the Universidade Federal de São Paulo. A total of 43 aphasic subjects (27 men) were referred for audiological evaluation after stroke, with mean age of 54.48 years. Basic audiological evaluation tests were performed, including pure tone audiometry, speech audiometry (speech recognition threshold and word recognition score), immittance measures (tympanometry and contralateral acoustic reflex), and transient otoacoustic emissions. Results Sensorineural hearing loss was prevalent (78.6%). Speech recognition threshold and word recognition score were not obtained in some patients because they were unable to perform the task. Hearing loss was a common finding in this population. Conclusion Comprehension and/or oral emission disruptions in aphasic patients after stroke compromised conventional speech audiometry, resulting in the need for changes in the evaluation procedures for these patients. .
Objetivo Avaliar os achados audiológicos em pacientes afásicos após acidente vascular encefálico. Métodos Trata-se de um estudo transversal, realizado entre março de 2011 e agosto de 2012 no Departamento de Fonoaudiologia da Universidade Federal de São Paulo. Participaram do estudo 43 pacientes afásicos (27 homens) após acidente vascular encefálico, com média de idade de 54,48 anos. Foram realizados testes que compõem a bateria da avaliação audiológica básica: audiometria tonal liminar, logoaudiometria (limiar de reconhecimento de fala e índice percentual de reconhecimento de fala), medidas de imitância acústica (timpanometria e pesquisa do reflexo acústico contralateral) e emissões otoacústicas transitórias. Resultados A perda auditiva neurossensorial foi prevalente (78,6%). Não foi possível obter o limiar de reconhecimento de fala e o índice percentual de reconhecimento de fala em todos os pacientes, pois alguns eram incapazes de realizar a tarefa. A perda auditiva foi um achado comum nessa população. Conclusão As alterações de compreensão e/ou emissão oral apresentadas por estes pacientes afetaram a logoaudiometria convencional e apontam para a necessidade de uso de outros procedimentos de avaliação nessa população. .
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Afasia/etiologia , Perda Auditiva/etiologia , Acidente Vascular Cerebral/complicações , Afasia/fisiopatologia , Limiar Auditivo/fisiologia , Estudos Transversais , Testes Auditivos , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva/fisiopatologia , Valores de Referência , Reflexo Acústico/fisiologia , Estatísticas não Paramétricas , Acidente Vascular Cerebral/fisiopatologiaRESUMO
Tinnitus is characterized by an auditory perception of sound, with no stimuli from the external environment. Tinnitus is an increasingly significant complaint, affecting 10-17% of the world population. As a symptom, it should always be considered with pathology in the auditory system. Our study aims to assess the relationship of this symptom with the presence of a stapedial reflex and the phenomenon of recruitment. Medical records of patients complaining of subjective tinnitus during their first consultation in the Outpatient Clinic of the Unicamp Teaching Hospital, in Brazil, between 2011 and 2012 were analyzed. We carried out a study with 65 non-randomized tinnitus individuals using questionnaires, clinical and audiological evaluations. The visual analogue scale was used to characterize the degree of disturbance caused by tinnitus. Statistical tests were performed using the IBM SPSS Statistics 19. No association was found between tinnitus and the presence of acoustic reflex or phenomenon of recruitment. We concluded that there is no relationship between tinnitus, the phenomenon of recruitment or the presence of an acoustic reflex.
Assuntos
Hiperacusia/fisiopatologia , Recrutamento Neurofisiológico/fisiologia , Reflexo Acústico/fisiologia , Zumbido/fisiopatologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Detecção de Recrutamento AudiológicoRESUMO
INTRODUCTION: The most important stage in fitting a cochlear implant is the identification of its dynamic range. The use of objective measures, in particular the electrically elicited stapedius reflex, may provide suitable assistence for initial fitting of cochlear implant, especially in children or adult with multiple disorders, because they provide specific values that serve as the basis of early cochlear implant programming. OBJECTIVE: Verify through a review the use of the electrically elicited stapedius reflex threshold during the activation and mapping process of cochlear implant. METHODS: Bibliographical search on the Pubmed and Bireme plataforms, and also on Medline, LILACS and SciELO databases, with standard searches until September 2012, using specific keywords. For the selection and evaluation of scientific studies found in the search, criterias have been established, considering the following aspects: author, year/location, grade of recommendation/level of evidence, purpose, sample, age, mean age in years, evaluative testing, results and conclusion. RESULTS: Among 7,304 articles found, 7,080 were excluded from the title, 152 from the abstract, 17 from the article reading, 43 were repeated and 12 were selected for the study. CONCLUSION: The electrically elicited stapedius reflex may support when programming the cochlear implant, especially in patients with inconsistent responses.
Assuntos
Limiar Auditivo/fisiologia , Implante Coclear , Implantes Cocleares , Surdez/cirurgia , Reflexo Acústico/fisiologia , Estimulação Elétrica , HumanosRESUMO
Introdução: A determinação da área dinâmica do implante coclear é um dos procedimentos mais importantes em sua programação. O uso de medidas objetivas, em especial a do limiar do reflexo estapédico evocado eletricamente, pode contribuir para a definição deste campo, principalmente em crianças ou em indivíduos com múltiplos comprometimentos, pois fornecem valores específicos que servem como base no início da programação do implante coclear. Objetivo: Verificar por meio de uma revisão a utilização do limiar do reflexo estapédico evocado eletricamente durante o processo de ativação e de mapeamento do implante coclear. Métodos: Levantamento bibliográfico nas plataformas Pubmed e Bireme e nas bases de dados MedLine, LILACS e SciELO, com buscas padronizadas até setembro de 2012, utilizando-se palavras-chave. Para a seleção e avaliação dos estudos científicos levantados, foram estabelecidos critérios, contemplando os seguintes aspectos: autor, ano/local, grau de recomendação/nível de evidência científica, objetivo, amostra, faixa etária, média de idade em anos, testes avaliativos, resultados e conclusão. Resultados: Dos 7.304 artigos encontrados, 7.080 foram excluídos pelo título, 152 pelo resumo, 17 pela leitura do artigo, 43 eram repetidos e 12 foram selecionados para o estudo. Conclusão: O reflexo estapédico evocado eletricamente é capaz de auxiliar na programação do implante coclear, principalmente em pacientes que apresentam respostas inconsistentes. .
Introduction: The most important stage in fitting a cochlear implant is the identification of its dynamic range. The use of objective measures, in particular the electrically elicited stapedius reflex, may provide suitable assistence for initial fitting of cochlear implant, especially in children or adult with multiple disorders, because they provide specific values that serve as the basis of early cochlear implant programming. Objective: Verify through a review the use of the electrically elicited stapedius reflex threshold during the activation and mapping process of cochlear implant. Methods: Bibliographical search on the Pubmed and Bireme plataforms, and also on Medline, LILACS and SciELO databases, with standard searches until September 2012, using specific keywords. For the selection and evaluation of scientific studies found in the search, criterias have been established, considering the following aspects: author, year/location, grade of recommendation/level of evidence, purpose, sample, age, mean age in years, evaluative testing, results and conclusion. Results: Among 7,304 articles found, 7,080 were excluded from the title, 152 from the abstract, 17 from the article reading, 43 were repeated and 12 were selected for the study. Conclusion: The electrically elicited stapedius reflex may support when programming the cochlear implant, especially in patients with inconsistent responses. .
Assuntos
Humanos , Limiar Auditivo/fisiologia , Implante Coclear , Implantes Cocleares , Surdez/cirurgia , Reflexo Acústico/fisiologia , Estimulação ElétricaRESUMO
OBJECTIVE: To outline the audiological findings of aphasic patients after cerebrovascular accidents. METHODS: This is a cross-sectional study performed between March 2011 and August 2012 in the Speech, Language, and Hearing Pathology Department of the Universidade Federal de São Paulo. A total of 43 aphasic subjects (27 men) were referred for audiological evaluation after stroke, with mean age of 54.48 years. Basic audiological evaluation tests were performed, including pure tone audiometry, speech audiometry (speech recognition threshold and word recognition score), immittance measures (tympanometry and contralateral acoustic reflex), and transient otoacoustic emissions. RESULTS: Sensorineural hearing loss was prevalent (78.6%). Speech recognition threshold and word recognition score were not obtained in some patients because they were unable to perform the task. Hearing loss was a common finding in this population. CONCLUSION: Comprehension and/or oral emission disruptions in aphasic patients after stroke compromised conventional speech audiometry, resulting in the need for changes in the evaluation procedures for these patients.
Assuntos
Afasia/etiologia , Perda Auditiva/etiologia , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Afasia/fisiopatologia , Limiar Auditivo/fisiologia , Estudos Transversais , Feminino , Perda Auditiva/fisiopatologia , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Testes Auditivos , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reflexo Acústico/fisiologia , Estatísticas não Paramétricas , Acidente Vascular Cerebral/fisiopatologiaRESUMO
CONCLUSION: The results suggested mercury (Hg)-induced anomalies in the brainstem-mediated acoustic stapedius muscle reflex in children. OBJECTIVES: Hg exposure has been associated with hearing impairment and brainstem anomalies. Acoustic stapedius reflex (ASR) thresholds, growth functions, decay/adaptation times, and behavioral auditory thresholds were used to screen Andean children and adults for Hg-induced auditory brainstem and facial nerve impairment. METHODS: Fifty-one participants, which included 22 children (aged 6-17 years) and 29 adults (aged 19-83 years) living in gold mining areas of Ecuador where Hg is widely used in amalgamation, were screened using ASR immittance procedures. RESULTS: Mean blood mercury (HgB) level in the children was 15.6 µg/L (SD, 21.3; median, 7 µg/L; range, 2.0-89 µg/L), and in the adults 8.5 µg/L (SD, 7.1; median, 6 µg/L; range, 2.0-32 µg/L). Mean contralateral ASR thresholds (ASRT) for the screening frequency of 2000 Hz in the children (39 ears) was 92.9 dB HL (SD, 6.1; range, 80-105 dB HL), and in the adults (53 ears) 90.0 dB HL (SD, 6.4; range, 65-105 dB HL). The ASRT in the children increased significantly with HgB level (rho = 0.433; p = 0.008).