Hearing among children with neurological disorders

Background: Neurologic disorders are not rare in our environment but studies determining the hearing of these children are almost non- existent. This study therefore is to determine the prevalence of hearing loss in these children and also determine the care seeking attitude of the parents/guardians concerning the hearing.Methods: A hospital based descriptive study of all children attending the children neurologic clinic of university of Port Harcourt teaching hospital. A semi structured questionnaire was administered to parents / guardians who gave their consent for their children to be recruited into the study. Hearing loss in the children was taken as reported by the parents/guardians. Data collected were then entered into Microsoft Excel and then exported to the IBM Statistical Package for Social Sciences (SPSS) version 20 for statistical analysis.Results: The study comprised 49 children; 29 males and 20 females. Age range was from 8months to 18years.  Age group 1-5 years comprised the majority of the study population. Commonest neurological disorder seen was childhood epilepsy n=27, 55.1%. Prevalence of hearing loss was 26.5%. Children with childhood epilepsy had 15.4% having hearing loss while children with cerebral palsy, autistic spectrum disorder and microcephaly had 50% hearing loss recorded. Maternal illness during pregnancy was significantly related to the hearing loss with a p value = 0.045 and presence of neonatal illness with p value =0.009.  Only 7.7% was formally treated while 92.3% had no form of treatment whatsoever.Conclusions: Childhood epilepsy was the commonest type of neurologic disorder seen while highest point prevalence for hearing loss was in cerebral palsy. Majority of parents/caregivers did not seek medical care concerning the hearing loss neither were there any form of treatment given to the children.

Audiological Abnormalities in Vitiligo Patients: A Hospital-Based Cross-Sectional Study

Abstract Introduction There are some discrepancies in the literature about the influence of vitiligo on auditory functions. According to some authors, vitiligo influences hearing, whereas others question such influence. Therefore, we conducted a study to evaluate audiological functions in vitiligo patients. Objectives To determine the effect of vitiligo on auditory functions. Methods A hospital-based observational study was done from January 2017 to July 2017. Clinically diagnosed cases of vitiligo were enrolled for the study. A complete otological examination was conducted in all patients. Results Fifty-two patients (male: female 28:24) were included in the study. Ten patients (19.2%) had sensorineural hearing loss (SNHL). Seven patients (13.5%) had bilateral and 3 (5.7%) had unilateral SNHL. High frequency loss was seen in 17 out of 20 ears (10 affected patients), 6 ears had both low and high-frequency hearing loss. Of 12 ears with speech frequency involvement, mild hearing loss was seen in 5 and moderate to severe in 1 ear.Most cases of SNHL were detected in the age group 41 to 60 years old (63.6%), which was statistically significant (p-value 0.00). Conclusion The results of this study suggest that vitiligo patients require routine monitoring for auditory functions for early identification of SNHL. Older subjects with vitiligo might be at a higher risk for audiological abnormalities. These patients should also be informed regarding the associated risk with noise and ototoxic drug exposure.

Preservation of residual hearing after cochlear implant surgery: an exploration of residual hearing function in a group of recipients at cochlear implant units / Preservação da audição residual após cirurgia de implante coclear: avaliação da função auditiva residual em um grupo de receptores em unidades de implante coclear

Abstract Introduction: The preservation of residual hearing is becoming increasingly important in cochlear implant surgery. Conserving residual hearing is a positive prognostic indicator for improved hearing abilities. Objective: The primary aim of the study was to explore the preservation of residual hearing following cochlear implantation in a group of recipients at two major cochlear implant centers. Methods: A quantitative paradigm was adopted and exploratory research conducted within a retrospective data review design. The sample consisted of 50 surgical records and 53 audiological records from 60 observations (53 patients, seven of whom were implanted bilaterally). The records were selected using purposive sampling and consisted of records from participants ranging from six to 59 years of age. The average time of when the postoperative audiograms were performed in the current study was 24.7 months (s.d. = ±9.0). Data were analyzed through both qualitative and inferential statistics and a comparative analysis of unaided pre- and postoperative audiological test results was conducted. Results: Results indicated a high success rate of 92% preservation of residual hearing with half of the sample exhibiting complete preservation in cochlear implant recipients across all frequencies postoperatively. A total postoperative hearing loss was found in only 8% of cochlear implantees across all frequencies. There was no relationship between preoperative hearing thresholds and preservation of hearing postoperatively. The two main surgical techniques used in the current study were the contour on stylet and the advance off-stylet techniques, with the majority of surgeons utilizing a cochleostomy approach. From the findings, it became apparent that the majority of cases did not have any reported intraoperative complications. This is a positive prognostic indicator for the preservation of residual hearing. Conclusion: Findings suggest improved cochlear implant surgical outcomes when compared to previous studies implying progress in surgical techniques. The surgical skill and experience of the surgeon are evidenced by the minimal intraoperative complications and the high success rate of hearing preservation. This is a positive prognostic indicator for individuals with preoperative residual hearing as the preserved residual hearing allows for the potential of electro-acoustic stimulation, which in turn has its own hearing benefits.

Resumo Introdução: A preservação da audição residual tem se tornado cada vez mais importante na cirurgia de implante coclear. Conservar a audição residual é um indicador prognóstico positivo para melhorar as habilidades auditivas. Objetivo: Avaliar a preservação da audição residual pós-implante coclear em um grupo de pacientes de dois grandes centros de implantes cocleares. Método: Foram adotados um paradigma quantitativo e uma pesquisa exploratória em um projeto retrospectivo de revisão de dados. A amostra consistiu de 50 registros cirúrgicos e 53 registros audiológicos de 60 observações (53 pacientes, sete dos quais foram implantados bilateralmente). Os registros foram selecionados com amostragem proposital e consistiram em registros de participantes de seis a 59 anos. Neste estudo, o tempo médio para audiogramas no pós-operatório foi de 24,7 meses (dp = ± 9,0). Os dados foram analisados através de estatísticas qualitativas e inferenciais, foi feita uma análise comparativa de resultados de testes audiológicos pré e pós-operatórios, sem auxílio de aparelho auditivo. Resultados: Os resultados indicaram uma alta taxa de sucesso, de 92%, de preservação da audição residual, metade da amostra dos implantados exibia preservação completa em todas as frequências no pós-operatório. Perda auditiva total em todas as frequências no pós-operatório foi observada em apenas 8% dos implantes cocleares. Não houve relação entre limiares auditivos pré-operatórios e preservação auditiva no pós-operatório. As duas principais técnicas cirúrgicas usadas no presente estudo foram contour on stylet e a técnica advance off-stylet e a maioria dos cirurgiões usou uma abordagem por cocleostomia. A partir dos achados, tornou-se evidente que a maioria dos casos não apresentou complicação intraoperatória. Esse é um indicador prognóstico positivo para a preservação da audição residual. Conclusão: Os achados sugerem melhoria dos resultados cirúrgicos do implante coclear quando comparados com estudos prévios, sugerem um progresso nas técnicas cirúrgicas. A habilidade cirúrgica e a experiência do cirurgião são evidenciadas pelas complicações intraoperatórias mínimas e pela alta taxa de sucesso de preservação auditiva. Esse é um indicador prognóstico positivo para indivíduos com audição residual pré-operatória, uma vez que a audição residual preservada possibilita o potencial de estimulação eletroacústica (EAS - do inglês Electric Acoustic Stimulation), que, por sua vez, tem benefícios auditivos próprios.

Hallazgos audiológicos en personas menores de 65 años diagnosticadas con osteoporosis: estudio preliminar / Audiological findings in persons under age of 65 diagnosed with osteoporosis: preliminary study

RESUMEN Introducción: La osteoporosis afecta a 200 millones de personas en el mundo y corresponde a una enfermedad crónica que afecta más a mujeres que a hombres, con una prevalencia en Chile del 1,7% y 0,2%, respectivamente. Debido al gran porcentaje de pacientes que la padecen, se han llevado a cabo diversos estudios sobre los síntomas secundarios que pueden encontrarse en esta patología. En el último tiempo, se ha investigado la osteoporosis como un factor de riesgo para padecer pérdida auditiva. Objetivo: Comparar los resultados de umbrales auditivos aéreos, timpanometria y reflejos acústicos ipsilaterales entre pacientes con osteoporosis y pacientes sin osteoporosis, menores de 65 años sin otra patología de base. Material y método: Estudio preliminar de tipo observacional de caso y controles con alcance exploratorio. Se analizaron 28 oídos de una muestra conformada por un grupo estudio de 7 participantes con osteoporosis y un grupo control de 7 participantes sin osteoporosis. Se evaluó el sistema tímpano osicular con la timpanometria y el umbral del reflejo acústico estapedial ipsilateral, y el nivel auditivo por frecuencia con la audiometria tonal. Resultados: Se observaron diferencias estadísticamente significativas entre ambos grupos en los umbrales auditivos, con predominancia sensorioneural en el grupo estudio, y en los umbrales del reflejo acústico ipsilateral. Conclusión: La osteoporosis podría ser un factor de riesgo para padecer pérdida auditiva del tipo sensorioneural. Es necesario continuar el estudio para obtener resultados con mayor representatividad.

ABSTRACT Introduction: Osteoporosis affects over 200 million people in the world and corresponds to a chronic disease that affects more women than men, with a prevalence in Chile of 1.7% and 0.2% respectively. Due to the large percentage of patients who suffer it, several studies about the secondary symptoms that can be found in this pathology have been carried out. In the last time, osteoporosis has been investigated as a risk factor for hearing loss. Aim: To compare the results of air auditory thresholds, tympanometry, and ipsilateral acoustic reflexes in patients with osteoporosis versus patients without osteoporosis, under 65 years old without another underlying disease. Material and method: Preliminary study of observational type of case and controls with exploratory scope. We analyzed 28 ears of a sample consisted of a group study of 7 participants with osteoporosis and a control group of 7 participants without osteoporosis. The tympanic oscillating system and auditory level of each participant were evaluated with tympanometry, ipsilateral stapedial acoustic reflex threshold and tonal audiometry. Results: Statistically significant differences were observed between both groups in the auditory thresholds with a sensorineural predominance and in the ipsilateral stapedial acoustic reflex thresholds. Conclusions: The osteoporosis could be a risk factor for suffer hearing loss of sensorineural type. It is necessary to continue the study to obtain results with greater representativeness.

Factores de riesgo de la hipoacusia infantil en Holguín, Cuba / Risk factors of infants’ hypoacusic in Holguín, Cuba

Introducción: los trastornos auditivos constituyen un problema de salud, que afecta a una proporción importante de la población infantil. Al nacer, aproximadamente uno de cada mil niños, presentan pérdida auditiva severa bilateral y, diez de cada cien tienen trastornos de moderados a ligeros. Objetivo: caracterizar el comportamiento de los factores de riesgo audiológicos, que provocan hipoacusias neurosensorial (HNS), en niños menores de seis años. Métodos: se realizó un estudio descriptivo de 63 pacientes, a los que se diagnosticaron hipoacusia neurosensorial. Resultados: en el grupo etáreo más significativo, fue el de 4 a 6 años de edad, con un 57,1%. Predominó el sexo masculino, con un 63,5%. La hipoacusia más frecuente fue la adquirida, con 62%. La hipoxia con ventilación asistida, ototoxicidad, los antecedentes de hipoacusia familiar, los de causa desconocida, y la hipertensión arterial en el embarazo, fueron los factores de riesgo que causaron hipoacusia en la infancia. La edad de diagnóstico más frecuente es de cero a dos años, con el 49,2%; unida a la hipoacusia neurosensorial bilateral de severa a profunda, de etiología multifactorial. Conclusiones: el screening universal de todos los niños nacidos, para evitar trastornos en el lenguaje y el aprendizaje, es de suma importancia.

Introduction: auditory disorders affect large number of children. About 1 of 1000 children present birth severe bilateral auditive loss and 10 of 100 suffer light to moderate disorders. Objective: to characterize risk factors´ audiological behavior of children under six years old, affected by sensorineural hypoacusia. Methods: descriptive study with a sample of 63 neurosensorial hipoacusia patients. Results: most cases were at the 4 to 6 years old group, with 57.1%. Males predominated with a 63.5%. Acquired hypoacusia was the most frequent up to 62%. Hypoxia and assisted ventilation, ototoxicity, unknown hypoacusia family history, and hypertension in pregnancy, were risk factors present, during the study. More frequent diagnosis ages were from 0 to 2 years old, with 49.2%, and the most common type was, from severe to profound, sensorineural bilateral hypoacusia of multifactorial etiology. Conclusions: universal screening to all children is very important to the early detection of hypoacusia and to avoid language and learning disturbances.

Prácticas audiológicas en Chile: encuesta online para tecnólogos médicos mención otorrinolaringología / Audiological practices in Chile: an internet based survey for medical technologist with mayor in otorhinolaryngology

Introducción: A nivel internacional existen diversas instituciones que sugieren los estándares mínimos para la realización de los procedimientos audiológicos. Esto tiene como objetivo asegurar la calidad de las evaluaciones auditivas. Esto resulta de importancia en Chile debido a la implementación de programas de salud auditiva en el marco de las garantías explicitas de salud (GES). Objetivo: Documentar las prácticas comunes dentro de Tecnólogo Médico c/m Otorrinolaringología con la finalidad de obtener información para la creación y desarrollo de protocolos estandarizados para la evaluación audiológica. Material y método: Se aplicó un cuestionario de 38 preguntas distribuido a partir de una plataforma online a través de redes sociales y por correo electrónico a los socios de la Sociedad Chilena de Audiología y Otoneurología. Resultados: Se analizaron 121 encuestas finalizadas. Sobre el 70% de los encuestados que ejerce en la zona central. Procedimientos como audiometría de tonos puros, impedanciometría y logoaudiometría son frecuentemente realizados dentro de los encuestados. Estos procedimientos son realizados de acuerdo a lo sugerido dentro de estos profesionales. Conclusión: Existe una alta adherencia de las conductas sugeridas por instituciones internacionales para la realización de los procedimientos más comunes realizados en clínica por parte de los Tecnólogos Médicos c/m Otorrinolaringología.

Introduction: Internationally several institutions suggest minimum standards for the conduct of audiological procedures. This aims to ensure the quality of auditory assessments. This is of importance in Chile due to the implementation of hearing programs under the Explicit Health Guarantees (EHG). Aim: To document common audiological practices of Medical Technologist in order to development standardized protocols for audiological assessment. Material and method: An online-based questionnaire with 38 questions was provided through social networks and by email to members of the Chilean Society of Audiology and Otoneurology. Results: One hundred and twenty one completed surveys were analysed. About 70% of respondents work in the central region of Chile. Procedures such as pure audiometry, tympanometry and speech audiometry were frequently performed by respondents. Respondents followed international guidelines. Conclusion: There is a high adherence to international recommendations when conducting the most common procedures performed in audiology clinics in Chile by the Medical Technologists who responded to the survey.

Early Intervention in Audiology: Exploring the Current Status from a Developing Country Context.

Aims: Analysis of the current audio logical management protocols for children with hearing impairment in South Africa’s Gauteng state hospitals was investigated in this study. Study Design and Methods: A retrospective record review was conducted, with 70 files/medical records of paediatric patients between the ages of birth and three years. These records came from three state hospitals’ audiology clinics where full audio logical and otological services were available. Results: Findings of this study revealed concerning trends. Firstly, findings indicated that on average children were identified with a hearing loss at 23.65 months. Secondly, they received amplification 7.11 months after diagnosis and were only introduced into aural rehabilitation at the average age of 31.2 months. However, 81% of children received appropriate audio logical tests; with 85.7% of children who were identified with a hearing loss receiving amplification. All children identified with a bilateral hearing loss in the current sample were aided bilaterally. As far as communication development was concerned, 48.57% of the children identified with a hearing loss received the auditory verbal therapy approach, with 18.57% receiving sign language as a means of communication, while 11.43% received a total communication approach. A significant number (14.29%) were not receiving aural rehabilitation therapy. Conclusion: Findings raise important implications for the success of early hearing detection and intervention (EHDI) initiatives in South Africa. Improved and concerted efforts in the form of systematic planning and implementation of EHDI protocols are required.

Procesamiento auditivo en adultos mayores: reporte de casos / Auditory processing in elderly: case reports

La disminución de la capacidad de comprensión del habla en los adultos mayores puede ser producida por la interacción de diferentes factores como: a) pérdida auditiva periférica, b) alteraciones cognitivas y c) déficit del procesamiento auditivo. En la actualidad existen pruebas audiológicas que nos permiten evidenciar los déficits del procesamiento auditivo en esta población permitiendo así ayudar en los procesos de selección y adaptación de audífonos tanto en forma monoaural como biaural.

The decline in speech understanding ability in older adults can be caused by the interaction of different factors including: a) peripheral hearing loss, b) cognitive and c) auditory processing deficits. There are currently audio logical tests that allow us to demonstrate auditory processing deficits in this population and assist in allowing the processes of selection and hearing aid fitting in both monaural and binaural way.

Perfil epidemiológico e audiológico dos trabalhadores atendidos pelo Serviço Social da Indústria de Brusque – Santa Catarina / Epidemiological and audiological profile of workers cared for at the Social Service of the Industry of Brusque, SC, South Brazil

Introdução: A deficiência auditiva pode ser conseqüência de exposições a ruídos e/ou agentes ototóxicos. É importante que se reconheça a potencialidade de outros agentes e sua possível interação com o ruído sobre a saúde auditiva dos trabalhadores. Objetivo: Traçar o perfil epidemiológico e audiológico das empresas atendidas pelo Serviço Social da Indústria de Santa Catarina SESI/ SC na cidade de Brusque. Metodologia: estudo exploratório, transversal, incluindo todos os exames audiológicos registrados no banco de dados do programa Winaudio® 6.0 da Unidade de Operações Sociais de Brusque. Resultados: Mais de 81 por cento dos trabalhadores referiram estar expostos ao ruído. O uso de protetor auricular foi referido por 66,6 por cento. A prevalência de perda auditiva foi de 24,7 . O tipo de perda mais prevalente foi o bilateral, com 17,1 por cento. A perda auditiva à esquerda foi 62 por cento maior que a perda auditiva à direita (RP=1,62; p<0,001). Da mesma forma, o rebaixamento dos limiares de 250Hz, 6000Hz e/ou 8000Hz à esquerda foi mais prevalente que à direita. Conclusões: A opinião dos trabalhadores sobre a própria audição tem um baixo valor preditivo para diagnóstico de perda auditiva. A perda auditiva ainda é pouco percebida e não causa desconforto social, interferindo pouco na qualidade de vida do indivíduo. Os sintomas clínicos iniciais da disacusia sensório-neural ocupacional por ruído não são detectados pelo trabalhador.

Introduction: Hearing deficiency may be a consequence of exposure to noises and/or ototoxic agents. It is important to recognize the potentiality of other agents and their possible interaction with noise on the worker’s hearing health. Aim: To outline the epidemiological and audilogical profile of workers cared for at the Social Service of the Industry of Santa Catarina (SESI/SC) in the municipality of Brusque. Methods: This is an exploratory transversal study of all the audiological tests registered in the databank of the Winaudio® 6.0 program of the Social Operations Unity of Brusque. Results: More than 91 percent of the workers reported being exposed to noise. The use of ear protection was reported by 66.6 percent. The prevalence of hearing loss was 24.7 percent. The most prevalent type of loss was the bilateral, in 17.1 percent of the cases. Hearing loss on the left ear was 62 percent greater than hearing loss on the right ear (RP=1.62; p<0.001). Similarly, the downgrading in thresholds of 250Hz, 6000Hz and/or 8000Hz on the left was more prevalent than on the right. Conclusions: Workers’ self-reports on their hearing have a low predictive value for the diagnosis of hearing loss. Hearing loss still goes unnoticed and does not cause much social discomfort, interfering little in the quality of life of the individual. The early clinical symptoms of occupational sensory-neural dysacousia due to noise are not detected by the workers.

Auditory disorders and acquisition of the ability to localize sound in children born to HIV-positive mothers

The objective of the present study was to evaluate children born to HIV-infected mothers and to determine whether such children present auditory disorders or poor acquisition of the ability to localize sound. The population studied included 143 children (82 males and 61 females), ranging in age from one month to 30 months. The children were divided into three groups according to the classification system devised in 1994 by the Centers for Disease Control and Prevention: infected; seroreverted; and exposed. The children were then submitted to audiological evaluation, including behavioral audiometry, visual reinforcement audiometry and measurement of acoustic immittance. Statistical analysis showed that the incidence of auditory disorders was significantly higher in the infected group. In the seroreverted and exposed groups, there was a marked absence of auditory disorders. In the infected group as a whole, the findings were suggestive of central auditory disorders. Evolution of the ability to localize sound was found to be poorer among the children in the infected group than among those in the seroreverted and exposed groups.

Audiologia do envelhecimento: revisão da literatura e perspectivas atuais / Audiology and aging: literature review and current horizons

OBJETIVO: Revisar a literatura sobre a perda auditiva associada ao envelhecimento e suas implicações, numa perspectiva atual. REVISÃO DA LITERATURA: Nos estudos realizados no Brasil, a presbiacusia vem sendo apontada como causa mais freqüente da deficiência auditiva em pessoas idosas, implicando em uma dificuldade de compreensão durante a comunicação verbal. Estudos internacionais também mostram alta prevalência da perda auditiva em pessoas idosas. DISCUSSÃO: Segundo pesquisas recentes, à medida que o quantitativo da população idosa vem aumentando, também aumenta a prevalência da presbiacusia que interfere na qualidade de vida do idoso. Mesmo entre os profissionais de saúde, ainda é grande o desconhecimento em relação às vantagens e ganhos que a reeducação auditiva específica para idosos com perda auditiva pode oferecer. CONCLUSÃO: Os artigos aqui analisados mostraram que os serviços de saúde da rede pública, que envolvem médicos e fonoaudiólogos, devem estabelecer diretrizes para o desenvolvimento de programas de diagnóstico, aquisição de aparelhos de amplificação sonora individual e, principalmente, de reeducação auditiva para os idosos portadores de presbiacusia, para que eles possam participar e desfrutar das relações sociais, mantendo uma boa qualidade de vida. Entretanto, no Brasil, os estudos e pesquisas nesta área estão apenas começando.

AIM: to review the literature on aging-related hearing loss and its current impacts. LITERATURE REVIEW: In studies carried out in Brazil, presbycusis has been blamed for being the most frequent cause of hearing loss in the elderly, causing verbal communication impairment. International studies also show the high prevalence of hearing loss in the elderly. DISCUSSION: According to recent investigations, as the number of elderly people increase, the prevalence of presbycusis interfering in the life quality of this population also increases. Even among health care professionals, there is a huge lack of knowledge about the advantages and gains a specific hearing reeducation can bring about for the elderly with hearing impairment. CONCLUSIONS: the papers hereby analyzed showed that the public health care centers with physicians and speech and hearing therapists, should establish the guidelines for the development of diagnostic programs, purchase of hearing aids and, most specially, hearing reeducation for the elderly with presbycusis, so that they may enjoy their social relations, and thus enhance their life quality. However, in Brazil, studies and research in this area only beginning.