Ocular Toxicity of Ethambutol During Both Intensive and Continuation Phases of Anti-Tubercular Therapy in Children

Objective: The study was conducted to evaluate the ocular toxicity of ethambutol given in both intensive and continuation phases of treatment in children with drug-sensitive tuberculosis. Methods: A prospective study of 94 eyes from 47 patients receiving an ethambutol-containing regimen was conducted between 1 December, 2018 and 31 August, 2020. Visual acuity, visual field, visual evoked response (VER), contrast sensitivity, colour perception, and retinal nerve fiber layer (RNFL) thickness [using optical coherence tomography (OCT)] were tested for each patient before, during, and after the treatment. Results: On follow-up, visual acuity, color vision, contrast sensitivity, fundus, and visual fields were not affected in any of the patients. There was no statistically significant increase in the mean latency of the P(100) wave at any point in time. On OCT, no significant loss of mean RNFL thickness was detected. Conclusions: Ethambutol is safe to use up to a dose of 20 mg/kg/day throughout the entire course of anti-tubercular therapy in children with drug-sensitive tuberculosis

Auditory brainstem response in type 2 diabetes mellitus patients

Background: Diabetes is a chronic metabolic disorder and its complications pose a significant healthcare burden. Basic pathophysiology of diabetic complications is angiopathy leading to neuropathy. Angiopathy of small vessels of cochlea and neuropathy of cochlear nerve may lead to hearing impairment. Aim and Objectives: The present study was taken up with an objective to evaluate the changes in the auditory brainstem evoked potentials in type 2 diabetic patients leading to hearing loss compared to healthy controls. Materials and Methods: A total of 40 subjects in the age group of 40–60 were enrolled into the study and were categorized into 2 groups of 20 each. In the Group 1, age- and sex-matched healthy controls were included and in the Group 2 subjects with type 2 diabetes of more than 5 years duration were included in the study. Any hearing impairment caused by a known disease, drug or injury either traumatic, iatrogenic or noise induced were excluded from the study. They were subjected to auditory brainstem response test Brainstem evoked response audiometry. Absolute latency of wave I-V and interpeak latencies (IPL) I-III, III-V, and I-V was recorded. The data obtained were evaluated using VassarStats. Results: There was no significant difference in the wave latency of wave I and II between the groups; however, the latencies of waves III, IV, and V was higher in the diabetic group compared to controls on both right and left ear stimulation and it was statistically significant. With respect to the IPL comparison, it was observed that IPL I-III, III-V, and I-V were significantly increased in diabetics with both right and left ear stimulation were statistically significant on comparison with the controls. Conclusion: The delayed transmission of the auditory pathway at the level of brainstem and midbrain observed in the study advocates the presence of central neuropathy in patients with type 2 diabetes mellitus.

Pure-Tone Hearing Thresholds and Brainstem Auditory Evoked Potentials in Sporadic Ataxia

Abstract Introduction Spinocerebellar ataxia (SCA) is part of a genetic and clinical heteroge- neous group of neurodegenerative diseases characterized by progressive cerebellar ataxia. Objective To describe the results of audiological and electrophysiological hearing evaluations in patients with sporadic ataxia (SA). Methods A retrospective cross-sectional study was carried out with 11 patients submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, tonal and vocal audiometry, acoustic immittance and brainstem auditory evoked potential (BAEP) tests. Results The patients presented with a prevalence of gait imbalance, of dysarthria, and of dysphagia; in the audiometric and BAEPs, four patients presented with alterations; in the acoustic immittance test, five patients presented with alterations, predominantly bilateral. Conclusion The most evident alterations in the audiological evaluation were the prevalence of the descending audiometric configuration between the frequencies of 2 and 4 kHz and the absence of the acoustic reflex between the frequencies of 3 and 4 kHz bilaterally. In the electrophysiological evaluation, the patients presented changes with a prevalence of increased I, III and V wave latencies and the interval in the interpeak I-III, I-V and III-V. In the present study, it was observed that auditory complaints did not have a significant prevalence in this type of ataxia, which does not occur in some types of autosomal recessive and dominant ataxia.

A Comparative Study on Brain Stem Evoked Response Audiometry among Pre-school Children with Normal and Delayed Development of Speech Attending Bankura Sammilani Medical College

Introduction: The main consequence of hearing loss,especially in children, is the impact caused by sensorydeprivation in the development of auditory and languageskills and learning. Any degree of hearing loss can resultin significant damage, as it interferes with perception andunderstanding of speech sounds.This proposed descriptivecross sectional study tries to compare BERA parametersbetween normal and delayed speech/language impairmentchildren. Study also examines possible abnormalities inBERA in children with speech and language impairment.Material and Methods: One descriptive study withcross-sectional design was conducted in neurophysiologylaboratory in the Department of Physiology, BankuraSammilani Medical College and Hospital for one year.About106 pre-school children (1 to below 6years) of eithersex were selected from those referred from Paediatric andENT Department with complaint of delayed speech who hadbeen advised BERA test. About 105 children without havingdelayed speech development were chosen randomly.Results: Descriptive analysis was done of BERA parametersamong all subjects. Mean and standard deviation of both maleand female were calculated separately. Independent ‘t’ testwas done between the BERA parameters of normal childrenand children diagnosed with speech impairment. The testshowed significant changes (p value <0.05) in waves I, IIIlatency, I-III, I-V, III-V inter peak in study subject.Conclusion: The brainstem speech evoked auditory responsescan serve as an efficient tool in identifying underlying auditoryprocessing difficulties in children with learning disability andcan help in early intervention.

Targeted Newborn Hearing Screening: A Hospital based Observational Study

Introduction: Hearing is an important factor in the processof learning to talk. Speech and hearing is important fordevelopment of interpersonal relationships. Index study aimsto screen high risk newborn for hearing loss by Transientevoked oto-acoustic emission (TEOAE) and Auditory brainstem evoked Response (ABER) technique and to identify therisk factor associated with hearing loss in neonates.Material and Methods: A total of 105 high risk neonates wererandomly selected from NICU of this hospital after stabilizingtheir clinical condition. All the neonates have undergoneTransiently evoked otoacoustic emissions. Neonates whopassed transiently evoked otoacoustic emissions test weresubjected to Auditory Brainstem Evoked Response (ABER)test for confirming the diagnosis of hearing loss.Results: Hearing assessment done in all 105 neonates anda total of 9 neonates were reported to be having hearingabnormalities, out of these 5 newborns had conductive hearingloss and 4 had sensorineural hearing loss. Low Birth weightand mechanical ventilation were observed significantlyassociated with diagnosis of hearing loss. No significantassociation of hearing loss was reported with gestational age,sex, infection, and associated diseases.Conclusion: Low Birth weight and mechanical ventilatorsupport were significantly associated with hearing loss.

Neonatal hearing screening- time to make a noise- experience from a private medical college in South Rajasthan

Background: Neonatal Hearing Loss has a prevalence that is twice than that of disorders like congenital hypothyroidism, phenyl ketonuria etc. Early detection of hearing impairment is vital since early intervention in form of hearing aids and speech therapy would help lead a child a normal life. The aim of the study was to set up a neonatal hearing screening program and to study the various risk factors which could be associated with hearing loss.Methods: The prospective descriptive study was carried over a period of two years. All neonates before being discharged were subjected to OAE. OAE was done on Oto Read Machine (Intra acoustic) and BERA was done on BERA eclipse machine (Intra acoustic). Babies who failed the first OAE were called back for a repeat OAE at six weeks of age. Babies who failed the second OAE were referred to a trained audiologist for BERA which was performed on BERA Eclipse machine.Results: Out of 1114 neonates screened, 285 neonates failed the first OAE and were called back at six weeks for repeat OAE. Out of the 285 babies who were called for repeat OAE, 258 turned up 27(9.47%) were lost to follow up. Out of the 258 babies who turned up, 245 passed the test while 13 failed the test. 13 Babies who had failed the second OAE screening were called back 1 month later for BERA testing. Out of the 13 babies who turned up for BERA testing, 12 passed the test and 1 failed giving us a prevalence of 0.89 per 1000 population. Of the various risk factors studied only low birth weight was found to be having significant association with hearing loss.Conclusion: Neonatal hearing screening is the need of the hour. Larger multi centric studies are required to establish the prevalence of hearing impairment among newborns.

Universal hearing screening in newborns: experience in a tertiary care hospital of Mangalore, Karnataka, India

Background: The aim of the study was to do universal hearing screening of all newborns using otoacoustic emission (OAE), to know the incidence and risk factors of hearing loss in neonates.Methods: This was a prospective observational study done in a tertiary care hospital in Mangalore city in Karnataka. 950 neonates were screened with distortion product otoacoustic emission (DPOAE) during the study period of one year from 2017 to 2018. A repeat test was done at one and a half months of age if the first test failed. Auditory brain stem evoked response (ABER) was performed at 3 months of age if both the tests failed. Babies with hearing loss were referred to ENT specialist for further management. Comparison of the variables was done by student's t test and Chi-square test. P-value <0.05 was considered statistically significant.Results: Out of the 950 newborns screened with DPOAE test, 204 (21.4 %) babies had abnormal screen either in single or both ears. 7 out of 204 (3.43%) babies had abnormal OAE on repeat testing at one and half months. 2 out of 7 babies (0.96 %) had significant hearing loss ABER was performed at 3 months of age.Conclusions: Early identification by screening of hearing loss prevents a significant public health concern. Early recognition and intervention prior to 6 months have a significant positive impact on development.

Finding out incidence of deafness among neonates at a tertiary care centre of western Rajasthan, India using otoacoustic emission

Background: Newborn hearing screening is conducted to identify suspected hearing loss and not to confirm the presence/absence of hearing loss or define features of the loss. Speech and hearing are interrelated, i.e., a problem with one could mean a problem with the other as speech and language is acquired normally through auditory system.Methods: A descriptive study conducted in the Department of Paediatrics, Dr. S. N. Medical College, Jodhpur, from June 2016 to December 2017. 5000 neonates were screened using otoacoustic emissions (OAE) in 2 stages at birth during 3rd to 7th day and 15-30 days respectively, followed by BERA at 3 months of age.Results: 1.4 infants per thousand infants had hearing loss. Presence of high-risk factors was seen to be associated be associated with hearing loss more than normal infants on screening with distortion product otoacoustic emissions (DPOAE) tests. However, on testing with BERA no such association was seen.Conclusions: 1.4 per 1000 infants had hearing loss. This study has shown that two stage distortion product otoacoustic emissions (DPOAE) hearing screening followed by british educational research association '(BERA) to confirm the hearing deficit, can be successfully implemented as new born hearing screening method in a hospital set-up, for early detection of hearing impaired, on a large scale, to achieve the high-quality standard of screening programs in a resource limited and developing nation like India.

A Prospective Study Of The Hearing Loss In Global Developmental Delay Children

Background: Developmental disabilities are a group of related chronic disorders of early onset estimated to affect 5–10% ofchildren. Global developmental delay is a subset of developmental disabilities defined as a significant delay in two or more of thefollowing developmental domains: Gross/fine motor, speech/language, cognition, social/personal, and activities of daily living.Aim of the Study: The aim of this study was to describe the clinical profile and audiological profile in children with globaldevelopmental delay presenting to the pediatric ENT unit.Materials and Methods: The study sample size was a total of 121 children with global developmental delay. Children withcomplaints of global developmental delay underwent a detailed ENT examination including examination under microscope ofear which is the standard of care. Hearing loss was assessed by audiological tests such as behavioral observation audiometry(BOA), otoacoustic emission, brain stem evoked response audiometry (BERA), and tympanometry (Tymps). The degree ofhearing loss was classified using the American Speech-Language-Hearing Association classification.Observations and Results: Among 121 children with global developmental delay, there were 72 (59.5%) males. The meanage of the study group was 3.2 years. The youngest child in the study was 6 months old and the oldest child being 14 yearsold. 25 (20.6%) children participating in the study had syndromic association. Of 121 children, only 36 (29%) presented withspeech delay and suspected hearing loss. BOA done in 242 ears showed 56 (23%) ears with normal hearing, 68 (28%) withhearing loss, and inconsistent report in 38 (15.5%) ears. In the 80 remaining ears (33%), test could not be done.Conclusions: The mean age of referral was 3.2 years in global developmental delay children who were referred for theevaluation of speech delay. Among the 121 global developmental delay children included in the study, 36 (29%) had hearingloss with speech delay. Our study detected a higher incidence of undetected hearing loss of 144 ears (59.5%) in children withglobal developmental delay

Effects of Residual Hearing on the Auditory Steady State Response for Cochlear Implantation in Children

BACKGROUND AND OBJECTIVES: We aim to explore the effects of residual auditory steady state response (ASSR) on cochlear implantation (CI) outcomes in children lacking auditory brainstem responses (ABRs). SUBJECTS AND METHODS: We retrospectively reviewed the data of child CI recipients lacking ABRs. All ears were divided into two groups: with residual ASSR and without ASSR. For each frequency, the T- and C-levels and the electrical dynamic ranges of postoperative 3-month and 1-year mappings were compared between the groups. To evaluate speech perception, patients who received simultaneous bilateral CIs were divided into two groups: group 1 exhibited responses at all frequencies in both ears; in group 2, at least one ear evidenced no response. The Categories of Auditory Perception (CAP) and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores were compared between the groups. RESULTS: We enrolled 16 patients. At 2 kHz, the postoperative 3-month and 1-year T-levels of patients with residual hearing were lower than those of hearing loss group (p=0.001, p=0.035). In residual hearing group, the ASSR threshold correlated positively with the postoperative 1-year T-level (p=0.012, R² =0.276) and C-level (p=0.002, R² =0.374). Of 10 simultaneous bilateral CI recipients, 5 exhibited ASSRs at all frequencies and the other 5 showed no response at ≥1 frequency. The latter had higher CAP scores at the postoperative 1-year (p=0.018). CONCLUSIONS: In children exhibiting hearing loss in ABR testing, residual hearing at 2 kHz ASSR correlated positively with the post-CI T-level. Those with ASSRs at all frequencies had significantly lower CAP scores at the postoperative 1year. CI should not be delayed when marginal residual hearing is evident in ASSR.

Asymptomatic Hearing Impairment Frequently Occurs in Early-Onset Parkinson's Disease

OBJECTIVE: Recent reports of hearing impairment in Parkinson's disease (PD) have suggested that auditory dysfunction could be a non-motor manifestation of PD. These reports were based on observations of elderly patients for whom presbycusis may, to some extent, have contributed to hearing dysfunction. Therefore, we aimed to explore the auditory functions in younger patients with PD. METHODS: We conducted a case-control study in a relatively younger (< 55 years of age at study time) population of PD patients and healthy volunteers to test whether auditory dysfunction is a significant non-motor dysfunction in PD. Pure tone audiometry (PTA) and brainstem evoked response audiometry (BERA) were performed in all participants. RESULTS: None of the patients or controls reported hearing deficits. Fifty-one patients with PD and 50 healthy volunteers who were age- and gender-matched to the patients participated. PTA-detected hearing impairment was found in 64.7% of patients and 28% of controls (p < 0.001) for both low-mid and/or high frequencies. Hearing impairment was more frequent in the younger subgroups of patients than age-matched controls, while the frequency of hearing impairment was similar in older groups of subjects. BERA was not different between patients and controls. CONCLUSION: Asymptomatic auditory dysfunction is a common non-motor manifestation of early-onset PD and more frequent in younger patients, indicating that it may be independent of aging. The mechanism underlying this dysfunction appears to be peripheral, although a central dysfunction cannot be ruled out based on the findings of this study.

Applicability of Evoked Auditory Brainstem Responses with Complex Stimuli in Adults with Hearing Loss

Abstract Introduction The use of the speech-evoked auditory brainstem response (ABR) shows how the brainstem operates up to the subcortex in a more complexmanner than when the click-evoked ABR is used. Objective To study the applicability of the speech-evoked ABR in adults with hearing loss. Methods The sample was composed of a study group of 11 subjects, with ages ranging between 18 and 59 years, and auditory thresholds within normal standards, with loss of up to 65 dB at high frequencies or up to moderately severe symmetric sensorineural hearing loss. The sample underwent a basic audiological assessment, as well as speech-evoked ABR and click-evoked ABR, in which waves I, III and V, and V, A, C, D, E, F were respectively marked. The electrophysiological assessments were performed using the SmartEP device (Intelligent Hearing Systems, Miami, FL, US). Results For the speech-evoked ABR, the reference values were used in the identification and analysis of the study group. Those values found for the study group were: V = 8.56; A = 10.97; C = 21.33; D = 29.51; E = 37.93; F = 46.96; and O = 55.97. In the comparison between groups, the study group presented an increase in latency only in wave C. Conclusion The speech-evoked ABR can be performed in subjects with up to moderately severe hearing loss, and the test proved to be appropriate, because, unlike the click-evoked ABR, the former does not suffer influence of peripheral hearing loss.

Análise da diferença entre os limiares auditivos comportamentais e os resultados obtidos através do exame potencial evocado auditivo de estado estável (PEAEE) em adultos jovens / Analysis of difference between the behavioral hearing thresholds and the results obtained through the auditory steady state response (ASSR) in young adults / Análisis de la diferencia entre los umbrales auditivos comportamentales y los resultados obtenidos a través del examen potencial evocado auditivo de estado estable (PEAEE) en adultos jóvenes

Introdução: A audição, sentido que nos permite receber a informação sonora, se apresenta como um dos facilitadores para uma interação social eficaz. Um déficit nessa função acarreta prejuízo no processo comunicativo, devendo ser diagnosticado e tratado precocemente. Atualmente dispomos de meios subjetivos e objetivos para avaliar o sistema auditivo. A audiometria tonal é a forma subjetiva mais aplicada para medir esse sentido. Entretanto, em populações impossibilitadas de responder subjetivamente, aplicam-se técnicas objetivas, como o Potencial Evocado Auditivo de Estado Estável. Ambos pesquisam respostas auditivas do sujeito sob teste, utilizando técnicas distintas. Objetivo: Avaliar adultos jovens, sem queixas auditivas, pesquisando a sensibilidade auditiva e, a partir de indicadores estatísticos, calcular as médias das diferenças das respostas obtidas nesses procedimentos, verificando se há correlação entre eles. Método: Pesquisa de respostas auditivas via Audiometria Tonal e Potencial Evocado Auditivo de Estado Estável, nas frequências de 500, 1000, 2000 e 4000 Hz, em 30 sujeitos normo-ouvintes. Resultados: Ao calcularmos a média das diferenças entre as frequências testadas nos dois procedimentos, elas variaram de 10,47 a 18,22, não havendo forte correlação em nenhuma delas, deixando dúvidas na frequência de 1000 Hz. Conclusão: Podemos dizer que as médias das diferenças entre os valores obtidos nos dois procedimentos foram razoavelmente elevadas, principalmente em 500 Hz e, em menor proporção, para 4 kHz. Os valores obtidos nos dois exames, embora não tenham apresentado forte correlação, apresentaram-se discretamente melhores para 500 Hz. Resultados de 1000 Hz não nos permitem afirmar, inclusive, se existe alguma correlação entre os testes.

Introduction: Hearing is the sense which allows us to receive auditory information; therefore it facilitates efficient social interaction. Any loss in this function damages the communicative process, so it must be diagnosed and treated as soon as possible. Nowadays, both objective and subjective hearing tests are available. Pure Tone Audiometry is the most widely used subjective way to evaluate this sense. However, for those who are unable to respond subjectively, we can try objective techniques like the Auditory Steady State Response. Both will search for patients' minimum hearing responses, applying different approaches. Objective: To evaluate normal-hearing young adults with no hearing complaints by analyzing their hearing sensibility and, based on statistical indicators, calculate the average of the differences between the results obtained in both procedures in order to verify the existence of correlation between them. Method: We studied the hearing responses from 30 normal-hearing subjects through Pure Tone Audiometry and Auditory Steady State Response at 500, 1000, 2000 and 4000 Hz. Results: When we calculated the average of the differences between the tested frequencies, they ranged from 10,47 to 18,22 with no strong correlation, except at 1000 Hz whose results were uncertain. Conclusion: We concluded that the average of the differences of hearing values obtained in Pure Tone Audiometry and Auditory Steady State Response were reasonably elevated mainly at 500 Hz, and at a lower level at 4000 Hz. Although the scores obtained in both tests had not shown strong correlation, they were slightly better at 500 Hz. The results for 1000 Hz are inconclusive regarding any existing correlation between these two tests.

Introducción: La audición, sentido que nos permite recibir la información sonora, se presenta como uno de los facilitadores para una interacción social eficaz. Un déficit en esta función acarrea perjuicio en el proceso comunicativo, lo que debe ser diagnosticado y tratado lo antes posible. Actualmente disponemos de medios subjetivos y objetivos para evaluar el sistema auditivo. La audiometría tonal es la forma subjetiva más aplicada para medir ese sentido. Sin embargo, en poblaciones imposibilitadas de responder subjetivamente, se aplican técnicas subjetivas como el Potencial Evocado Auditivo de Estado Estable. Ambas investigan las respuestas auditivas del sujeto bajo test, utilizando técnicas distintas. Objetivo: Evaluar a adultos jóvenes, sin quejas auditivas, investigando la sensibilidad auditiva y, a partir de los indicadores estadísticos, calcular los promedios de la diferencias de las respuestas obtenidas en esos procedimientos, y comprobar si existe correlación entre ellos. Método: Pesquisa de respuestas auditivas vía Audiometría Tonal y Potencial Evocado Auditivo de Estado Estable en las frecuencias de 500,1000, 2000 y 4000 Hz, en 30 sujetos oyentes normales. Resultados: Tras el cálculo del promedio de las diferencias entre las frecuencias testadas en los dos procedimientos, se pudo verificar una variación de 10,47 a 18,22, donde no se ha registrado fuerte correlación en ninguna de ellas, dejando duda en la frecuencia de 1000 Hz. Conclusión: Podemos decir que los promedios de las diferencias entre los valores obtenidos en los dos procedimientos fueron razonablemente elevados, sobre todo en 500 Hz y, en menor proporción, para 4kHz. Los valores que se obtuvieron en los dos exámenes, aunque no hayan presentado fuerte correlación, se presentaron discretamente mejores para 500 Hz. Resultados de 1000 Hz no nos permiten afirmar, incluso, si hay alguna correlación entre los testes.

Evaluation of Brainstem Auditory Evoked Response (BAER) in Parkinson’s Disease

Background: Parkinson’s disease (PD) is a progressive long-term, neurodegenerative disorder of central nervous system which mainly affects the motor system, caused by loss of dopaminergic neurons in the substantia nigra, but also in other dopaminergic and non-dopaminergic areas of the brain and mainly in the brainstem. Brainstem Auditory Evoked Response are routinely used in clinical practice to evaluate the function of the auditory nerve and auditory pathways in the brainstem. Objective: The aim of this study was to evaluate the Brainstem Auditory Evoked Response in patients with Parkinson’s disease. Methods30 subjects (18 males and 12females) with Parkinson’s disease. And same number of healthy age-matched subject control group was assessed. Age of Control Group was 61.2±11.6 & of Test Group 61.7±10.4. A complete & detailed neurological examination (CNS) were performed in all individuals clinically especially of motor system to evaluate the severity of the disease for the occurrence of Parkinson’s disease. Recordings of BAERs were performed with Neurostim Plus software of Medicaid Company, using 70 dB HL in the form of rarefaction clicks were used in each ear obtain good quality BAER recording. Results. The BAER results were interpreted for the latencies and Interpeak latencies. The result of this study shows that the waves II, III, IV, V and IPL III-V were significantly delayed. Conclusion. Parkinson’s disease population showed significant differences to Brainstem Auditory Evoked Response

Statistical non-parametric mapping in sensor space

Establishing the significance of observed effects is a preliminary requirement for any meaningful interpretation of clinical and experimental Electroencephalography or Magnetoencephalography (MEG) data. We propose a method to evaluate significance on the level of sensors whilst retaining full temporal or spectral resolution. Input data are multiple realizations of sensor data. In this context, multiple realizations may be the individual epochs obtained in an evoked-response experiment, or group study data, possibly averaged within subject and event type, or spontaneous events such as spikes of different types. In this contribution, we apply Statistical non-Parametric Mapping (SnPM) to MEG sensor data. SnPM is a non-parametric permutation or randomization test that is assumption-free regarding distributional properties of the underlying data. The method, referred to as Maps SnPM, is demonstrated using MEG data from an auditory mismatch negativity paradigm with one frequent and two rare stimuli and validated by comparison with Topographic Analysis of Variance (TANOVA). The result is a time- or frequency-resolved breakdown of sensors that show consistent activity within and/or differ significantly between event or spike types. TANOVA and Maps SnPM were applied to the individual epochs obtained in an evoked-response experiment. The TANOVA analysis established data plausibility and identified latencies-of-interest for further analysis. Maps SnPM, in addition to the above, identified sensors of significantly different activity between stimulus types.

Study of brainstem auditory evoked response in type 2 diabetes mellitus.

Background: Diabetes is a major cause of morbidity and among its complications neuropathies are the most common. Diabetes may alter both the central and peripheral nerve functions but the peripheral manifestations of diabetic neuropathy are more frequently discussed in the literature than the impairment of central nervous system. Objective: To study the Brainstem Auditory Evoked Response (BAER) in 30 type 2 diabetes mellitus patients and compared to age and sex matched 30 non diabetic group. Methods: 30 Type 2 diabetics and 30 age and sex matched control group were selected and subjected to BAER. Duration of latencies, interpeak latencies and amplitudes were recorded. Results: According to BAER report, Left side latencies III , both left and right IPL III – V , right side ampliude V decreased with p > 0.05 in type 2 DM compared to control group . Conclusion: The study showed bilateral changes in BAER report in type 2 DM. This indicates use of evoked potentials like BAER helps in evaluating central neuropathy in patients with type2 DM. Earlier diagnosis of central neuropathy is recommended for proper management.

Comparison between Pure Tone Audiometry and Auditory Steady-State Responses in Korean Children and Adult / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Assessing accurate audiometry might be an important index treating patients with hearing loss. So far there have been no studies on analysis of correlations between pure tone audiometry (PTA) and auditory steady-state response (ASSR) for children in Korea. We analyzed correlations between PTA and ASSR in order to investigate the usefulness of ASSR. SUBJECTS AND METHOD: Past medical records were retrieved from the patients who visited Department of Otolaryngology at Tertiary Referral Hospital from January 2012 to December 2012 and underwent the correlation study between ASSR and PTA with a correlation analysis of frequency. The participants over the age of 15 were classified into the adult group and those below in the children group. RESULTS: There was a statistically significant correlation between the average hearing threshold of ASSR and PTA (correlation coefficient=0.934). There was a strong correlation between children and adult group, too. With the frequency range of 500, 1000, 2000, and 4000 Hz, the correlation coefficients were 0.875, 0.896, 0.915, and 0.900, respectively. The degree of hearing loss was classified by using PTA follows: below 25 dB as normal; between 26-55 dB as moderate hearing loss; above 56 dB as severe hearing loss. Correlation coefficients for the above hearing ranges were 0.527, 0.670, and 0.744, respectively. Strong correlation was found between children and adult group, too. CONCLUSION: The comparison results between the average hearing threshold of ASSR and PTA indicated that the threshold of ASSR could well reflect the results of both children and adult group.

Electrocochleography for Ménière's disease: is it reliable?, / Eletrococleografia na doença de Ménière: é confiável?,

Introduction: Endolymphatic hydrops, the histopathological substrate of Ménière's disease, is an almost universal finding in postmortem studies of patients with this disease. The cause of hydrops is still unknown, as is the mechanism by which it causes progressive dysfunction of the sensory organs of inner ear. The fluctuating course of the disease complicates the interpretation of certain tests, such as electrocochleography; thus, for some authors its diagnostic value is questionable. Objective: The aim of this study was to analyze the clinical applicability of electrocochleography in the diagnosis of hydrops. It is a valuable tool, but still generates conflicting opinions among otolaryngologists. Methods: Systematic review of the literature on electrocochleography in patients diagnosed with endolymphatic hydrops. Results: A total of 34 articles regarding the use of electrocochleography in patients with hydrops, from the year 2000 onwards, were selected. Of these, 15 were excluded from the review as they were not observational studies. Only one cross-sectional study addressing the clinical use of electrocochleography by otolaryngologists was included. Conclusion: Electrocochleography is a valuable tool in the diagnosis of hydrops, as it is a non-invasive, easy to handle procedure, which offers new techniques to increase the sensitivity of the test, and thereby assists otolaryngologists in the management of Ménière's disease. .

Introdução: A hidropisia endolinfática é o substrato histopatológico e achado quase universal nos estudos post-mortem de pacientes com doença de Ménière. A causa da hidropisia ainda é desconhecida, assim como o mecanismo pelo qual causa disfuncção progressiva dos órgãos sensitivos da orelha interna. O curso flutuante da doença dificulta a interpretação de exames como a eletrococleografia, que apresenta, para alguns autores, valor diagnóstico controverso. Objetivos: O objetivo deste estudo é analisar a aplicabilidade clínica da eletrococleografia no diagnóstico da hidropisia endolinfática, sendo uma ferramenta de uso comum e que ainda gera opiniões conflitantes entre os otorrinolaringologistas. Método: Revisão sistemática da literatura sobre eletrococleografia em pacientes com diagnóstico de hidropisia endolinfática. Resultados: Foram selecionados 34 artigos sobre o uso da eletrococleografia em pacientes portadores de hidropisia endolinfática a partir do ano 2000; 15 artigos foram excluídos da revisão por não se tratarem de estudos observacionais, com inclusão de somente um estudo transversal que trata sobre o uso clínico da eletrococleografia entre os otorrinolaringologistas. Conclusão: A eletrococleografia é uma importante ferramenta no diagnóstico da hidropisia endolinfática, por ser não invasiva, de fácil mensuração, e por oferecer novas técnicas capazes de aumentar a sensibilidade do exame e auxiliar o otorrinolaringologista no tratamento da Doenca de Ménière. .

Potencial evocado auditivo de tronco encefálico por frequência específica por via aérea e via óssea em neonatos ouvintes normais / Air and bone-conduction frequency-specific auditory brainstem response in neonates with normal hearing

Objetivo determinar os níveis mínimos de resposta (NMR) e a latência da onda V do Potencial Evocado Auditivo de Tronco encefálico por Frequência específica (PEATE-FE) em neonatos ouvintes normais nas frequências de 0.5, 1, 2 e 4 kHz por via aérea e via óssea e determinar valores normativos. Métodos foram avaliados neonatos com audição normal, sendo realizado o PEATE-FE nas frequências de 0.5, 1, 2 e 4 kHz, tanto por via aérea (VA) quanto por via óssea (VO). Para cada frequência, foram avaliadas 12 orelhas em um total de 18 neonatos. A análise dos resultados avaliou o tempo de latência e a presença da onda V até a intensidade de 20 dBnNA para quatro intensidades e para os dois tipos de condução (aérea e óssea). Resultados observou-se aumento da latência da onda V com a diminuição da intensidade e maiores latências nas frequências mais baixas, tanto na VA quanto na VO. Porém, em fortes intensidades, em ambas condições, não houve diferença entre as latências de 0.5 e 1 kHz, contrariando os achados da literatura. Para VA, na frequência de 500 Hz, houve presença da onda V até 30 dBnNA em todas as orelhas, e em 1000 Hz, 11 orelhas (91,66 %) apresentaram resposta em 20 dBnNA; nas demais frequências, 100% das orelhas avaliadas apresentaram resposta em 20 dBnNA. Na VO, a presença da onda V em 20 dBnNA foi observada em todas as frequências estudadas. Conclusão os valores descritos podem ser considerados normativos e utilizados na clinica como padrão de normalidade, auxiliando no diagnóstico diferencial da perda auditiva ao nascimento. .

Purpose to determine the minimum response and the latency of V wave in the Frequency-specific auditory brainstem responses (FS-ABR) in normal hearing neonates at the frequencies: 0.5, 1, 2 and 4 kHz by air and bone conduction and to determine normative values. Methods normal hearing neonates were assessed with FS-ABR at 0.5, 1, 2 and 4 kHz, air and bone conduction. Twelve ears were assessed in each frequency, totalizing 18 neonates. Results analysis considered the latency and the presence of wave V until 20 dB nHL in air and bone conduction, for four intensities. Results it was observed an increase of wave V latency with the decrease of intensity, and greater latencies at lower frequencies in both air and bone conduction. Nevertheless, there was no difference between the latencies at 0.5 and 1 kHz with strong intensity stimuli in both conditions, contrasting to literature findings. Considering air conduction, wave V was present at 0,5 kHz at 30 dB nHL in all ears and at 1 kHz 11 ears (91,66%) presented it at 20 dB nHL. All subjects (100%) presented responses to the other frequencies at 20 dBn HL. Considering bone conduction, all subjects presented wave V at 20 dB nHL in all frequencies. Conclusion the found values can be used in clinical practice in order to guide the differential diagnosis of hearing loss, complementing the evaluation as for hearing neonates. .

Auditory evoked potentials: predicting speech therapy outcomes in children with phonological disorders

OBJECTIVES: This study investigated whether neurophysiologic responses (auditory evoked potentials) differ between typically developed children and children with phonological disorders and whether these responses are modified in children with phonological disorders after speech therapy. METHODS: The participants included 24 typically developing children (Control Group, mean age: eight years and ten months) and 23 children clinically diagnosed with phonological disorders (Study Group, mean age: eight years and eleven months). Additionally, 12 study group children were enrolled in speech therapy (Study Group 1), and 11 were not enrolled in speech therapy (Study Group 2). The subjects were submitted to the following procedures: conventional audiological, auditory brainstem response, auditory middle-latency response, and P300 assessments. All participants presented with normal hearing thresholds. The study group 1 subjects were reassessed after 12 speech therapy sessions, and the study group 2 subjects were reassessed 3 months after the initial assessment. Electrophysiological results were compared between the groups. RESULTS: Latency differences were observed between the groups (the control and study groups) regarding the auditory brainstem response and the P300 tests. Additionally, the P300 responses improved in the study group 1 children after speech therapy. CONCLUSION: The findings suggest that children with phonological disorders have impaired auditory brainstem and cortical region pathways that may benefit from speech therapy. .