Electroacoustic and electrophysiological auditory assessment in aphasic individuals / Avaliação eletroacústica e eletrofisiológica da audição em indivíduos afásicos

ABSTRACT Purpose: to verify the functioning of the outer hair cells and the medial efferent olivocochlear system, and the integrity of the auditory pathways in the brainstem up to the auditory cortex, in aphasic individuals. Methods: the sample comprised 20 individuals - 10 without aphasia and 10 with it, aged from 21 to 58 years. The procedures used were the research of the otoacoustic emissions by a transient stimulus with and without noise, and the cognitive potential (tone-burst and speech stimuli). The findings were analyzed based on descriptive statistics. Results: the suppression effect was more present in individuals without aphasia when compared with the aphasic ones. In the cognitive potential, the mean latency values of P3 was within normality standards, with a higher latency in the individuals presented with aphasia for the tone-burst stimulus in both ears. A statistically significant difference of the P3-N2 amplitude was observed for the tone-burst stimulus, comparing the ears in both groups, and for speech stimulus only to the left ear in both groups. Conclusions: aphasic individuals did not present significant differences regarding suppression of the otoacoustic emissions. As for the cognitive potential, the aphasic individuals presented higher latency values when compared to those with no aphasia.

RESUMO Objetivos: verificar o funcionamento das células ciliadas externas e do sistema olivococlear eferente medial e a integridade das vias auditivas no tronco encefálico até o córtex auditivo, em indivíduos afásicos. Métodos: a amostra foi composta por 20 indivíduos, sendo 10 indivíduos sem afasia e 10 indivíduos afásicos, com idades entre 21 e 58 anos. Os procedimentos utilizados foram: pesquisa das emissões otoacústicas por estímulo transiente sem e com ruído, e potencial cognitivo (estímulo toneburst e de fala). Os achados foram analisados a partir da estatística descritiva. Resultados: o efeito de supressão esteve mais presente nos indivíduos sem afasia quando comparado com os afásicos. No potencial cognitivo, o valor médio das latências P3, mostrou-se dentro dos padrões da normalidade com maior latência nos indivíduos com afasia para o estímulo toneburst em ambas as orelhas. Observou-se diferença estatisticamente significante da amplitude P3-N2 para o estímulo toneburst, comparando as orelhas em ambos os grupos, e para o estímulo de fala apenas à orelha esquerda em ambos os grupos. Conclusões: indivíduos afásicos não apresentaram diferenças significantes quanto à supressão das emissões otoacústicas. Quanto ao potencial cognitivo, os indivíduos afásicos apresentaram maior valor de latência em relação aos indivíduos sem afasia.

Emissões otoacústicas em recém-nascidos com hipóxia perinatal leve e moderada / Otoacoustic emissions in newborns with mild and moderate perinatal hypoxia

RESUMO Introdução Atualmente, somente a hipóxia neonatal grave (evidenciada pelo valor do Apgar) é considerada risco para a deficiência auditiva. A hipóxia é uma das causas mais comuns de lesão e morte celular. Nos casos de hipóxia leve ou moderada, embora menor, a privação da oxigenação está presente e, dessa forma, algum dano ao sistema auditivo pode ocorrer. Objetivo Investigar as amplitudes das emissões otoacústicas em recém-nascidos a termo sem risco para deficiência auditiva que apresentaram hipóxia leve ou moderada. Métodos Foram selecionados 37 recém-nascidos de ambos os sexos, divididos em dois grupos: 25 do grupo controle, formado por recém-nascidos sem hipóxia, e 12 do grupo estudo, formado por recém-nascidos com hipóxia leve ou moderada. Resultados Foram pesquisadas as EOAT e EOAPD em ambos os grupos e comparados os seus resultados. Nas EOAPD foram encontradas diferenças estatísticas entre as amplitudes nas frequências 1.000, 2.800, 4.000 e 6.000 Hz. Nas EOAT foram encontradas diferenças estatísticas nas bandas de frequência de 1.000, 1.400, 2.000, 2.800 e 4.000 Hz, sendo as EOA do grupo estudo menores que as do grupo controle. Conclusão Embora a ocorrência de hipóxia neonatal leve e moderada não seja considerada risco para perda auditiva, a mínima privação do oxigênio durante o momento de hipóxia neonatal parece interferir no funcionamento das células ciliadas externas e, consequentemente, no nível de respostas das emissões otoacústicas. Dessa forma, faz-se necessário o acompanhamento longitudinal desses lactentes, a fim de identificar o possível impacto desses resultados na aquisição de linguagem e, futuramente, no desempenho escolar.

ABSTRACT Introduction Severe neonatal hypoxia (as evidenced by the Apgar value) is currently considered the only risk for hearing loss. Hypoxia is one of the most common causes of injury and cell death. The deprivation of oxygen in mild or moderate cases of hypoxia, although smaller, occurs and could cause damage to the auditory system. Objective To investigate the amplitude of otoacoustic emissions in neonates at term with mild to moderate hypoxia and no risk for hearing loss. Methods We evaluated 37 newborns, divided into two groups: a control group of 25 newborns without hypoxia and a study group of 12 newborns with mild to moderate hypoxia. TEOAE and DPOAE were investigated in both groups. Results The differences between groups were statistically significant in the amplitude of DPOAE at the frequencies of 1000, 2800, 4000 and 6000 Hz. In TEOAE, statistically significant differences were found in all tested frequency bands. OAE of the study group were lower than those in the control group. Conclusion Although the occurrence of mild and moderate neonatal hypoxia is not considered a risk factor for hearing loss, deprivation of minimum oxygen during neonatal hypoxia seems to interfere in the functioning of the outer hair cells and, consequently, alter the response level of otoacoustic emissions. Thus, hese children need longitudinal follow-up in order to identify the possible impact of these results on language acquisition and future academic performance.

Changes of Cochlear Nerve Terminals after Temporary Noise-Induced Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Overexposure to intense sound can cause temporary or permanent hearing loss. Post-exposure recovery of thresholds has been assumed to indicate reversal of damage to the inner ear without persistent consequences for auditory function. However, there was a report that acoustic overexposures causing moderate temporary threshold shift caused acute loss of afferent nerve terminals and delayed degeneration of the cochlear ganglion cells while cochlear sensory cells were intact. The purpose of the study was to evaluate the numerical changes of ribbon synapses and efferents to the outer hair cells in ears with temporary noise-induced threshold shifts. MATERIALS AND METHODS: Four-week old CBA mice with normal Preyer's reflexes were used. Mice were exposed to white noise of 110 dB SPL for one hour. Auditory brainstem response (ABR) and distortion-product otoacoustic emission (DPOAE) were recorded before exposure and at four different post-exposure times, 1, 3, 5, and 7 days after noise exposure. Ribbon synapses and efferents near cochlear nerve terminals were stained and calculated in the control group mice at two post-exposure times, 3 and 5 days after the exposure. RESULTS: In the noise-exposed ears, there was no loss of hair cells, in either inner hair cells or outer hair cells. ABR and DPOAE showed maximum threshold shifts after noise-exposure; they returned to the normal pre-exposure values by at day 5. The number of ribbon synapses tended to decrease at 3 days after noise-exposure, but the number of efferent fibers was not statistically different from those of the control mice. CONCLUSION: Our results suggest that the loss of ribbon synapses could be related with the recovery course of temporary threshold shift, even to the point of full hearing recovery.

Apoptosis Progression in the Hair Cells in the Organ of Corti of GJB2 Conditional Knockout Mice

OBJECTIVES: Apoptosis may play an important role in the mechanism underlying the GJB2 gene conditional knockout (cCx26) mice cochlear cell death. The objective of this study was to explore the the damage mode of the outer hair cells (OHCs) and its real time point of apoptosis and provide information to further explore the role of apoptosis in the happening of hearing loss in cCx26 mice. METHODS: Cochleae from mice at various developmental stages (P8, P12, and P21) were dissected out and first used to be observed under the scanning electron microscope (SEM). Basilar membranes from mice at P8, P14, P18, and P21 were stained by fluorescein isothiocyanate-conjugated phalloidin and propidium iodide (PI) and examined under confocal microscope. RESULTS: The loss of OHCs of cCx26 knockout mice was first set between P12 and P21 under SEM. Whole mount phalloidin and PI staining revealed that obvious apoptotic appearance of the OHCs surface morphology was observed at P18. CONCLUSION: Typical apoptotic morphology was found in the OHCs in the organ of Corti of the cCx26 mice at P18. This may provide information to further study the role of apoptosis in the occurrence of hearing loss of cCx26 mice.

Alterações auditivas da exposição ocupacional em músicos / Auditory alterations for occupational exposition in musicians

Introdução: A exposição à música tornou-se interesse entre os especialistas em audição e acústica, uma vez que está relacionada à atividade profissional e social e à alta prevalência da Perda Auditiva. Objetivo: Investigar a saúde auditiva de músicos. Método: Fizeram parte do estudo 30 músicos, os quais foram submetidos à entrevista específica, audiometria tonal convencional e de altas freqüências, timpanometria e emissões otoacústicas evocadas transiente e por produto de distorção. Resultado: 17% dos sujeitos apresentaram audiograma sugestivo de Perda Auditiva Induzida por Ruído, 7% normal com entalhe e 7% com outras configurações. A média dos limiares das freqüências de 3, 4 e 6kHz mostraram-se com maior nível de intensidade quando comparada com a de 500, 1 e 2kHz; assim como a média dos limiares da audiometria de altas freqüências quando comparada com a audiometria convencional. Houve correlação positiva dos limiares com idade e com tempo de profissão. Encontrado ausência de emissões otoacústicas evocadas transiente em 26,7% (orelha direita) e 23,3% (orelha esquerda) e ausência de emissões em freqüências isoladas nas emissões otoacústicas evocadas por produto de distorção. Conclusão: Foram observadas alterações nos testes realizados na ausência de queixa de dificuldade auditiva; o teste das emissões otoacústicas mostrou-se com maior sensibilidade na detecção precoce de alterações auditivas; músicos apresentam risco significativo de desenvolverem perda auditiva.

Introduction: Exposure to music has become an interest among experts in hearing and acoustics, once it's related to the professional and social activity and to the high prevalence of Hearing Loss. Objective: To investigate musicians auditory health. Method: 30 musicians participated in the study and were submitted to specific interview, conventional and highfrequency tonal audiometry, tympanometry and transient-evoked and distortion-produced otoacoustic emissions. Results: 17% of the participants presented an audiogram that suggested Noise-Induced Hearing Loss, 7% normal with notch and 7% with other characteristics. The frequency thresholds average of 3, 4 and 6kHz presented a more intense level when compared to the one of 500, 1 and 2kHz; as well as the high frequency audiometry thresholds average when compared to the conventional audiometry. There was a threshold positive correlation with the age and time of profession. There hasn't been found transiently evoked otoacoustic emissions in 26,7% (right ear) and 23,3% (left ear), as well as in isolated frequencies in distortion-produced evoked otoacoustic emissions. Conclusion: Alterations were observed in tests with no complaints of hearing difficulties; the otoacoustic emissions test presented more sensitivity in the early detection of hearing alterations; musicians present a significant risk of developing hearing loss.