ABSTRACT
Com o objetivo de avaliar a correlação entre a melhora da audição e do zumbido em pacientes com hipoacusia condutiva e sua estabilidade a médio prazo, analisamos 33 pacientes submetidos à timpanoplastia ou estapedotomia por meio da audiometria tonal e da nota de incômodo pela escala numérica de 0 a 10, repetindo os procedimentos após 1 e 6 meses de cirurgia. Houve melhora significante do incômodo com a hipoacusia e com o zumbido após 1 e 6 meses, assim como uma correlação positiva entre a variação do incômodo de ambos os sintomas após 1 e 6 meses. Concluímos que os pacientes com zumbido e hipoacusia condutiva submetidos à timpanoplastia ou estapedotomia incomodam-se mais com a hipoacusia do que o zumbido, mas ambos os sintomas apresentam melhora significante no pós-operatório, que se mantém estável entre 1 e 6 meses / In clinical practice, hearing improvement procedures often promote tinnitus improvement as well. The aims of this study were to evaluate: 1) the correlation between hearing improvement and tinnitus evolution in patients with conductive hearing loss submitted to tympanoplasty or stapedotomy; 2) the stability of such results after 1 and 6 months of surgery. Patients with tinnitus and hearing loss with indication of stapedotomy and tympanoplasty have major bannoyance with hearing loss than with tinnitus and show significant and stable improvement after 5 months of surgical follow-up. Tinnitus improvement is correlated with annoyance with hearing loss but not do the audiometric thresholds...
Subject(s)
Humans , Male , Female , Child , Stapes Surgery/methods , Hearing Loss/surgery , Tympanoplasty/methods , Tinnitus/physiopathology , Audiometry, Pure-Tone/methods , Follow-Up Studies , Auditory Threshold/classification , Ear, Middle/surgeryABSTRACT
The human perception of sound at frequencies below 200 Hz is reviewed. Knowledge about our perception of this frequency range is important, since much of the sound we are exposed to in our everyday environment contains significant energy in this range. Sound at 20-200 Hz is called low-frequency sound, while for sound below 20 Hz the term infrasound is used. The hearing becomes gradually less sensitive for decreasing frequency, but despite the general understanding that infrasound is inaudible, humans can perceive infrasound, if the level is sufficiently high. The ear is the primary organ for sensing infrasound, but at levels somewhat above the hearing threshold it is possible to feel vibrations in various parts of the body. The threshold of hearing is standardized for frequencies down to 20 Hz, but there is a reasonably good agreement between investigations below this frequency. It is not only the sensitivity but also the perceived character of a sound that changes with decreasing frequency. Pure tones become gradually less continuous, the tonal sensation ceases around 20 Hz, and below 10 Hz it is possible to perceive the single cycles of the sound. A sensation of pressure at the eardrums also occurs. The dynamic range of the auditory system decreases with decreasing frequency. This compression can be seen in the equal-loudness-level contours, and it implies that a slight increase in level can change the perceived loudness from barely audible to loud. Combined with the natural spread in thresholds, it may have the effect that a sound, which is inaudible to some people, may be loud to others. Some investigations give evidence of persons with an extraordinary sensitivity in the low and infrasonic frequency range, but further research is needed in order to confirm and explain this phenomenon.
Subject(s)
Acoustics , Adolescent , Adult , Auditory Threshold/classification , Female , Hearing/physiology , Humans , Loudness Perception/physiology , Male , Middle Aged , Radio Waves , SoundABSTRACT
In order to investigate whether the energy-equivalence principle is at least acceptable for exposures with a duration in the range of hours and in order to disclose the actual physiological responses to exposures which varied with respect to the time structure and the semantic quality of sounds, a series of tests was carried out where physiological costs associated with varying exposures were measured audiometrically. In a cross-over test design, 10 Subjects (Ss) participated in test series with 3 energetically equal sound exposures on different days. The exposures corresponded with a tolerable rating level of 85 dB / 8 h. In a first test series (TS I), the Ss were exposed to a prototype of industrial noise with a sound pressure level of 94 dB(A) / 1 h. In a second test series (TS II), the same type of noise was applied, but the exposure time of a reduced level of 91 dB(A) was increased to 2 hours. In a third test series (TS III), classical music was provided also for 2 h at a mean level of 91 dB(A). The physiological responses to the 3 exposures were recorded audiometrically via the temporary threshold shift TTS2, the restitution time t(0 dB), and the IRTTS-value. IRTTS is the integrated restitution temporary threshold shift which is calculated by the sum of all threshold shifts. It represents the total physiological costs the hearing must "pay" for the sound exposure. Physiological responses of the hearing to the industrial noise exposures in TS I and TS II, all in all, were identical in the 3 parameters. Maximum threshold shifts of approximately 25 dB occurred which did not dissipate completely until 2.5 h after the end of the exposure and IRTTS-values of about 800 dBmin were calculated. Therefore, at least for exposure times in the range of hours, the equilibration of intensity and duration of sound exposures according to the energy-equivalence principle seems to have no influence on the hearing. Classical music was associated with the least severe TTS of less than 10 dB which disappeared much more quickly. IRTTS added up to just about 100 dBmin and, in comparison with 800 dBmin as specific responses to industrial noise, amounted to only about 12%. The substantially lower physiological costs of classical music apparently indicate a decisive influence of the type of sound exposures. Making inferences from the results of the study, the conventional approach of rating sound exposures exclusively by the principle of energy equivalence can lead to gravely misleading assessments of their actual physiological costs.
Subject(s)
Adult , Audiometry , Auditory Threshold/classification , Female , Humans , Male , Music , NoiseABSTRACT
O colabamento do meato acústico externo pode resultar em uma piora dos limiares auditivos, principalmente nas freqüências mais agudas, em decorrência de um fechamento total ou parcial do meato acústico externo, devido à pressão dos fones exercida sobre o pavilhão auricular durante a avaliação audiológica. Para evitar erros deste tipo, algum método deve ser utilizado para que meatos acústicos externos estreitos e/ou pavilhões auriculares flácidos permaneçam livres permitindo que a onda sonora seja capaz de atingir a membrana timpânica durante a obtenção dos limiares tonais. Material e métodos: Neste trabalho estão demonstrados os resultados com 47 pacientes que apresentaram melhora de seus limiares auditivos de até 50 dBNA quando um tubo de polietileno foi inserido no meato acústico externo para evitar o colabamento.
Collapse of the external auditory meatus during audiometry can lead to spuriously increased hearing thresholds being obtained, particularly at high frequencies, by pressure exerted on the pinna during audiometryc testing. The pressure of the earphone against the pinna may result in the partial closure or complete collapse of the external auditory meatus during audiometry. To avoid such errors, na effective method has to be used to eliminate outer ear closure to allow sound to reach" the tympanic membrane during tonal audiometry. Material and methods: In a sample of 47 patients, we demonstraded best. results after using a small piece of polyethylene tubbing inserted in the canal to avoid the collapse of the ear canal.
Subject(s)
Humans , Male , Female , Auditory Threshold/classification , Auditory Threshold/physiology , Ear Canal/physiology , Ear Canal/anatomy & histologyABSTRACT
Se estudió desde el punto de vista audiológico, un grupo de 49 pre-escolares sanos seleccionados previamente por medio de examen general de ORL y audiometría, mediante la técnica de emisiones otoacústicas por distorción (EOD). Se compararon los valores de los umbrales auditivos con estímulos a las frecuencias 1000, 2000 y 4000 Hz de la audiometría y de 1000-1187, 2000-2406 y 4000-4812 Hz de las EOD por el coeficiente de correlación de Pearson. Se observaron coeficientes de correlación significativos entre ambas pruebas. Estos resultados muestran que las EOD pueden ser una buena herramienta clínica confiable para determinar audición normal o anormal en sujetos que no cooperan
Subject(s)
Child, Preschool , Humans , Male , Female , Hearing/physiology , Audiometry , Auditory Threshold/classification , Otoacoustic Emissions, Spontaneous/physiology , Data Interpretation, StatisticalABSTRACT
En Chile la infección por rubeola es adquirida tempranamente: cerca del 90 por ciento de los niños menores de 5 años presentaban pruebas inmunológicas positivas (Clin Obst Gynecol 25:585,82). Los objetivos fueron medir con audiometría por potenciales evocados auditivos de tronco cerebral (PEAT) la prevalencia de hipoacusia sensorioneural (HSN) en niños que consultaban la clínica ORL de nuestro hospital Universitario por sospecha de daño auditivo y comparar la prevalencia de HSN en niños sospechosos de rubeola congénita con el grupo no rubeólico. 199 niños fueron estudiados en 34 meses. Su audición fue medida en cada oído usando PEAT. Se consideró probable portador de rubeola congénita (RC) por examen clínico y/o pruebas inmunológicas positivas a 16 pacientes. Se encontró una discapacidad auditiva severa (umbral del mejor oído 61 dBnHL o mayor) en el grupo rubeólico a un 81 por ciento (13/16). En el grupo no rubeólico un 41 por ciento (75/183) presentaban la misma discapacidad y 39 por ciento (72/183) tenían un oído normal. Se concluye que la discapacidad auditiva severa en esta población pediátrica es sorprendentemente alta (41 por ciento). La sospecha de RC en un niño aumenta su probabilidad de daño auditivo severo y la vacunación de mujeres en edad fértil negativas para rubeola debe considerarse para prevenir daño auditivo fetal. La RC sería responsable de un 15 por ciento de las discapacidades auditivas graves en esta población