Utilização do Potencial Auditivo de Estado Estável em lactentes com baixo risco para perda auditiva / Use of Auditory Steady State Response in infants at low risk for hearing loss / Uso del potencial auditivo de estado estacionario en bebés con bajo riesgo de pérdida auditiva

Introdução: Com base na necessidade do diagnóstico audiológico e da intervenção precoce na vida de uma criança com perda auditiva, faz-se necessário a elaboração de protocolos de avaliação auditiva que forneçam o maior número de informações. Objetivo: Analisar um programa de saúde auditiva infantil com relação à adesão à triagem auditiva e procedimentos de diagnóstico. Metodologia: Pesquisa de caráter transversal com análise quantitativa. Realizado em três etapas: 1ª etapa: triagem auditiva de neonatos de alojamento conjunto; 2ª etapa: reteste das falhas; 3ª etapa: diagnóstico audiológico dos lactentes que falharam nas etapas anteriores com a utilização do Potencial Evocado Auditivo de Estado Estável (PEAEE) em conjunto com o Potencial Evocado Auditivo de Tronco Encefálico (PEATE). Resultados: Em 2019, 1.898 neonatos foram triados e destes, 287 (15.2%) falharam na primeira testagem em pelo menos uma orelha. Um total de 197 (10.3%) foram retestados e 14 (0,73%) falharam em pelo menos uma orelha. Dez (0,52%) neonatos retornaram para diagnóstico compondo uma amostra homogênea de neonatos nascidos a termo. Um neonato apresentou perda auditiva unilateral. O tempo necessário para coleta de dados no PEAEE foi de 20 minutos. Conclusão: O PEAEE pode ser considerado uma alternativa a ser utilizado na bateria de testes na avaliação audiológica infantil, juntamente com outros procedimentos, utilizando-se do princípio de verificação cruzada e adicionando uma informação valiosa, especialmente com relação às baixas frequências. (AU)

Introduction: Based on the need for audiological diagnosis and intervention as soon as possible in the life of a child with hearing loss, it is necessary to elaborate of hearing evaluation protocols with high efficiency, which provide the greatest amount of information. Aim: To analyze a pediatric hearing health program regarding their adherence to hearing screening, failure rates, and diagnostic procedures. Method: This is a cross-sectional, descriptive, quantitative study, and consisted of tree stages: Performed in three steps: 1st step: hearing screening of rooming-in neonates; 2nd stage: retest of failures; 3rd stage: audiological diagnosis of infants who failed in the previous stages using the Steady State Response (ASSR) together with the Brainstem Evoked Response Audiometry (BERA). Results: In 2019, 1,898 infants were submitted to the program, of whom 287 (15.2%) failed the screening in at least one of the ears. A total of 197 (10.3%) infants attended the retest and 14 (0.73%) failed the TOAE in at least one of the ears. Ten (0.52%) infants returned for diagnosis. The sample was homogeneously full-term children. One child showed unilateral HL. The average amount of time required to collect information in the ASSR was 20 minutes. Conclusion: For diagnosis, ASSR can be an alternative to be used in the battery of examinations in pediatric hearing assessment along with the other procedures, using the cross-check principle and adding valuable information, especially regarding the low frequencies. (AU)

Introducción: En base a la necesidad de diagnóstico audiológico e intervención lo antes posibles en la vida de un niño con pérdida auditiva, es necesario elaborar protocolos de evaluación auditiva de alta eficiencia, que proporcionan la mayor cantidad de información. Objetivo: Analizar un programa de salud auditiva infantil en cuanto a la adherencia al tamizaje auditivo, tasa de fracaso y procedimientos diagnósticos. Metodología: Investigación transversal con análisis cuantitativo, Realizado en tres pasos: 1er paso: tamizaje auditivo de los neonatos en alojamiento conjunto; 2ª etapa: retest de fallas; 3ª etapa: diagnóstico audiológico de los lactantes que fracasaron en las etapas anteriores utilizando el Potencial Evocado Auditivo de Estado Estacionario junto con el Potencial Evocado Auditivo de Tallo Cerebral. Resultados: Em 2019, se cribaron 1,898 neonatos y de estos, 287 (15,2%) no pasaron la primera prueba en al menos un oído. Un total de 197 (10,3) fueron reevaluados y 14 (0,73%) fallaron en al menos un oído. Diez (0,52%) neonatos regresaron para diagnóstico, conformando una muestra homogénea de neonatos a término, con una edad gestacional media de 39 semanas y dos días. Un neonato tuvo pérdida auditiva unilateral. El tiempo de recogida de los resultados en el ASSR fue de 20 min. Conclusión: Para el diagnóstico, la ASSR puede considerarse una alternativa para ser utilizada en la batería de pruebas en la evaluación audiológica infantil, junto con otros procedimientos, utilizando el principio de verificación cruzada y agregando información valiosa, especialmente en lo que se refiere a las bajas frecuencia. (AU)

Potenciales evocados auditivos de tronco en neonatos nacidos a gran altitud / Brainstem auditory evoked potentials in newborn infants born in a high-altitude area

Introducción. Una forma no invasiva y segura de evaluar los parámetros neurofisiológicos en recién nacidos es la evaluación de los potenciales evocados auditivos del tronco encefálico (PEAT). Objetivo. Evaluar las latencias e intervalos de ondas de los PEAT en neonatos sanos nacidos a gran altitud (Cusco, 3399 msnm). Población y métodos. Estudio transversal y prospectivo. Se incluyeron neonatos menores a 14 días de vida, dados de alta a menos de 7 días de nacidos, evaluados para determinar los valores de los PEAT a intensidades sonoras de 70 dB, 80 dB y 90 dB. Se incluyeron las variables edad gestacional, peso al nacer, tipo de parto. Se calcularon las diferencias de las medianas de las latencias e intervalos de las ondas según edad gestacional y peso al nacer. Resultados. Se evaluaron 96 neonatos (17 pretérminos). Las medianas de las latencias de las ondas I a V a 90 dB fueron las siguientes: onda I 1,56 ms; onda II 2,74 ms; onda III 4,37 ms; onda IV 5,62 ms, onda V 6,63 ms. La latencia de la onda I para 80 dB fue de 1,71 ms y para 70 dB de 1,88 ms. Los intervalos para las ondas (I-III), (III-V) y (I-V) fueron de 2,8 ms, 2,2 ms y 5,0 ms respectivamente, sin diferencias entre intensidades (p >0,05). La prematuridad y el bajo peso estuvieron asociados a latencias de la onda I más prolongadas (p <0,05). Conclusiones. Se presentan valores ajustados de latencias e intervalos de los PEAT en neonatos nacidos a gran altitud. Se identificó que, a distintas intensidades sonoras, se ven diferencias en las latencias de las ondas, pero no en los intervalos entre ondas.

Introduction. A non-invasive and safe way to assess neurophysiological parameters in newborn infants is the evaluation of brainstem auditory evoked potentials (BAEPs). Objective. To assess the latencies and wave intervals of BAEPs in healthy newborn infants born in a high-altitude area (Cusco, 3399 MASL). Population and methods. Cross-sectional and prospective study. Newborn infants younger than 14 days of age, discharged less than 7 days after birth, were assessed to determine BAEP values at intensities of 70 dB, 80 dB, and 90 dB. The study variables were gestational age, birth weight, and type of delivery. The median differences in wave latencies and intervals were estimated according to gestational age and birth weight. Results. A total of 96 newborn infants (17 preterm infants) were assessed. The median latencies of waves I­V at 90 dB were for wave I: 1.56 ms, wave II: 2,74 ms, wave III: 4.37 ms, wave IV: 5.62 ms, and wave V: 6.63 ms. The latency of wave I for 80 dB was 1.71 ms and for 70 dB, 1.88 ms. Wave intervals (I­III, III­V, I­V) were 2.8 ms, 2.2 ms, and 5.0 ms, respectively, without differences among intensities (p > 0.05). Prematurity and low birth weight were associated with a longer wave I latency (p < 0.05). Conclusions. Here we describe adjusted BAEP latency and interval values for newborn infants born at high altitude. At different sound intensities, we identified differences in wave latencies, but not in interwave intervals.

Limiar Diferencial de mascaramento e potencial evocado auditivo de tronco encefálico em adultos normo-ouvintes com zumbido / Masking Level Difference and Auditory Brainstem ResponseIn Normal Hearing Adults With Tinnitus / Umbral de enmascaramiento diferencial y potencial evocado auditivo del tronco encefálico en adultos con audición normal y tinnitus

Introdução: O zumbido é uma ilusão auditiva consciente, uma sensação sonora não relacionada com uma fonte externa de estimulação. Objetivos: Caracterizar a Acufenometria, Limiar Diferencial de Mascaramento, o questionário de qualidade de vida Inventário de Desvantagem do Zumbido e Potencial Auditivo de Tronco Encefálico em adultos normo-ouvintes com zumbido, com a finalidade de comparar seus achados. Método: Vinte indivíduos do sexo feminino e masculino, entre 20 e 60 anos de idade, normo-ouvintes com queixa de zumbido, foram submetidos ao Acufenometria, Limiar Diferencial de Mascaramento, Inventário de Desvantagem do Zumbido e Potencial Evocado Auditivo de Tronco Encefálico. Resultados: AAcufenometriarevelou que o pitch médio foi de 4,3 KHz à orelha direita e 4,6 KHz à orelha esquerda. O loudness médio foi de 21,7 dBNS à orelha direita e 23,5 dBNS à orelha esquerda. O Limiar Diferencial de Mascaramento médio mostrou-se alterado. O Inventário de Desvantagem do Zumbido médio correspondeu à classificação de grau leve. O Potencial Evocado Auditivo de Tronco Encefálico apresentou parâmetros dentro da normalidade bilateralmente. Conclusão: Constatou-se que adultos normo-ouvintes com queixa de zumbido apresentam zumbido de pitch agudo bilateral com discreto impacto na qualidade de vida, condução adequada das vias auditivas até o tronco encefálico e comprometimento na identificação de sons na presença de ruído, demonstrando que o zumbido pode ter repercussões nas habilidades auditivas centrais. (AU)

Introduction: Tinnitus is a conscious auditory illusion, a sound perception unrelated to any external stimulus source. Objectives: To characterize the Acuphenometry, Masking Level Difference, the quality of life questionnaire Tinnitus Handicap Inventory and Auditory Brainstem Response in normal hearing adults with tinnitus, with the purpose of comparing the findings. Method: Twenty female and male individuals, between 20 and 60 years of age, normal hearing with complaints of tinnitus, underwent Acuphenometry, Masking Level Difference, Tinnitus Handicap Inventory and Auditory Brainstem Response. Results: The Acuphenometry showed the average pitch was 4.3 KHz to the right ear and 4.6 KHz to the left ear. The average loudness was 21.7 dBSL to the right ear and 23.5 dBs to the left ear. The average Masking Level Difference was altered. The average Tinnitus Handicap Inventory corresponded to the classification of mild grade. Auditory Brainstem Response showed parameters within normal range bilaterally. Conclusion: It was found that normal hearing adults with tinnitus complaints have bilateral acute pitch tinnitus with a slight impact on quality of life, appropriate conduction of auditory pathways to the brainstem and impaired identification of sounds in the presence of noise, demonstrating that tinnitus can have repercussions on central auditory skills. (AU)

Introducción: El tinnitus es una ilusión auditiva consciente, una sensación de sonido no relacionada con una fuente externa de estimulación. Objetivos: Caracterizar la coincidencia de tono y volumen, el umbral de enmascaramiento diferencial, el inventario de minusvalía para acúfenos y el potencial auditivo del tronco encefálico en adultos normoyentes con acúfenos, con el fin de comparar sus hallazgos. Método:Veinte sujetos masculinos y femeninos, con edades entre 20 y 60 años, audición normal con tinnitus, fueron sometidos a acúfenos, Umbral de Enmascaramiento Diferencial, Inventario de Desventajas de Tinnitus y Potenciales Evocados Auditivos del Tronco Encefalico. Resultados: La combinación de tono y volumen reveló que el tono promedio era de 4,3 KHz en el oído derecho y de 4,6 KHz en el oído izquierdo. Mientras que el volumen medio fue de 21,7 dBNS para el oído derecho y de 23,5 dBNS para el oído izquierdo. Se modificó el umbral diferencial de enmascaramiento promedio. El Inventario de Desventajas de Tinnitus promedio correspondió a la clasificación de grado leve. El Potenciales Evocados Auditivos del Tronco Encefalico presentó parámetros dentro del rango normal bilateralmente. Conclusión:Se encontró que los adultos normooyentes con quejas de tinnitus presentan tinnitus de tono alto bilateral con leve impacto en la calidad de vida, conducción adecuada de las vías auditivas al tronco encefálico y deterioro en la identificación de sonidos en presencia de ruido, demostrando que Tinnitus puede tener repercusiones en las habilidades auditivas centrales. (AU)

Contribuição do potencial evocado auditivo de estado estável na escolha do implante coclear ou aparelho de amplificação sonora em crianças com perda auditiva / Contribution of auditory steady state evoked potential to the election of cochlear implantation or hearing aid for children with hearing impairment / Contribución del potencial evocado auditivo de estado estable en la elección de implantación coclear o audífono en niños con deficiencia auditiva

Introdução: A deficiência auditiva em crianças prejudica a aquisição e o desenvolvimento da linguagem oral, o que pode ser minimizado com o diagnóstico e a confirmação da surdez nos primeiros meses de vida. O Potencial Evocado auditivo de estado estável (PEAEE) destaca-se diante dos demais potenciais evocados auditivos devido à facilidade de registro, à objetividade das respostas, à estimulação de várias frequências simultaneamente, em ambas as orelhas, além da identificação da audição residual. Objetivo: Verificar a contribuição do PEAEE na definição terapêutica (escolha do implante coclear ou aparelho de amplificação sonora) para a reabilitação auditiva de crianças. Método: Foram analisados os registros de 20 crianças de um mês a três anos de idade com perda auditiva neurossensorial de grau severo ou profundo bilateral e que foram submetidas ao PEAEE e ao potencial evocado auditivo de tronco encefálico frequência específica (PEATE-FE). Ambos realizados nas frequências de 500 Hz e 2000 Hz no equipamento Smart-EP Intelligent Hearing Systems®. Resultados: Houve diferença entre os exames quanto à ocorrência de resíduo auditivo, pois, um número significativo de indivíduos apresentou respostas ausentes no PEATE-FE e respostas presentes no PEAEE. Não ocorreu associação entre a presença de resíduo auditivo, o grau da perda e a idade da criança com o tipo de intervenção terapêutica. Conclusão: A presença de resíduo auditivo, a classificação do grau da perda e a idade da criança não influenciaram na conduta terapêutica final. (AU)

Introduction: Hearing impairment in children debilitates the acquisition and development of oral language, which can be minimized with diagnosis and confirmation of deafness in the first months of life. Auditory Steady State Evoked Potential (ASSEP) analysis stands out from others auditory evoked potentials due to the ease of recording, objectivity of the answers, stimulation of several frequencies simultaneously, in both ears, besides the identification of residual hearing. Purpose: Determine the contribution of the ASSEP for the therapeutic definition (election of cochlear implantation or hearing aid device) in hearing rehabilitation of children. Methods: The records of 20 children aged one month to three years with severe or profound bilateral neurosensory hearing loss, who were submitted to ASSEP and specific frequency brainstem auditory evoked potential (BAEP) analysis were analyzed. Both tests performed at frequencies of 500 Hz and 2000 Hz using the equipment Smart-EP Intelligent Hearing Systems®. Results: There was difference between the exams regarding the occurrence of residual hearing, since a significant number of individuals had absent responses on the BAEP and present responses on the ASSEP. There was no association between the presence of residual hearing, degree of hearing loss and the child's age with the type of therapeutic intervention. Conclusion: The presence of residual hearing, classification of the degree of loss and child's age exerted no influence on the final conduct. (AU)

Introducción: La deficiencia auditiva en niños hace daño a la adquisición y el desarrollo del lenguaje oral, que se puede minimizar con el diagnóstico y confirmación de la sordera en los primeros meses de vida. El Potencial Evocado de Estado Estable (PEAEE) se destaca de los demás potenciales evocados auditivos por la facilidad de registro, objetividad de las respuestas, estimulación de varias frecuencias simultáneamente, en ambos oídos, además de la identificación de audición residual. Objetivo: Verificar la contribución del PEAEE para la definición de las terapéuticas adoptadas (elección de implantación coclear o audífono) en la rehabilitación auditiva de niños. Método: Fueron analizados los registros de 20 niños de un mes a tres años de edad con pérdida auditiva sensorineural de grado severo o profundo bilateral y que fueron sometidas al PEAEE y al potencial evocado auditivo de tronco encefálico por frecuencia específica (PEATE-FE). Ambos se realizaron en las frecuencias de 500 Hz y 2000 Hz en el equipo Smart-EP Intelligent Hearing Systems®. Resultados: Hubo diferencia entre los exámenes con respecto a la ocurrencia de residuo auditivo, dado que, un número significativo de sujetos presentaron respuestas ausentes en PEATE-FE y respuestas presentes en PEAEE. No hubo asociación entre la presencia de residuo auditivo, el grado de pérdida y la edad del niño con el tipo de intervención terapéutica. Conclusión: La presencia de residuo auditivo, clasificación del grado de pérdida y edad del niño no influyeron en la conducta final. (AU)

Diagnóstico audiológico de lactentes após falha na triagem auditiva neonatal universal / Hearing assessment after referral in universal newborn hearing screening

RESUMO Objetivo Estudar o processo de diagnóstico audiológico de lactentes que falharam na Triagem Auditiva Neonatal Universal (TANU). Métodos Análise dos prontuários de 51 lactentes que falharam na TANU nas maternidades do munícipio e que foram encaminhados a um centro de referência em saúde auditiva para diagnóstico audiológico, entre janeiro e junho de 2021. Foram identificados os lactentes que finalizaram o diagnóstico, aqueles que não compareceram ao agendamento para exames ou evadiram durante o processo. Tentativas de contato foram realizadas com os responsáveis pelos lactentes que evadiram, para identificar o motivo da evasão. Resultados O comparecimento ao diagnóstico ficou em 75%, com evasões entre o encaminhamento da maternidade para o centro de referência, bem como durante o processo de diagnóstico. Cinquenta por cento dos sujeitos concluíram as avaliações audiológicas até os 3 meses de vida. A tentativa de contato foi bem-sucedida com os responsáveis pelos lactentes que evadiram, sendo os motivos mais frequentes: adoecimento do lactente, distância entre a moradia e o centro de referência, horário de trabalho dos pais. Conclusão Na etapa de diagnóstico, o índice de comparecimento e o tempo de conclusão até o terceiro mês de vida da criança ficaram abaixo dos índices recomendados, diminuindo a efetividade do Programa de Triagem Auditiva Neonatal Universal (PTANU). A busca ativa por contato telefônico e uso de aplicativo de mensagem telefônico foi importante para reduzir a evasão em 76%. Outras ferramentas que aprimorem o processo para um diagnóstico não prolongado, evitando evasões, necessitam ser estudadas.

ABSTRACT Purpose To study the process of hearing assessment in infants who were referred by professionals responsible for Universal Newborn Hearing Screening (UNHS). Methods Analysis of the medical records of 51 infants referred by maternity hospitals where UNHS was performed and were referred to a Hearing Health Center, between January and June 2021. Infants who completed hearing assessment, who never attended the appointments, or were lost during the diagnostic process were identified. Attempts were made to contact infants' guardians in order to understand the reason for missing the appointments. Results The attendance to the diagnosis was 75%. Fifty percent of the infants completed hearing assessment as recommended, up to 3 months of life. The attempt to contact parents who missed the appointments was successful, and the most frequent reasons are: the infant was ill on the day of scheduled appointment, distance from home to the hearing health center, parents' working hours. Conclusion For the diagnostic stage, the attendance rate and the age for completing hearing assessment were below the recommended. The active search for telephone contact and use of phone messaging application was important to reduce evasion by seventy-six percent. Tools that optimize the diagnostic process with less infants missing still must be studied.

Application of cochlear nerve action potential monitoring in the resection of vestibular schwannomas / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the application of cochlear nerve action potential (CNAP) monitoring in the resection of vestibular schwannoma, especially evaluating its significance for hearing preservation. Methods: From April 2018 to December 2021, 54 patients with vestibular schwannoma who underwent resection via retrosigmoid approach were collected in Chinese PLA General Hospital. Before surgery, all patients had effective hearing (AAO-HNS grade C or above). Brainstem auditory evoked potential (BAEP) combined with CNAP monitoring was performed during surgery. The CNAP monitoring was combined with continuous monitoring and cochlear nerve mapping. And patients were divided into hearing preservation group and non-preserved group according to postoperative AAO-HNS grade. SPSS 23.0 software was used to analyze the differences of CNAP and BEAP parameters between the two groups. Results: A total of 54 patients completed intraoperative monitoring and data collection, including 25 males (46.3%) and 29 females (53.7%), aged 27-71 years with an average age of 46.2 years. The maximum tumor diameter were (18.1±5.9) mm (range 10-34 mm). All tumors were totally removed with preserved facial nerve function (House-Brackmann grade I-II). The hearing preservation rate of 54 patients was 51.9% (28/54). During surgery, the V wave extraction rate of BAEP waveform was 85.2% (46/54) before tumor resection, 71.4% (20/28) in the hearing preservation group after tumor resection, and disappeared in the hearing preservation group (0/26). CNAP waveform was elicited in 54 patients during operation. Differences were found in the distribution of CNAP waveforms after tumor resection. The waveforms of the hearing-preserving group were triphasic and biphasic, while those in the non-preserving group were low-level and positive. For hearing preservation group, the amplitude of N1 wave after tumor resection was significantly higher than that before tumor resection[14.45(7.54, 33.85)μV vs 9.13(4.88, 23.35)μV, P=0.022]; However, for the non-preserved group, the amplitude of N1 wave after tumor resection was significantly lower than that before tumor resection [3.07(1.96, 4.60)μV vs 6.55(4.54, 9.71)μV, P=0.007]; After tumor resection, the amplitude was significantly higher than that of the unreserved group [14.45(7.54, 33.85)μV vs 3.07(1.96, 4.60)μV, P<0.001]. Conclusions: BAEP combined with CNAP monitoring is conducive to intraoperative hearing protection, and the application of cochlear nerve mapping can prompt the surgeon to avoid nerve injury. The waveform and N1 amplitude of CNAP after tumor resection have a certain value in predicting postoperative hearing preservation status.

Preliminary application of combined auditory monitoring technique in resection of vestibular neurinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the value of electrically evoked auditory brainstem response (EABR) monitoring combined with brainstem auditory evoked potential (BAEP) and compound action potential (CAP) monitoring during vestibular schwannoma resection for the protection of the cochlear nerve. Methods: Clinical data from 12 patients with vestibular schwannomas who had useful hearing prior to surgery were analyzed at the PLA General Hospital from January to December 2021. Among them, there were 7 males and 5 females, ranging in age from 25 to 59 years. Before surgery, patients underwent audiology assessments (including pure tone audiometry, speech recognition rate, etc.), facial nerve function evaluation, and cranial MRI. They then underwent vestibular schwannoma resection via the retrosigmoid approach. EABR, BAEP, and CAP were simultaneously monitored during surgery, and patients' hearing preservation was observed and analyzed after surgery. Results: Prior to surgery, the average PTA threshold of the 12 patients ranged from11 to 49 dBHL, with a SDS of 80% to 100%. Six patients had grade A hearing, and six patients had grade B hearing. All 12 patients had House-Brackman grade I facial nerve function prior to surgery. The MRI indicated tumor diameters between 1.1 and 2.4 cm. Complete removal was achieved in 10/12 patients, while near-total removal was achieved in 2/12 patients. There were no serious complications at the one-month follow-up after surgery. At the three-month follow-up, all 12 patients had House-Brackman grade I or II facial nerve function. Under EABR with CAP and BAEP monitoring, successful preservation of the cochlear nerve was achieved in six of ten patients (2 with grade B hearing, 3 with grade C hearing, and 1 with grade D hearing). Successful preservation of the cochlear nerve was not achieved in another four patients (all with grade D hearing). In two patients, EABR monitoring was unsuccessful due to interference signals; however, Grade C or higher hearing was successfully preserved under BAEP and CAP monitoring. Conclusion: The application of EABR monitoring combined with BAEP and CAP monitoring during vestibular schwannoma resection can help improve postoperative preservation of the cochlear nerve and hearing.

Brainstem auditory evoked potential combined with high resolution cranial base CT can optimize the diagnosis of auditory nerve injury / 中华创伤杂志(英文版)

PURPOSE@#Auditory nerve injury is one of the most common nerve injury complications of skull base fractures. However, there is currently a lack of auxiliary examination methods for its direct diagnosis. The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.@*METHODS@#Through retrospectively analyzing the results of brainstem auditory evoked potential (BAEP) and high-resolution CT (HRCT) in 37 patients with hearing impairment following trauma from January 1, 2018 to July 31, 2020, the role of the two inspection methods in the diagnosis of auditory nerve injury was studied. Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma; while exclusion criteria were: (1) severe patient with a Glasgow coma scale score ≤5 because these patients were classified as severe head injury and admitted to the intensive care unit, (2) patient in the subacute stage admitted 72 h after trauma, and (3) patient with prior hearing impairment before trauma. According to Goodman's classification of hearing impairment, the patients were divided into low/medium/severe injury groups. In addition, patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results. The positive rates of BEAP for each group were observed, and the results were analyzed by Chi-square test (p < 0.05, regarded as statistical difference).@*RESULTS@#A total of 37 patients were included, including 21 males and 16 females. All of them were hospitalized patients with GCS score of 6-15 at the time of admission. The BAEP positive rate in the medium and severe injury group was 100%, which was significantly higher than that in the low injury group (27.27%) (p < 0.01). The rate of BEAP positivity was significantly higher in the HRCT-positive group (20/30, 66.7%) than in the HRCT-negative group (1/7, 14.3%) (p < 0.05). Twenty patients (54.05%) were both positive for BEAP and HRCT test, and considered to have auditory nerve damage. Six patients (16.22%) were both negative for BEAP and HRCT test, and 10 patients (27.03%) were BAEP-negative but HRCT-positive: all the 16 patients were considered as non-neurological injury. The rest 1 case (2.70%) was BAEP-positive but HRCT-negative, which we speculate may have auditory nerve concussion.@*CONCLUSION@#By way of BAEP combining with skull base HRCT, we may improve the accuracy of the diagnosis of auditory nerve injury. Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.

Preliminary observation on the differential expression of metformin in preventing noise-induced hearing loss in inner ear protein group of rats / 中华劳动卫生职业病杂志

Objective: To study the protective effects of metformin on noise-induced hearing loss (NIHL) and its differential protein omics expression profile. Methods: In January 2021, 39 male Wistar rats were randomly divided into control group, noise exposure group and metformin+noise exposure group, with 13 rats in each group. Rats in the noise exposure group and metformin+noise exposure group were continuously exposed to octave noise with sound pressure level of 120 dB (A) and center frequency of 8 kHz for 4 h. Rats in the metformin+noise exposure group were treated with 200 mg/kg/d metformin 3 d before noise exposure for a total of 7 d. Auditory brainstem response (ABR) was used to test the changes of hearing thresholds before noise exposure and 1, 4, 7 d after noise exposure in the right ear of rats in each group. Tandem mass tag (TMT) quantitative proteomics was used to identify and analyze the differentially expressed protein in the inner ear of rats in each group, and it was verified by immunofluorescence staining with frozen sections. Results: The click-ABR thresholds of right ear in the noise exposure group and metformin+noise exposure group were significantly higher than those in the control group 1, 4, 7 d after noise exposure (P<0.05) . The click-ABR threshold of right ear in the metformin+noise exposure group were significantly lower than that in the noise exposure group (P<0.05) . Compared with the noise exposure group, 1035 up-regulated proteins and 1145 down-regulated proteins were differentially expressed in the metformin+noise exposure group. GO enrichment analysis showed that the significantly differentially expressed proteins were mainly involved in binding, molecular function regulation, signal transduction, and other functions. Enrichment analysis of KEGG pathway revealed that the pathways for significant enrichment of differentially expressed proteins included phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) signaling pathway, focal adhesion, diabetic cardiomyopathy, mitogen, and mitogen-activated protein kinase (MAPK) signaling pathway. Immunofluorescence experiments showed that compared with the noise exposure group, the fluorescence intensity of insulin-like growth factor 1 receptor (IGF1R) in the metformin+noise exposure group was increased, and the fluorescence intensity of eukaryotic translation initiation factor 4E binding protein 1 (eIF4EBP1) was decreased. Conclusion: Noise exposure can lead to an increase in rat hearing threshold, and metformin can improve noise-induced hearing threshold abnormalities through multiple pathways and biological processes.

Research progress of the regulation of cochlear sensitivity to noise by circadian rhythm / 生理学报

High level noise can damage cochlear hair cells, auditory nerve and synaptic connections between cochlear hair cells and auditory nerve, resulting in noise-induced hearing loss (NIHL). Recent studies have shown that animal cochleae have circadian rhythm, which makes them different in sensitivity to noise throughout the day. Cochlear circadian rhythm has a certain relationship with brain-derived neurotrophic factor and glucocorticoids, which affects the degree of hearing loss after exposure to noise. In this review, we summarize the research progress of the regulation of cochlear sensitivity to noise by circadian rhythm and prospect the future research direction.

Zumbido crônico: análise das contribuições clínicas de diferentes avaliações audiológicas / Chronic tinnitus: analysis of clinical contributions from different audiological evalutions

RESUMO Objetivo Investigar se há diferenças nos achados audiológicos periféricos e centrais entre indivíduos com limiares auditivos normais com e sem zumbido crônico e, com isso, entender quais exames auditivos são importantes nessa população. Métodos A amostra foi composta por conveniência, incluindo indivíduos de 18 a 59 anos, divididos em dois grupos: grupo 1 (G1), formado por sujeitos sem queixa de zumbido crônico e grupo 2 (G2), por indivíduos com zumbido crônico. A avaliação consistiu nos seguintes procedimentos: anamnese, audiometria de altas frequências (AAF), emissões otoacústicas transientes (EOAT), potencial evocado auditivo de tronco encefálico (PEATE)-clique, frequency following response (FFR) e o potencial evocado auditivo de longa latência (PEALL)-fala. Resultados O G2 apresentou valores aumentados para a AFF, com diferenças significativas. Para ambos os grupos, a EOAT mostrou predominância de presença de respostas. No PEATE, não houve diferenças estatisticamente significativas. No FFR, o G1 obteve maior amplitude de onda V e houve maior ocorrência de ausências no PEALL dos potenciais P1, N2 e P300, no G2. Conclusão A AAF, a análise da relação da onda V/I do PEATE, o FFR e o PEALL identificaram alterações nos indivíduos com zumbido crônico, demonstrando que tais procedimentos são promissores na avaliação dessa população.

ABSTRACT Purpose To investigate whether there are differences in peripheral and central audiological findings between individuals with normal hearing thresholds with and without chronic tinnitus, and thereby understand which hearing tests are most important in this population. Methods The sample was composed of convenience, including individuals from 18 to 59 years old, divided into two groups: Group 1 (G1) composed of subjects without complaints of chronic tinnitus, and Group 2 (G2) composed of individuals with chronic tinnitus. The evaluation consisted of the following procedures: Anamnesis, High-frequency audiometry (HFA), Transient Otoacoustic emissions (TOAEs), Auditory Brainstem Response (ABR)-click, Frequency Following Response (FFR), and Long Latency Auditory Evoked Potential (LLAEP)-speak. Results G2 showed increased values for HFA, with significant differences. For both groups, TOAEs showed a predominance of responses. In ABR there were no statistically significant differences. In FFR, G1 obtained a greater amplitude of wave V and there was a greater absence in LLAEP of P1, N2, and P300 in G2. Conclusion The HFA, the analysis of the wave V/I ratio in ABR, the FFR, and the LLAEP identified alterations in individuals with chronic tinnitus, demonstrating that such procedures are promising in the evaluation of this population.

Monitoramento audiológico de lactentes em diferentes programas de triagem auditiva neonatal: uma revisão sistemática / Audiological monitoring of infants in different newborn hearing screening programs: a systematic review

RESUMO Objetivos Buscar na literatura informações quanto aos aspectos que guiam o monitoramento audiológico infantil, descrevendo os procedimentos utilizados, a idade em que são realizados, qual a população monitorada e os países que mais estudam sobre o assunto. Além de discutir a importância dessa etapa e a eficácia desses aspectos. Estratégia de pesquisa A revisão foi conduzida com base nas recomendações PRISMA e registrada na plataforma PROSPERO. Os estudos foram pesquisados nas bases de dados eletrônicas Medline (Pubmed), Web of Science e SciELO, com os descritores hearing, neonatal screening e follow up. Critérios de seleção Foram incluídos estudos que descrevessem o monitoramento audiológico. Não foram empregados filtros do ano de publicação, tampouco para os idiomas dos mesmos. Resultados Foram encontrados 432 artigos e 21 foram incluídos nesse estudo, sendo que a maioria foi produzida em países desenvolvidos. O Potencial Evocado Auditivo de Tronco Encefálico e a Avaliação Comportamental foram os procedimentos mais utilizados. Quanto a idade e população, a maioria realiza o monitoramento até os três anos e em crianças com Indicadores para a Deficiência Auditiva. Conclusão Os estudos demonstraram que não há padrão entre os protocolos para a realização do monitoramento audiológico, porém foi possível identificar que as pesquisas apresentam uma maior concordância quanto a idade em que tal monitoramento acontece e qual a população que deve ser monitorada. Entretanto, embora haja discordâncias, os métodos de avaliação utilizados pelos estudos são eficazes para a detecção de perdas auditiva de caráter leve, progressivo e/ou tardio, além dos casos de falso negativo.

ABSTRACT Purpose To search the literature for guidelines on infant's audiological monitoring, most commonly used procedures, the age at which they are performed, which population should be monitored and the countries that study the subject the most. Besides, the importance and effectiveness of these measures will be discussed. Research strategy The review was conducted based on the PRISMA recommendations, registered on the PROSPERO platform. The studies were searched for in the electronic databases Medline (Pubmed), Web of Science and SciELO, using the descriptors hearing, neonatal screening and follow up. Selection criteria studies reporting the audiological monitoring were included. No filters on year and language of publication were used. Results A total of 432 articles were found and 21 were included in this study, mostly produced in developed countries. The Auditory Brainstem Response and the Behavioral Assessment were the most frequently used procedures. As to age and population, most infants are subjected to audiological monitoring up to three years of age and have Risk Factors for Hearing Loss in their clinical history. Conclusion The studies pointed that there is no standard among the protocols for performing audiological monitoring, but it was possible to identify agreement as to the age at which such monitoring takes place and which population should be monitored. However, although there is some disagreement, the assessment methods used in the studies are effective in detecting mild, progressive and/or late hearing loss, in addition to false negative cases.

Resultado do PEATE e Resposta Auditiva de Estado Estável em lactentes com e sem falha na TANU / Results of BAEP and Auditory Steady State Response in infants with and without UNHS failure / Resultados del PEATC e Respuesta Auditiva del Estado Estable en lactantes con y sin falla de CANU

Introdução: A triagem auditiva neonatal universal (TANU) é realizada por meio do exame de potencial evocado auditivo de tronco encefálico (PEATE), na população com indicador de risco para deficiência auditiva. A resposta auditiva de estado estável (RAEE) é uma técnica objetiva e automática de determinação dos limiares auditivos por frequência específica, porém ainda pouco explorada antes da alta hospitalar. Objetivo: analisar os resultados obtidos no exame de PEATE e RAEE em lactentes com indicadores de risco para deficiência auditiva, antes da alta hospitalar, com e sem falha na TANU. Métodos: Estudo observacional analítico prospectivo feito em lactentes com risco para a deficiência auditiva e que realizaram o PEATE e a RAEE na mesma sessão. Resultados: Atenderam ao critério de inclusão 66 lactentes, de ambos os gêneros, idade mediana de 1,2 meses, idade gestacional média de 31 semanas, peso médio ao nascimento 1601 g. Tiveram PEATE normal, 53 (80%) lactentes, denominados de G1 e 13 (20%) tiveram PEATE alterado, denominados de G2. Os limiares eletrofisiológicos da RAEE foram estatisticamente menores nos lactentes de G1. Conclusão: Houve relação entre os achados dos exames de PEATE e RAEE em lactentes de risco para deficiência auditiva, quando realizado antes da alta hospitalar. A mediana dos limiares eletrofisiológicos da RAEE foi menor para os lactentes que tiveram PEATE normal e maior para aqueles que tiveram PEATE alterado na TANU.

Introduction: Universal neonatal hearing screening (UNHS) is performed by examining brainstem auditory evoked potential (BAEP), in the population with a risk indicator for hearing loss. The auditory steady-state response (ASSR) is an objective and automatic technique for determining hearing thresholds by specific frequency, but still little explored before hospital discharge. Objective: to analyze the results obtained in the BAEP and RAEE tests in infants with risk indicators for hearing loss, before hospital discharge, with and without failure in UNHS. Methods: Prospective analytical observational study carried out in infants at risk for hearing loss and who underwent BAEP and ASSR in the same session. Results: 66 infants attempted the inclusion criteria, of both genders, the median age was 1.2 months, the mean gestational age was 31 weeks and the mean weight at birth was 1601 g. 53 (80%) infants, called G1, had normal BAEP, and 13 (20%) had abnormal BAEP, called G2. The electrophysiological thresholds of ASSR were statistically lower in infants of G1. Conclusion: There was a relationship between the findings of the BAEP and ASSR exams in infants at risk for hearing loss, when performed before hospital discharge. The median of the ASSR electrophysiological thresholds was lower for the infants who had normal BAEP and higher for those who had abnormal BAEP in the UNHSque tenían un PEATC normal y mayor para aquellos que tenían un PEATC alterado en CANU.

Introducción: El cribado auditivo neonatal universal (CANU) se realiza examinando el potencial evocado auditivo del tronco cerebral (PEAC), en la población con un indicador de riesgo de hipoacusia. La respuesta auditiva en estado estable (RAEE) es una técnica objetiva y automática para determinar los umbrales de audición por frecuencia específica, pero aún poco explorada antes del alta hospitalaria. Objetivo: analizar los resultados obtenidos en la exploración de PEAC y RAEE en lactantes con indicadores de riesgo de hipoacusia, antes del alta hospitalaria, con y sin fallo en CANU. Metodos: Estudio observacional analítico prospectivo realizado en lactantes con riesgo de hipoacusia a los que se les realizó PEATC y RAEE en una misma sesión. Resultados: Los criterios de inclusión cumplieron con 66 lactantes, de ambos sexos, edad media de 1,2 meses, edad gestacional media de 31 semanas, peso medio al nacer 1601 g. Tenían un PEATC normal, 53 (80%) lactantes, llamados G1 y 13 (20%) tenían un PEATC anormal, llamado G2. Los umbrales electrofisiológicos de RAEE fueron estadísticamente más bajos en lactantes del G1. Conclusión: Hubo una relación entre los hallazgos de los exámenes PEATC y RAEE en lactantes con riesgo de hipoacusia, cuando se realizaron antes del alta hospitalaria. La mediana de los umbrales electrofisiológicos de RAEE fue menor para los lactantes.

Automated analysis of bone-conduction cortical auditory evoked potential in normal-hearing neonates / Análise automática do potencial evocado auditivo cortical por via óssea em neonatos norma-ouvintes

Abstract Introduction The cortical auditory evoked potential allows the possibility of objectively evaluating the entire auditory system, which is desirable in the pediatric population. Bone conduction auditory stimulation is recommended in the differential diagnosis of conductive hearing loss. However, there are not many studies of cortical auditory evoked potential using bone conduction. Objective The aim of this study was to characterize the response of cortical auditory evoked potential through bone conduction in normal-hearing neonates using an automated response analysis equipment. Methods This study included 30 normal-hearing neonates, without risk factors for hearing loss. The equipment used was the HEARlab automated response analysis and the cortical responses were evaluated at the frequencies of 500-4000 Hz through bone conduction, at intensity ranging from 0 to 60 dBnHL. The latencies and amplitudes were manually marked by experienced judges. Results Cortical auditory evoked potential responses were detected in 100% of the evaluated subjects and there was no difference regarding the cortical response of the neonates in relation to the variables of gender, ear and masking use. At an intensity of 60 dBnHL for the frequencies of 500, 1000, 2000 and 4000 Hz the latencies were 234; 241; 239 and 253 ms and the amplitudes were 15.6; 8.4; 6.2; 6.3 µV. The mean thresholds were 23.6; 28; 31 and 33.1 dBnHL, respectively. Conclusion It was possible to measure the cortical auditory evoked potential response in the neonatal population using bone vibrator as sound transducer and to draw the profile of the cortical auditory evoked potential latencies and amplitudes by frequencies at the intensity of 60 dBnHL and at the threshold.

Resumo Introdução O potencial evocado auditivo cortical traz a possibilidade de avaliar de forma objetiva todo o sistema auditivo, o que é desejável na população infantil. A estimulação auditiva por condução óssea é recomendada no diagnóstico diferencial da perda auditiva condutiva. Entretanto, não há muitos estudos de potencial evocado auditivo cortical com o uso do vibrador ósseo. Objetivo Caracterizar a resposta do potencial evocado auditivo cortical por vibrador ósseo em neonatos normo-ouvintes com equipamento de análise automática de resposta. Metodologia A pesquisa incluiu 30 neonatos normo-ouvintes e sem fator de risco para deficiência auditiva. Foi usado o equipamento de análise automática de resposta HEARlab e foram avaliadas as repostas corticais na frequências de 500 a 4000 Hz por vibrador ósseo, na intensidade de 0 a 60 dBnNA. As latências e amplitudes foram marcadas manualmente por juízes experientes. Resultados Foram detectadas respostas de potencial evocado auditivo cortical em 100% dos sujeitos avaliados. Não houve diferença na resposta cortical dos neonatos para as variáveis: sexo, orelha e uso do mascaramento. Para as frequências de 500, 1000, 2000 e 4000 Hz foram observadas as latências de 234; 241; 239 e 253 ms, as amplitudes de 15,6; 8,4; 6,2; 6,3 µV, na intensidade de 60 dBnNA, e os limiares médios de 23,6; 28; 31 e 33,1 dBnNA, respectivamente. Conclusão Foi possível obter a resposta do potencial evocado auditivo cortical na população neonatal com vibrador ósseo como transdutor de som e traçar o perfil das latências e amplitudes dos potencial evocado auditivo cortical por frequência nas intensidades de 60 dBnNA e no limiar.

Hearing of neonates without risk indicators for hearing loss and use of antimalarial drugs during pregnancy: a historical cohort study in the Northern Region of Brazil / Audição de neonatos sem indicadores de risco para perda auditiva e utilização de antimaláricos na gestação: um estudo de coorte histórica na Região Norte

Abstract Introduction: Studies have demonstrated the ototoxic effects of antimalarial drugs in individuals who receive these drugs, but little is known regarding the toxicity of these drugs in the newborn auditory system when administered to the mother receive the drug during pregnancy. Objective: To verify the incidence of hearing loss in neonates who have no other associated risk indicators, born to mothers treated for malaria during pregnancy. Methods: A retrospective, quantitative cohort study was developed at Hospital de Base Dr. Ary Pinheiro and Clínica Limiar, both located in the municipality of Porto Velho (Rondônia). The sample consisted of 527 newborns divided into two groups: exposed to antimalarials drugs during pregnancy group (n = 32) and non-exposed group (n = 495). Data collection took place from September 2014 to December 2015, through an interview with the mothers and/or guardians of the newborn, through the newborns' and the mothers' records, and the neonatal hearing screening database of the above-mentioned institutions. Results: All the neonates in the exposed group, assessed through the recording of transient otoacoustic emissions associated with the automated brainstem auditory evoked potential test, underwent neonatal hearing screening in the first examination. Among the newborns in the non-exposed group, 30 showed failure and were retested. Of these, one continued to fail and was referred for diagnosis, in whom the results showed to be within the normal range. Among the neonates of the exposed group, infection with Plasmodium vivax was the most frequent, and was similarly distributed among the gestational trimesters, and chloroquine was the most commonly used antimalarial drug treatment more often given during the third trimester; these findings did not show any influence on the audiological findings of the studied neonates. Conclusion: The present study did not identify any cases of hearing loss in neonates born to mothers who used antimalarial drugs during gestation.

Resumo Introdução: Estudos comprovam os efeitos ototóxicos dos antimaláricos em pessoas que fazem uso destes medicamentos, porém pouco se sabe sobre a toxicidade destes fármacos no sistema auditivo de neonatos quando ingeridos pelas mães no período gestacional. Objetivo: Verificar a incidência de perda auditiva em neonatos de mães tratadas para malária durante a gestação sem outros indicadores de risco associados. Método: Estudo quantitativo, de coorte retrospectivo, desenvolvido no Hospital de Base Dr. Ary Pinheiro e na Clínica Limiar, ambos em Porto Velho (Rondônia). Compuseram a amostra 527 recém-nascidos divididos em dois grupos: grupo exposto (n = 32) e grupo não exposto (n = 495). A coleta de dados ocorreu de setembro de 2014 a dezembro de 2015, através de entrevista com as genitoras e/ou responsáveis pelo recém-nascido, investigação nos prontuários dos neonatos e das genitoras e no banco de dados da triagem auditiva neonatal das instituições supracitadas. Resultados: Todos os neonatos do grupo exposto, avaliados através do registro das emissões otoacústicas transientes associado a realização do potencial evocado auditivo de tronco encefálico automático passaram na triagem auditiva neonatal no primeiro exame. Já, entre os recém-nascidos do grupo não exposto, 30 apresentaram falha e foram retestados. Destes, um continuou falhando e foi encaminhado para diagnóstico, no qual foram evidenciados resultados dentro da normalidade. Nos neonatos do grupo exposto, a infecção pelo Plasmodium vivax foi a mais frequente, mostrando distribuição semelhante entre os trimestres gestacionais, sendo a cloroquina o antimalárico mais utilizado e o tratamento medicamentoso realizado mais frequentemente no terceiro trimestre, porém tais achados não mostraram influência sobre os achados audiológicos dos neonatos estudados. Conclusão: O presente estudo não identificou casos de perda auditiva nos neonatos de mães que utilizaram antimaláricos na gestação.

Association between autism spectrum disorder and changes in the central auditory processing in children

SUMMARY OBJECTIVE: To verify the scientific evidence on the association between Autistic Spectrum Disorder and Central Auditory Processing Disorder in children, aiming to answer the following research question: What is the association between Autistic Spectrum and Alteration of Auditory Processing in Children? METHODS: Studies were chosen through the combination based on the Medical Subject Heading Terms (MeSH): [(auditory processing) and (children) and (autism) and (neurological disorders)]. The MEDLINE (PubMed), LILACS, and SciELO databases were used. The analyzed papers covered a ten-year period, from 2010 to 2020. We selected descriptive, cross-sectional, cohort, and case studies. We evaluated the quality of the papers, which had a minimum score of six in the modified scale of the literature. RESULTS: 126 papers were retrieved after the exclusion phase, and 17 of them followed the inclusion criteria. Only two papers answered the guiding question with audiological results. CONCLUSIONS: Patients diagnosed with autistic spectrum disorder may have disturbance central auditory processing, considering that changes were found both in absolute and interpeak latencies in the brainstem evoked response audiometry, as well as in latency and laterality of the N1c wave amplitude. In addition, there were changes in the assessment behavioral auditory processing. Thus, disturbance central auditory processing is common in children with autistic spectrum disorder.

Investigação da discriminação neural das características acústicas dos sons de fala em normo-ouvintes por meio do Frequency Following Response (FFR) / Investigation of the neural discrimination of acoustic characteristics of speech sounds in normal-hearing individuals through Frequency-following Response (FFR)

RESUMO Objetivo Avaliar como as vias auditivas codificam e diferenciam as sílabas plosivas [ga],[da] e [ba], por meio do potencial evocado auditivo Frequency Following Response (FFR), nas crianças em desenvolvimento típico. Método Vinte crianças (6-12 anos) foram avaliadas por meio do FFR para estímulos [ga],[da] e [ba]. Os estímulos foram compostos por seis formantes, sendo diferenciados na transição F2 e F3 (porção transiente). Os demais formantes foram idênticos nas três sílabas (porção sustentada). Foram analisadas latências de 16 ondas que compõe a porção transiente do estímulo (<70ms) e latências de 21 ondas da porção sustentada (90-160ms) nas respostas neurais obtidas para cada uma das sílabas. Resultados As respostas eletrofisiológicas registradas por meio do FFR demonstraram que as latências da porção transiente da resposta neural foram diferentes nas três silabas evocadas. Além disso, os valores de latência das ondas da porção transiente foram aumentando progressivamente, sendo [ga]<[da]<[ba]. Já na porção sustentada da resposta, não houve diferenças significantes nas latências das ondas que compõe essa porção. Conclusão O FFR mostrou-se uma ferramenta eficiente na investigação da discriminação subcortical de diferenças acústicas dos sons de fala, uma vez que demonstrou diferentes resposta eletrofisiológica para três silabas evocadas. Na porção transiente (consoantes) foram observadas mudanças de latência e na porção sustentada (vogal) não houve diferenças entre as latências para os três estímulos. Esses resultados demonstram a capacidade neural de distinção entre características acústicas dos estímulos [ga],[da],[ba].

ABSTRACT Purpose To evaluate how the auditory pathways encode and discriminate the plosive syllables [ga], [da] and [ba] using the auditory evoked Frequency-following Response (FFR) in children with typical development. Methods Twenty children aged 6-12 years were evaluated using the FFR for the [ga], [da] and [ba] stimuli. The stimuli were composed of six formants and were differentiated in the F2 to F3 transition (transient portion). The other formants were identical in the three syllables (sustained portion). The latencies of the 16 waves of the transient portion (<70ms) and of the 21 waves of the sustained portion (90-160ms) of the stimuli were analyzed in the neural responses obtained for each of the syllables. Results The transient portion latencies were different in the three syllables, indicating a distinction in the acoustic characteristics of these syllables through their neural representations. In addition, the transient portion latencies progressively increased in the following order: [ga] <[da] <[ba], whereas no significant differences were observed in the sustained portion. Conclusion The FFR proved to be an efficient tool to investigate the subcortical acoustic differences in speech sounds, since it demonstrated different electrophysiological responses for the three evoked syllables. Changes in latency were observed in the transient portion (consonants) but not in the sustained portion (vowels) for the three stimuli. These results indicate the neural ability to distinguish between acoustic characteristics of the [ga], [da] and [ba] stimuli.

Esketamine may be an ideal substitute for ketamine during cochlear function measurement

The mixture of ketamine and xylazine is widely used for the auditory brainstem response (ABR) measurement. Esketamine is twice as potent as ketamine. Our objective was to assess the influence of esketamine in mice undergoing cochlear function measurement including ABR and distortion product otoacoustic emission (DPOAE) measurement. C57Bl/6J mice were treated with an equivalent dose of analgesia and received either a single intraperitoneal (ip) injection of 100 mg/kg ketamine and 25 mg/kg xylazine or 50 mg/kg esketamine and 25 mg/kg xylazine. Hearing thresholds, peak latencies of waves I and V, and DPOAE thresholds were recorded. Time to loss of righting and time to regain righting were also assessed. We found that hearing thresholds, the peak latencies of waves I and V, and DPOAE thresholds were similar between the two groups (all P>0.05). Time to regain righting was significantly shorter in the esketamine group (P<0.001) than in the ketamine group. We concluded that when using equivalent doses of analgesia, esketamine may be an ideal substitute for ketamine during cochlear function test.

Acoustically controlled binaural auditory training with vocal duets: assessment and effectiveness

OBJECTIVES: We aimed to evaluate the effectiveness of a binaural auditory training program with vocal duets by comparing skills through outcomes from behavioral and electrophysiological assessment instruments at three moments: before the intervention, moment one (M1); immediately after training, moment two (M2); and 3 months after, moment three (M3). METHODS: This interventional, longitudinal, prospective, and uncontrolled study was approved by our Research Ethics Committee. Binaural auditory training with vocal duets (ATVD) was applied in 10 adults with normal audiometric thresholds and auditory processing disorders. ATVD used four different vocals of a public domain song sung in a cappella as stimuli. Participants were asked to register any perceived difference in frequency for each syllable of the song during 30-minute sessions twice a week. The number of sessions required ranged from 12 (6 hours) to 20 (10 hours). RESULTS: Regarding behavioral tests, the dichotic consonant-vowel test showed significant evidence of an improved advantage in the left ear (LE) in the non-forced condition and a significant reduction in the number of errors at M2 and M3 in the forced left condition. The speech-in-noise test and frequency pattern test showed a significant reduction in impaired results at M2 and M3. Electrophysiological results showed a significant increase in the LE amplitude in the P3 long-latency auditory evoked potentials test, as well as a decrease in the auditory brainstem response test (III-V and I-V inter-peak latencies in the right ear and wave I and I-III inter-peak latencies in LE). CONCLUSION: The effectiveness of ATVD was evidenced, and the results were maintained after 3 months.

Comparison of ASSR, ABR and 40 Hz AERP Response Thresholds at Different Frequencies and Their Forensic Applications / 法医学杂志

OBJECTIVES@#To explore the relationship between the frequency characteristics and response threshold of auditory steady-state response (ASSR), auditory brainstem response (ABR) and 40 Hz auditory event related potential (40 Hz AERP), and their application values in forensic medicine.@*METHODS@#Thirty volunteers with normal hearing (60 ears) were selected to perform pure tone audiometry (PTA) threshold and ASSR, ABR and 40 Hz AERP response threshold tests in the standard sound insulation shielding room, and the results were statistically analyzed by SPSS 22.0 software.@*RESULTS@#At 0.5 kHz and 1.0 kHz frequencies, the correlation between 40 Hz AERP response threshold and PTA threshold was good, which was better than that of ASSR and ABR response threshold. At 2.0 kHz and 4.0 kHz frequencies, the correlation between ASSR and ABR response thresholds and PTA threshold was good, which was better than that of 40 Hz AERP response threshold.@*CONCLUSIONS@#To evaluate the hearing at 0.5 kHz and 1.0 kHz frequencies, it is recommended to use 40 Hz AERP and ASSR to comprehensively assess the PTA threshold of the subjects. To evaluate the hearing at 2.0 kHz and 4.0 kHz frequencies, ABR and ASSR are recommended to assess the PTA threshold of subjects comprehensively. The combination of ASSR, ABR and 40 Hz AERP can improve the accuracy of hearing function evaluation.