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Article in Chinese | WPRIM | ID: wpr-879884


OBJECTIVE@#To study brainstem auditory evoked potential (BAEP) in neonates with hyperbilirubinemia using short auditory stimuli (60 dBnHL), and to investigate the differences in the inter-aural latency difference (ILD) of wave V between neonates with different total serum bilirubin (TSB) levels.@*METHODS@#A prospective study was conducted in neonates with hyperbilirubinemia who were admitted to the Department of Neonatology, Yuhuan People's Hospital of Zhejiang Province, from May 2019 to October 2020. The neonates were divided into a severe group (@*RESULTS@#Compared with the mild group, the severe group had significantly higher proportions of neonates with abnormal hearing threshold and abnormal ILD (@*CONCLUSIONS@#Serum bilirubin in neonates affects the ILD of BAEP wave V, especially in those with severe hyperbilirubinemia. ILD at the optimal cut-off value of ≥0.4 ms shows potential value in the diagnosis of hearing impairment caused by neonatal hyperbilirubinemia.

Bilirubin , Evoked Potentials, Auditory, Brain Stem , Hearing Loss , Humans , Hyperbilirubinemia , Hyperbilirubinemia, Neonatal , Infant, Newborn , Prospective Studies
CoDAS ; 33(1): e20180324, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1249593


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.

Humans , Child , Speech Perception , Phonetics , Acoustic Stimulation , Acoustics , Evoked Potentials, Auditory, Brain Stem , Hearing
Clinics ; 76: e2085, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153963


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.

Humans , Adult , Auditory Perceptual Disorders , Evoked Potentials, Auditory , Speech , Acoustic Stimulation , Prospective Studies , Evoked Potentials, Auditory, Brain Stem , Noise
Braz. j. med. biol. res ; 54(11): e11503, 2021. graf
Article in English | LILACS | ID: biblio-1285661


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.

Animals , Rabbits , Ketamine , Xylazine , Evoked Potentials, Auditory, Brain Stem , Otoacoustic Emissions, Spontaneous
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 793-811, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142608


Abstract Introduction: The brainstem auditory evoked potential with speech stimulus, BAEP-speech, has been applied to observe how speech sounds are manifested in the brainstem. This tool can be used in children to assess central auditory processing, allowing preventive and early interventions. Objective: To assess the results found in the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders, through a systematic literature review. Methods: The search was carried out in the scientific databases Portal BVS, Pubmed, Lilacs, Medline, Scielo and Web of Science,, DissOnline, OpenDoar, OAIster and The New York Academy of Medicine. A systematic literature review was performed using the descriptors: auditory evoked potentials, children and their synonyms, combined by the Boolean operators AND and OR. The search filter "age: child" was used. The studies were independently read by peers and, in case of disagreement regarding the inclusion of studies, a third researcher was consulted. Original case-control articles that performed BAEP-speech without competitive noise, carried out in the pediatric population without and with oral language disorders, were included. Result: 14 articles published between 2008 and 2019 were included in this review. Methodological variability was observed in the exam, with the syllable / da / being the most frequently used as the stimulus. When performing the average of the groups, it was observed that the population with specific language disorders showed greater latency delays in the sustained portion, lower amplitude values and VA complex slope. The group with phonological disorders had higher values in the transient portion of the responses. Conclusion: Children with language disorders of different etiologies have different patterns of BAEP-speech responses when compared to children with typical development.

Resumo Introdução: O potencial evocado auditivo de tronco encefálico com estímulo de fala (PEATE-fala) tem sido aplicado para observar como os sons da fala se manifestam no tronco encefálico. Essa ferramenta pode ser usada em crianças na avaliação do processamento auditivo central, permite intervenções preventivas e precoces. Objetivo: Conhecer os resultados encontrados no potencial evocado auditivo de tronco encefálico com estímulo de fala na população pediátrica com e sem transtornos de linguagem oral, por meio de revisão sistemática da literatura. Método: As buscas foram feitas nas bases de dados científicos Portal BVS, Pubmed, Lilacs, Medline, Scielo e Web of Science,, DissOnline, OpenDoar, OAIster e The New York Academy of Medicine. Foi feita revisão sistemática da literatura, com os descritores auditory evoked potentials, children e seus sinônimos, combinados pelos operadores booleanos AND e OR. Foi usado o filtro de pesquisa "idade: criança". A leitura dos estudos foi feita por pares de forma independente e em caso de discordância na inclusão de estudos um terceiro pesquisador foi consultado. Foram incluídos artigos originais do tipo caso-controle que fizeram o PEATE-fala sem ruído competitivo na população pediátrica sem e com transtornos de linguagem oral. Resultado: Foram incluídos 14 artigos publicados entre 2008 e 2019 na presente revisão. Foi observada variabilidade metodológica na realização do exame, a sílaba /da/ foi a mais usada para estimulação. Ao se fazerem médias dos grupos, observou-se que a população com distúrbio específico de linguagem apresentou maiores atrasos de latência na porção sustentada, menores valores de amplitude e slope do complexo VA. O grupo com transtorno fonológico obteve maiores valores na porção transiente das respostas. Conclusão: Crianças com alterações de linguagem de diferentes etiologias apresentam padrões de respostas do PEATE-fala distintos quando comparadas às crianças com desenvolvimento típico.

Humans , Child , Speech Perception , Evoked Potentials, Auditory, Brain Stem , Speech , Acoustic Stimulation , Evoked Potentials, Auditory , Language Development Disorders
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 687-695, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142606


Abstract Introduction: The study of the threshold level of cortical auditory response in adults has been investigated in previous studies. Due to maturational issues, little is known about these responses in neonates. Technological advances with automatic analysis devices now allow investigation in specific populations. Thus, new studies are needed to establish the feasibility of using this auditory potential to identify the lowest levels of responses in children. Objective: Verify and compare latency and amplitude in 80 dBnNA and the minimum level of cortical auditory response in term and preterm neonates. Methods: A cross-sectional, comparative study involving 59 neonates, 35 full-term births and 24 preterm births, with positive results in the Neonatal Hearing Screening. The Hearlab system was used to investigate the P1i auditory potential with tone burst stimulus at frequencies of 500, 1000, 2000 and 4000 Hz. The minimum response level search ranged from 80 to 0 dBNA and was detected automatically. The results were compared between groups, evaluating the latency and amplitude in 80 dBNA and the minimum level of cortical auditory response. Results: The mean values obtained for the minimum level of cortical auditory response in term group were 26 ± 8.81; 26.14 ± 6.97; 29 ± 7.65 and 29.43 ± 7.04 dBNA and for preterm neonates of 31.96 ± 10.41; 34.13 ± 11.34; 33.64 ± 11.03 and 37.73 ± 11.92 dBNA, for the frequencies of 500, 1000, 2000 and 4000 Hz, respectively. There was a difference between groups for the latency of P1i at 4000 Hz and the minimum response levels at 500, 1000 and 4000 Hz, with higher values for preterm infants. Conclusion: It was possible to obtain latency and amplitude values at 80 dBnNA and the minimum level of cortical response in term and preterm newborns, with different results between groups, with higher values in those born preterm.

Resumo Introdução: A investigação do nível mínimo de resposta auditiva cortical tem sido alvo de diferentes estudos em adultos. Devido a questões de maturação, pouco se sabe sobre essas respostas em recém-nascidos. Com o avanço tecnológico, dispositivos de análise automática surgiram com o objetivo de retomar essa avaliação em populações específicas. Assim, novos estudos são necessários para verificar a viabilidade do uso desse potencial auditivo na obtenção de níveis mínimos de respostas na criança. Objetivo: Verificar e comparar latência e amplitude em 80 dBnNA e o nível mínimo de resposta auditiva cortical em recém-nascidos a termo e pré-termo. Método: Estudo transversal, comparativo, envolvendo 59 neonatos, 35 nascidos a termo e 24 pré-termos, com resultados positivos na triagem auditiva neonatal. O sistema Hearlab foi utilizado para investigar o potencial auditivo P1i com estímulo tone burst nas frequências de 500, 1000, 2000 e 4000 Hz. A busca do nível mínimo de resposta variou de 80 a 0 dBNA e foi detectado automaticamente. Os resultados foram comparados entre os grupos, avaliando a latência e amplitude em 80 dBNA e o nível mínimo de resposta auditiva cortical. Resultados: Os valores médios obtidos para o nível mínimo de resposta auditiva cortical no grupo nascido a termo foram 26 ± 8,81; 26,14 ± 6,97; 29 ± 7,65 e 29,43 ± 7,04 dBNA e para recém-nascidos pré-termos foram de 31,96 ± 10,41; 34,13 ± 11,34; 33,64 ± 11,03 e 37,73 ± 11,92 dBNA, para as frequências de 500, 1000, 2000 e 4000 Hz, respectivamente. Houve diferenc¸a entre os grupos para a latência de P1i em 4000 Hz e os níveis mínimos de resposta em 500, 1000 e 4000 Hz, com valores maiores em Pré-termos. Conclusão: Foi possível obter valores de latência e amplitude em 80 dBnNA e o nível mínimo de resposta cortical em recém-nascidos a termo e Pré-termos, com resultados diferentes entre osgrupos, com valores maiores em pré-termos.

Humans , Infant, Newborn , Infant, Premature , Evoked Potentials, Auditory , Acoustic Stimulation , Cross-Sectional Studies , Evoked Potentials, Auditory, Brain Stem , Hearing
Braz. j. otorhinolaryngol. (Impr.) ; 86(2): 191-200, March-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132572


Abstract Introduction: Brainstem auditory evoked potentials in response to complex sounds, such as speech sounds, investigate the neural representation of these sounds at subcortical levels, and faithfully reflect the stimulus characteristics. However, there are few studies that utilize this type of stimulus; for it to be used in clinical practice it is necessary to establish standards of normality through studies performed in different populations. Objective: To analyze the latencies and amplitudes of the waves obtained from the tracings of brainstem auditory evoked potentials using speech stimuli in Brazilian neonates with normal hearing and without auditory risk factors. Methods: 21 neonates with a mean age of 9 days without risk of hearing loss and with normal results at the neonatal hearing screening were evaluated according to the Joint Committee on Infant Hearing protocols. Auditory evoked potentials were performed with speech stimuli (/da/ syllable) at the intensity of 80 dBNA and the latency and amplitude of the waves obtained were analyzed. Results: In the transient portion, we observed a 100% response rate for all analyzable waves (Wave I, Wave III, Wave V and Wave A), and these waves exhibited a latency <10 ms. In the sustained portion, Wave B was identified in 53.12% of subjects; Wave C in 75%; Wave D in 90.62%; Wave E in 96.87%; Wave F in 87.5% and Wave O was identified in 87.5% of subjects. The observed latency of these waves ranged from 11.51 ms to 52.16 ms. Greater similarity was observed for the response latencies, as well as greater amplitude variation in the studied group. Conclusions: Although the wave morphology obtained for brainstem evoked potentials with speech stimulation in neonates is quite similar to that of adults, a longer latency and greater variation in amplitude were observed in the waves analyzed.

Resumo Introdução: Os potenciais evocados auditivos de tronco encefálico para sons complexos, como, por exemplo, sons de fala, investigam a representação neural desses sons em níveis subcorticais e refletem com fidelidade as características do estímulo. No entanto, existem ainda poucos estudos que usam esse tipo de estímulo e para que possa ser usado na prática clínica é necessário estabelecer padrões de normalidade por meio de estudos em diferentes populações. Objetivo: Analisar as latências e as amplitudes das ondas obtidas nos traçados dos potenciais evocados auditivos de tronco encefálico por estímulo de fala em neonatos brasileiros com audição normal e sem risco auditivo. Método: Foram avaliados 21 neonatos com média de 9 dias, sem risco auditivo segundo o Joint Committe on Infant Hearing e com resultado normal para triagem auditiva neonatal. Fizeram-se potenciais evocados auditivos por estímulo de fala (sílaba /da/) na intensidade de 80 dBNA e analisaram-se a latência e a amplitude das ondas obtidas. Resultados: Na porção transiente observaram-se 100% de ocorrência de resposta para todas as ondas analisáveis (Onda I, Onda III, Onda V e Onda A) e esse conjunto de ondas apresentou latência inferior a 10 ms. Na porção sustentada a frequência de ocorrência da Onda B foi de 53,12%; da Onda C 75%; da Onda D 90,62%; da Onda E 96,87%; da Onda F 87,5% e da Onda O 87,5% e a latência observada dessas ondas variou de 11,51 ms a 52,16 ms. Observou-se maior similaridade nas latências das respostas e maior variação da amplitude no grupo estudado. Conclusões: Embora a morfologia das ondas obtidas para os potenciais evocados de tronco encefálico para o estímulo de fala em neonatos seja bastante semelhante às dos adultos, observou-se maior latência e maior variação da amplitude das ondas analisáveis.

Humans , Male , Female , Infant, Newborn , Reaction Time/physiology , Speech/physiology , Acoustic Stimulation/methods , Evoked Potentials, Auditory, Brain Stem/physiology , Neonatal Screening
Braz. j. otorhinolaryngol. (Impr.) ; 86(2): 209-216, March-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132583


Abstract Introduction: Deficient auditory processing can cause problems with speech perception and affect the development and evolution of reading skills. The efferent auditory pathway has an important role in normal auditory system functions like speech-in-noise perception, but there is still no general agreement on this. Objective: To study the performance of the efferent auditory system in a group of children with reading impairment in comparison with normal reading and evaluation of its relationship with speech-in-noise perception. Methods: A total of 53 children between the ages of 8-12 years were selected for the study of which 27 were with reading impairment and 26 were normal reading children. Transient evoked otoacoustic emissions suppression and auditory recognition of words-in-noise test were performed for all the children. Results: The average amplitude of transient evoked otoacoustic emissions suppression showed a significant difference between the two groups in the right (p = 0.004) and in the left ear (p = 0.028). Assessment of the relationship between transient evoked otoacoustic emissions suppression and monaural auditory recognition of words-in-noise scores showed a significant moderate negative relationship only in the right ear (p = 0.034, r = −0.41) of the normal reading children. Binaural auditory recognition of words-in-noise scores were significantly correlated with the amplitude of transient evoked otoacoustic emissions suppression in the right ear (p < 0.001, r = −0.75) and in the left ear (p < 0.001, r = −0.64) of normal reading children. In the reading impaired group, ?a weaker correlation was observed between binaural auditory recognition of words-in-noise scores and transient evoked otoacoustic emissions suppression in the right (p = 0.003, r = −0.55) and in the left ear (p = 0.012, r = −0.47). Conclusions: Transient evoked otoacoustic emissions suppression pattern in the reading impaired group was different compared with normal reading children, and this difference could be related to efferent system performance. Words-in-noise scores in children with impaired reading were lower than in normal reading children. In addition, a relationship was found between transient evoked otoacoustic emissions suppression and words-in-noise scores in both normal and impaired reading children.

Resumo Introdução: O processamento auditivo deficiente pode causar problemas na percepção da fala e afetar o desenvolvimento e a evolução das habilidades de leitura. A via auditiva eferente tem um papel importante nas funções do sistema auditivo normal, como a percepção da fala no ruído, mas ainda não há um consenso sobre isso. Objetivo: Estudar o desempenho do sistema auditivo eferente em um grupo de crianças com dificuldade de leitura em comparação às com leitura normal e avaliação de sua relação com a percepção da fala no ruído. Método: Foram selecionadas para o estudo 53 crianças entre oito e 12 anos, das quais 27 tinham dificuldade de leitura e 26 apresentavam leitura normal. A avaliação por emissões otoacústicas evocadas transientes e o teste auditory recognition of words-in-noise foram feitos em todas as crianças. Resultados: A amplitude média da supressão das emissões otoacústicas evocadas transientes mostrou diferença significante entre os dois grupos na orelha direita (p = 0,004) e esquerda (p = 0,028). A avaliação da relação entre a supressão das emissões otoacústicas evocadas transientes e os escores monoaurais do teste auditory recognition of words-in-noise mostrou uma relação negativa moderadamente significante apenas na orelha direita (p = 0,034, r = -0,41) das crianças com leitura normal. Os escores binaurais do auditory recognition of words-in-noise foram significantemente correlacionados com a amplitude de supressão das emissões otoacústicas evocadas transientes na orelha direita (p < 0,001, r = -0,75) e na orelha esquerda (p < 0,001, r = -0,64) das crianças com leitura normal. No grupo com dificuldade de leitura, uma correlação mais fraca foi observada entre os escores binaurais do auditory recognition of words-in-noise e supressão das emissões otoacústicas evocadas transientes, na orelha direita (p = 0,003, r = -0,55) e na esquerda (p = 0,012, r = -0,47). Conclusões: O padrão de supressão das emissões otoacústicas evocadas transientes no grupo com dificuldade de leitura foi diferente em comparação com as crianças com leitura normal e essa diferença pode estar relacionada ao desempenho do sistema eferente. Os escores de palavras no ruído em crianças com dificuldade de leitura foram menores do que nas crianças com leitura normal. Além disso, foi encontrada uma relação entre a supressão das emissões otoacústicas evocadas transientes e os escores de palavras no ruído tanto em crianças com leitura normal quanto nas com dificuldade de leitura.

Humans , Male , Female , Child , Auditory Pathways/physiology , Speech Perception/physiology , Evoked Potentials, Auditory, Brain Stem/physiology , Otoacoustic Emissions, Spontaneous/physiology , Dyslexia/physiopathology , Efferent Pathways/physiology , Acoustic Stimulation , Case-Control Studies , Noise
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 47-52, Jan.-Mar. 2020. graf
Article in English | LILACS | ID: biblio-1090559


Abstract Introduction Cisplatin damages the auditory system and is related to the generation of free radicals. Glutathione peroxidase is an endogenous free radicals remover. Objective To investigate the mechanisms involved in otoprotection by N-acetylcys- teine through the expression of glutathione peroxidase in outer hair cells from rats treated with cisplatin. Methods Male Wistar rats were intraperitoneally injected with cisplatin (8 mg/Kg) and/or received oral administration by gavage of N-acetylcysteine (300 mg/Kg) for 3 consecutive days. On the 4th day, the animals were euthanized and beheaded. The tympanic bullae were removed and prepared for scanning electron microscopy and Results Among the groups exposed to ototoxic doses of cisplatin, there was an increase in glutathione peroxidase immunostaining in two groups, the one exposed to cisplatin alone, and the group exposed to both cisplatin and N-acetylcysteine. Conclusion The expression of glutathione peroxidase in the outer hair cells of rats exposed to cisplatin showed the synthesis of this enzyme under cellular toxicity conditions.

Animals , Male , Acetylcysteine/therapeutic use , Free Radical Scavengers/therapeutic use , Cisplatin/toxicity , Oxidative Stress/drug effects , Antineoplastic Agents/toxicity , Acetylcysteine/metabolism , Acetylcysteine/pharmacology , Microscopy, Electron, Scanning , Evoked Potentials, Auditory, Brain Stem , Free Radical Scavengers/metabolism , Free Radical Scavengers/pharmacology , Fluorescent Antibody Technique , Cisplatin/therapeutic use , Rats, Wistar , Cochlea/anatomy & histology , Cochlea/drug effects , Free Radicals , Glutathione Peroxidase/metabolism , Hearing Loss, Sensorineural/prevention & control
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 86-92, Jan.-Mar. 2020. tab
Article in English | LILACS | ID: biblio-1090561


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.

Humans , Male , Female , Adult , Middle Aged , Audiometry, Pure-Tone , Auditory Threshold/physiology , Evoked Potentials, Auditory, Brain Stem , Spinocerebellar Ataxias/physiopathology , Acoustic Impedance Tests , Cross-Sectional Studies , Retrospective Studies , Spinocerebellar Ataxias/complications , Hearing Disorders/diagnosis , Hearing Disorders/etiology
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 30-37, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089360


Abstract Introduction Ototoxicity is a health problem appearing after powerful treatments in serious health conditions. It is sometimes inevitable when treatment of the serious disease is required. Cisplatin is an antineoplastic agent which was investigated previously to reveal increased nitrogen and reactive oxygen radicals that damages hair cells, resulting in ototoxicity. N-acetylcysteine, previously shown to decrease ototoxicity caused by different agents, is known to be a powerful in vitro antioxidant. Probably N-acetylcysteine, in addition to its antioxidant effect, blocks a cascade where reactive oxygen species result in apoptosis in the cochlea. Objectives The possible preventive effect of N-acetylcysteine in cisplatin ototoxicity was studied with auditory brain stem responses, otoacoustic emissions, and histopathological investigation of the cochlea in a scanning electron microscopy. Methods This study was conducted on 21 Wistar Albino rats in four groups. 1 mL/kg/day three times in total intraperitoneal (i.p.) Saline (n = 5), 500 mg/kg/day i.p. three times in total N-acetylcysteine (n = 5), i.p. 15 mg/kg cisplatin alone (single dose) (n = 5) and i.p. 15 mg/kg cisplatin plus 500 mg/kg/day N-acetylcysteine (n = 6) were administered. The rats were anesthetized to study the hearing tests before and after the experiment. The rats were sacrificed to investigate the cochleas by scanning electron microscopy. Results Auditory brain stem responses and otoacoustic emissions values were attenuated in the cisplatin group. The group that received N-acetylcysteine in addition to cisplatin had better auditory brain stem responses thresholds and otoacoustic emissions. The samples obtained from the cisplatin group showed surface irregularities, degeneration areas, and total or partial severe stereocilia losses. The changes were milder in the cisplatin + N-acetylcysteine group. Conclusion Cisplatin ototoxicity can be detected by auditory brain stem responses and otoacoustic emissions testing in rats. N-acetylcysteine may protect the cochlear cells from histopathological changes. We concluded that N-acetylcysteine given 4 h after cisplatin injection has a potential otoprotective effect against cisplatin ototoxicity. which suggests it could be used in clinical trials.

Resumo Introdução A ototoxicidade é um problema que pode ocorrer após certos tipos de tratamentos para condições graves de saúde. Às vezes é inevitável quando o tratamento da doença é necessário. A cisplatina é um agente antineoplásico cujo uso em pesquisas anteriores demonstrou aumentar os radicais livres de nitrogênio e espécies reativas de oxigênio que danificam as células ciliadas e resultam em ototoxicidade. Por outro lado, a N-acetilcisteína, que já demonstrou diminuir a ototoxicidade causada por diferentes agentes, é conhecida por ser um potente antioxidante in vitro. Provavelmente a N-acetilcisteína, além de seu efeito antioxidante, bloqueia uma cascata onde espécies reativas de oxigênio resultam em apoptose na cóclea. Objetivos Estudar o possível efeito preventivo da N-acetilcisteína na ototoxicidade por cisplatina por meio de potencial evocado auditivo de tronco encefálico, emissões otoacústicas e investigação histopatológica da cóclea por microscopia eletrônica de varredura. Método Este estudo foi realizado em 21 ratos albinos Wistar, separados em quatro grupos. Foram administrados: 1 mL/kg/dia intraperitoneal (i.p.) de solução salina (n = 5), três vezes no total; 500 mg/kg/dia i.p. de N-acetilcisteína (n = 5), três vezes no total; 15 mg/kg i.p. (dose única) somente de cisplatina (n = 5) e 15 mg/kg i.p. de cisplatina e 500 mg/kg/dia i.p. de N-acetilcisteína (n = 6). Os ratos foram anestesiados para estudo dos testes auditivos antes e depois do experimento. Os ratos foram sacrificados para investigação da cóclea por microscopia eletrônica de varredura. Resultados Os potenciais evocados auditivos de tronco encefálico e os valores das emissões otoacústicas estavam atenuados no grupo cisplatina. O grupo que recebeu N-acetilcisteína além da cisplatina apresentou melhores limiares de respostas auditivas do tronco encefálico e emissões otoacústicas. As amostras obtidas do grupo cisplatina apresentaram irregularidades de superfície, áreas de degeneração, com perdas graves totais ou parciais de estereocílios. As alterações foram mais leves no grupo cisplatina + N-acetilcisteína. Conclusão A ototoxicidade por cisplatina pode ser detectada por meio de potenciais evocados auditivos de tronco encefálico e pelo teste de emissões otoacústicas em ratos. A N-acetilcisteína pode proteger as células cocleares contra alterações histopatológicas. Concluímos que a N-acetilcisteína administrada 4 horas após a injeção de cisplatina tem potencial efeito otoprotetor contra a ototoxicidade por cisplatina e pode ser utilizada em ensaios clínicos.

Animals , Male , Acetylcysteine/administration & dosage , Cisplatin/adverse effects , Protective Agents/administration & dosage , Ototoxicity/etiology , Antineoplastic Agents/adverse effects , Antioxidants/administration & dosage , Acetylcysteine/pharmacology , Microscopy, Electron, Scanning , Evoked Potentials, Auditory, Brain Stem , Rats, Wistar , Cochlea/pathology , Apoptosis , Hair Cells, Auditory, Outer/drug effects , Hair Cells, Auditory, Outer/pathology , Protective Agents/pharmacology , Disease Models, Animal , Stereocilia/drug effects , Stereocilia/pathology , Ototoxicity/prevention & control , Hearing Tests , Antioxidants/pharmacology
Arq. neuropsiquiatr ; 78(2): 63-69, Feb. 2020. tab
Article in English | LILACS | ID: biblio-1089001


Abstract Objective: Investigate the auditory pathway in the brainstem of children with acute lymphoblastic leukemia submitted to chemotherapy (by intravenous or intrathecal infusion). Methods: Fourteen children aged between 2 and 12 years with diagnosis of acute lymphoid leukemia were evaluated. The following procedures were used: meatoscopy, acoustic immitance measurements, tonal audiometry, vocal audiometry, transient otoacoustic emissions, and auditory brainstem response. Results: From the 14 children with normal auditory thresholds, 35.71% showed an alteration in auditory brainstem response, with a predominance of hearing impairment in the lower brainstem. It was found that 80% of the children with alteration had used intrathecal methotrexate less than 30 days and that 40% had the highest cumulative intravenous methotrexate doses. Conclusion: Children with acute lymphoblastic leukemia submitted to chemotherapy, present auditory pathway impairment in the brainstem, with a predominance of a low brainstem.

Resumo Objetivo: Investigar a via auditiva em tronco encefálico de crianças com leucemia linfoide aguda submetidas à quimioterapia (por infusão intravenosa ou por via intratecal). Métodos: Foram avaliadas 14 crianças com idade entre 2 e 12 anos, com diagnóstico de leucemia linfoide aguda. Foram utilizados os seguintes procedimentos: meatoscopia, medidas de imitância acústica, audiometria tonal, audiometria vocal, emissões otoacústicas transientes e potencial evocado auditivo de tronco encefálico. Resultados: Das 14 crianças com limiares auditivos normais, 35,71% demonstraram alteração no Potencial Evocado Auditivo de Tronco Encefálico, com predomínio de comprometimento de via auditiva em tronco encefálico baixo. Verificou-se que 80% das crianças com alteração haviam feito uso do metotrexato via intratecal a menos de 30 dias e que 40% tinham as maiores doses acumulativas de metotrexato por via endovenosa. Conclusão: Crianças com leucemia linfoide aguda submetidas à quimioterapia apresentam comprometimento na via auditiva em tronco encefálico, com predomínio em tronco encefálico baixo.

Humans , Child, Preschool , Child , Otoacoustic Emissions, Spontaneous , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Auditory Pathways , Auditory Threshold , Brain Stem , Methotrexate , Evoked Potentials, Auditory, Brain Stem
Rev Assoc Med Bras (1992) ; 66(7): 1002-1008, 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136306


SUMMARY The increase in bilirubin levels in newborns can cause toxic effects on the auditory system, which can lead to hearing loss. This review aimed to verify the impact of hyperbilirubinemia in the hearing of newborns, relating audiological findings to serum levels of bilirubin. A literature review was conducted during October 2017, using the terms "hyperbilirubinemia", "jaundice", "infant", "newborn" and "hearing loss", on databases CAPES journals, MEDLINE and BIREME (SciELO, BBO). 827 studies were identified and 59 were selected for full-text reading, resulting in the selection of seven articles that met the inclusion criteria and were considered relevant to the sample of this study. All the reviewed studies performed brainstem auditory evoked potential as the main test for audiological evaluation. Changes in the audiological findings of neonates with hyperbilirubinemia were observed in all studies. There was no consensus on the serum bilirubin levels that may cause auditory changes; however, the relationship between hearing disorders and blood levels of bilirubin was positive. We identify the need to establish reference values for bilirubin levels considered critical for the occurrence of hearing disorders as well as the audiological follow-up of neonates with hyperbilirubinemia.

RESUMO O aumento nos níveis de bilirrubina no neonato pode provocar efeitos tóxicos no sistema auditivo, podendo levar à perda auditiva. O objetivo desta revisão foi verificar o impacto da hiperbilirrubinemia na audição de recém-nascidos, relacionando os achados audiológicos aos níveis séricos de bilirrubina. Realizou-se uma revisão sistemática de literatura durante o mês de outubro de 2017, utilizando-se os termos hyperbilirubinemia, jaundice, infant, newborn e hearing loss, nas bases de dados periódicos Capes, Medline e Bireme (SciELO, BBO). Foram identificados 827 estudos, dentre os quais 59 foram selecionados para leitura do texto na íntegra, resultando na seleção de sete artigos que atendiam aos critérios de inclusão e foram considerados relevantes para a amostra deste trabalho. Em todas as pesquisas revisadas, o potencial evocado auditivo de tronco encefálico foi o principal exame audiológico realizado. Em todos os estudos foram observadas alterações nos resultados audiológicos de neonatos com hiperbilirrubinemia. Não houve consenso quanto aos níveis séricos de bilirrubina que podem causar alterações auditivas, porém, a relação entre as alterações audiológicas e os níveis sanguíneos de bilirrubina foi positiva. Percebeu-se a necessidade de estabelecer valores de referência para os níveis de bilirrubina considerados críticos para a ocorrência de alterações audiológicas, assim como de acompanhamento audiológico dos neonatos com hiperbilirrubinemia.

Humans , Infant, Newborn , Evoked Potentials, Auditory, Brain Stem , Hearing Loss/complications , Audiometry , Bilirubin , Hyperbilirubinemia/complications
Audiol., Commun. res ; 25: e2293, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1131784


RESUMO Objetivo investigar a audição de crianças com microcefalia pela síndrome congênita do Zika vírus. Métodos a amostra foi composta de 11 crianças com microcefalia causada pela síndrome congênita do Zika vírus. A coleta teve início no primeiro semestre de 2017, sendo finalizada no primeiro semestre de 2018. Procedimentos realizados: avaliação otorrinolaringológica e audiológica: observação do comportamento auditivo e audiometria de reforço visual; imitanciometria, emissões otoacústicas evocadas por estímulo transiente, potencial evocado auditivo de tronco encefálico por via áerea e potencial evocado auditivo por estado estável com estímulo narrow band CE-chirp. As respostas comportamentais foram comparadas com as respostas do potencial evocado auditivo de estado estável. Resultados apresentaram respostas dentro do esperado para idade, na avaliação comportamental 11 crianças, com 20 dB bilateralmente para tons calibrados em campo, nas frequências de 500 Hz, 1 kHz, 2 kHz e 4 kHz, sendo que 2 delas conseguiram realizar a audiometria em campo com fone de inserção bilateralmente. Em relação às emissões otoacústicas, todas tiveram respostas presentes em ambas as orelhas, 10 crianças apresentaram timpanometria tipo A e uma (1) do tipo Ar. Quanto ao potencial evocado auditivo, as 8 crianças avaliadas apresentaram resultados dentro da normalidade, com nível mínimo de respostas em 20 dBNAn bilateralmente. No potencial evocado auditivo de estado estável, 6 crianças avaliadas apresentaram nível mínimo derespostas em 500 Hz, 1 kHz, 2 kHz e 4kHz, em 20 dBNAn, bilateralmente. Conclusão as crianças avaliadas não apresentaram perda auditiva neurossensorial.

ABSTRACT Purpose to investigate the hearing of children with microcephaly due to congenital Zika virus syndrome. Methods the sample consisted of eleven children with microcephaly due to the congenital Zika virus syndrome. The collection was carried out in the first semester of 2017 until the first semester of 2018. Procedures performed: otorhinolaryngological and audiological evaluation: observation of auditory behavior and visual reinforcement audiometry; immittance testing, transient evoked otoacoustic emissions, brainstem auditory evoked potential, and auditory steady-state evoked potential with narrow band CE-chirp stimulus. The behavioral responses were compared with the responses of the auditory steady-state evoked potential. Results eleven children presented responses as expected for age in the behavioral assessment, with 20 dB bilaterally for tones calibrated in the field at frequencies of 500 Hz, 1kHz, 2 kHz, 4 kHz, with 2 children being able to perform field audiometry with bilateral earphone insertion. Regarding the transient evoked otoacoustic emissions, all presented responses in both ears, ten children had tympanometry type A and one had type Ar tympanometry. Regarding the auditory evoked potential, 8 children had results within the normal range, with a minimum level of response at 20 dBnHL bilaterally. In the auditory steady-state evoked potential, 6 children had a minimum response level of 500 Hz, 1 kHz, 2 kHz, and 4 kHz, bilaterally, at 20 dBnHL. Conclusion the children did not present sensorineural hearing loss.

Humans , Child , Evoked Potentials, Auditory, Brain Stem , Treatment Outcome , Zika Virus Infection/complications , Hearing Loss , Microcephaly/diagnosis , Cross-Sectional Studies , Risk Factors , Evoked Potentials, Auditory
Audiol., Commun. res ; 25: e2268, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1131787


RESUMO Objetivo Padronizar os parâmetros de latência e amplitude obtidos com o estímulo Ichirp de banda estreita, na pesquisa dos potenciais evocados auditivos de tronco encefálico nas frequências de 500 Hz, 1 kHz, 2 kHz e 4 kHz. Métodos O estudo foi realizado na Divisão de Saúde Auditiva do Hospital de Reabilitação de Anomalias Craniofaciais, da Universidade de São Paulo. Participaram 20 adultos ouvintes normais, na faixa etária de 18 a 35 anos. Todos os participantes foram submetidos à audiometria tonal limiar, logoaudiometria, imitanciometria e aos potenciais evocados auditivos de tronco encefálico, pesquisados com o estímulo Ichirp de banda estreita, nas frequências de 500 Hz, 1 kHz, 2 kHz e 4 kHz. Resultados Em todas as frequências avaliadas foi observada a função latência-intensidade, ou seja, o aumento na latência da onda V, na medida em que a intensidade do estímulo foi diminuída, bem como a diminuição na latência da onda V com o aumento da frequência avaliada. Além disso, verificou-se a redução na amplitude da onda V com a diminuição da intensidade do estímulo. Constatou-se o nível mínimo de resposta, em todas as frequências, em níveis inferiores aos valores sugeridos pela literatura como critério de normalidade no registro dos potenciais evocados auditivos de tronco encefálico de frequência específica, sendo os maiores valores nas frequências de 500 Hz e 1 kHz. Conclusão Foram obtidos os valores de referência de normalidade para os potenciais evocados auditivos de tronco encefálico em adultos ouvintes normais com o estímulo Ichirp, valores estes que podem contribuir para o aprimoramento do exame, na prática clínica.

ABSTRACT Purpose Standardize the latency and amplitude parameters using the narrow band Ichirp stimulus on Brainstem Auditory Evoked Potential (BAEP) at frequencies of 500 Hz, 1 kHz, 2 kHz and 4 kHz. Methods The study was performed at the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), Auditory Health Division, University of São Paulo (USP). Twenty normal hearing adults, aged between 18 and 35 years, were submitted to pure tone audiometry, speech audiometry, immittance and to BAEP with narrow band Ichirp stimulus at 500 Hz, 1 kHz, 2 kHz and 4 kHz frequencies. Results In all frequencies evaluated, the latency-intensity function was observed, that is, the increase in the latency of the V wave as the stimulus intensity was decreased, as well as the decrease in the latency of the V wave with the increase of the frequency. In addition, the reduction in the amplitude of the wave V was verified with the decrease of the intensity of the stimulus. The minimum response level, in all frequencies, was found to be lower than the values suggested in the literature as a criterion of normality in frequency - specific BAEP, with the highest values at frequencies of 500 Hz and 1 kHz. Conclusion Normal reference values to BAEP were obtained in normal hearing adults with the narrow band Ichirp stimulus, which may contribute to its improvement in clinical practice.

Humans , Adolescent , Adult , Reaction Time/physiology , Reference Standards , Reproducibility of Results , Evoked Potentials, Auditory, Brain Stem/physiology
Audiol., Commun. res ; 25: e2251, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1131800


RESUMO Objetivo Monitorar o sistema auditivo central de crianças nascidas pequenas para a idade gestacional, por meio da avaliação eletrofisiológica da audição, para verificar a ocorrência de eventuais disfunções neurais nesse sistema. Métodos Estudo longitudinal, cuja casuística foi composta por 23 crianças distribuídas em quatro grupos: 1) grupo de quatro crianças nascidas pequenas para a idade gestacional e a termo; 2) grupo de sete crianças nascidas pequenas para a idade gestacional e pré-termo; 3) grupo de quatro crianças nascidas com peso adequado para a idade gestacional e a termo; 4) grupo de oito crianças nascidas adequadas para a idade gestacional e pré-termo, cuja idade ao final da pesquisa foi de 3 anos (variação entre 34 e 39 meses). O critério de inclusão foi presença bilateral de emissões otoacústicas transientes. Todas as crianças foram submetidas ao potencial evocado auditivo de tronco encefálico ao nascimento, aos 6 meses e aos 3 anos de idade e à pesquisa do potencial evocado auditivo de longa latência aos 3 anos. Resultados crianças nascidas pequenas para a idade gestacional e a termo tiveram maior ocorrência de alterações, em relação aos demais grupos, com aumento da latência das ondas III e V e interpicos I-III e I-V. Todas apresentaram resultados normais no potencial evocado auditivo de longa latência. Conclusão Crianças nascidas pequenas para a idade gestacional e a termo apresentam disfunções na condução neural no tronco encefálico e devem ser consideradas de risco para alterações do desenvolvimento das habilidades auditivas necessárias para garantir qualidade de processamento da informação acústica.

ABSTRACT Purpose To follow up the central auditory system of children born small for gestational age, through electrophysiological evaluation of hearing, in order to verify the occurrence of possible neural dysfunctions in this system. Methods A longitudinal study was carried out with 23 children divided into four groups: Term-born group, subdivided into small for gestational age (four children) and four children born with appropriate weight for gestational age, whose age at the end of the research was three years old. Preterm group subdivided into small for gestational age (seven children), and appropriate for gestational age (eight children), whose corrected age, at the end of the research was three years old. All children were subjected to assessment of auditory brainstem auditory evoked potentials at birth, at six months and at three years of age, and Long-Latency Auditory Evoked Potential at three years. Results children born at term and small for gestational age had a higher occurrence of hearing alterations in relation to the other groups, with increased latency of waves III and V and interpeaks I-III and I-V. All children presented normal evaluation in the Long-Latency Auditory Evoked Potential. Conclusion Children born term and small for gestational age present dysfunctions in neural conduction in the brainstem and should be considered at risk for alterations in the development of the auditory skills that are necessary to guarantee quality of acoustic information processing.

Humans , Infant, Newborn , Infant , Infant, Small for Gestational Age , Evoked Potentials, Auditory, Brain Stem/physiology , Electrophysiology , Hearing Disorders/diagnosis , Hearing Disorders/physiopathology , Infant, Premature , Otoacoustic Emissions, Spontaneous/physiology , Language Development Disorders
Audiol., Commun. res ; 25: e2152, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1131801


RESUMO Objetivo avaliar a influência da variável sexo nos valores da latência e amplitude da onda V do potencial evocado auditivo de tronco encefálico, com diferentes estímulos em neonatos. Métodos participaram deste estudo 62 neonatos nascidos a termo (29 do sexo feminino e 33 do sexo masculino). Realizou-se a pesquisa de limiar eletrofisiológico do potencial evocado auditivo de tronco encefálico com quatro estímulos diferentes (clique, Ichirp banda larga-BL, tone burst e Ichirp-frequência específica-FE), nas intensidades de 60, 40 e 20 dBnNA. A variável sexo foi comparada para cada estímulo e intensidade. Resultados os resultados obtidos demonstraram menor latência e maior amplitude no sexo feminino para o estímulo clique. Entretanto, para o estímulo tone burst, o sexo feminino apresentou maior latência e maior amplitude. Quando utilizados os estímulos Ichirp-BL e Ichirp-FE, a variável sexo não apresentou diferença estatisticamente significativa para os valores de latência e amplitude. Conclusão a onda V do PEATE de neonatos sofre influência da variável sexo, quando utilizados os estímulos clique e tone burst. Entretanto, não houve tal influência quando utilizado o estímulo Ichirp banda larga-BL e o estímulo Ichirp frequência específica-FE.

ABSTRACT Purpose To evaluate the influence of gender on the brainstem auditory evoked potentials V-wave latency and amplitude values in newborns, with different stimuli. Methods 62 full-term newborns (29 females and 33 males) participated in this study. The electrophysiological threshold of the brainstem auditory evoked potential was investigated with four different stimuli - click, broadband (BB) Ichirp, tone-burst, and specific-frequency (SF) Ichirp -, in intensities of 60, 40 and 20 dBnHL. The genders were compared in each stimulus and intensity. Results The results obtained showed lower latency and greater amplitude in females for the click stimulus. However, for tone-burst, the females presented higher latency and greater amplitude. When the BB-Ichirp and SF-Ichirp stimuli were used, the gender did not present a statistically significant difference in the latency and amplitude values. Conclusion The BAEP V-wave in newborns is influenced by gender when the click and tone-burst stimuli are used. However, such influence was not noted when the BB-Ichirp and SF-Ichirp stimuli were used.

Humans , Male , Female , Infant, Newborn , Sex Factors , Evoked Potentials, Auditory, Brain Stem/physiology , Neonatal Screening , Term Birth , Electrophysiological Phenomena , Auditory Threshold , Audiology , Electrophysiology
Clinics ; 75: e1579, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133478


OBJECTIVES: Assessing infants' hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss. METHODS: This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook. RESULTS: A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process. CONCLUSION: There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.

Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Evoked Potentials, Auditory, Brain Stem , Hearing Loss/diagnosis , Cross-Sectional Studies , Delivery of Health Care , Hearing
Codas ; 32(3): e20180254, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1133493


RESUMO Objetivo: Analisar o slope e as latências e amplitudes das ondas V, A, C, D, E, F e da Frequency-Following Response, com estímulo de fala, em adultos com audição normal, tendo como base referência internacional. Método: Onze adultos normo- ouvintes com idade entre 18 e 30 anos, sem queixas auditivas, foram avaliados na pesquisa. O equipamento utilizado foi o Intelligent Hearing System. O estímulo de fala /da/ foi apresentado por meio de fone de inserção na orelha direita e a resposta foi captada por meio de eletrodos posicionados no vértex, na mastoide direita e eletrodo terra na fronte. Resultados: Os valores descritivos de latência dos componentes foram: V 6,50, A 7,87, C 17,74, D 22,77, E 32,07, F 40,03 e O 48,07 ms. As médias de amplitude foram V 0,17, A -0,12, C -0,14, D -0,14, E -0,20, F -0,22 e O -0,14 µV. A média do valor do slope encontrada foi 0,23. Na comparação com estudo de referência internacional, Krizman et al. (2012) mostraram que a maioria dos resultados se encontra dentro de um desvio padrão positivo e negativo para a faixa etária estudada tanto para o slope quanto para as latências e amplitudes. Conclusão: A resposta eletrofisiológica da Frequency Following Response, utilizando o estímulo de fala /da/, em adultos com audição normal e sem queixas auditivas, apresentou valores de slope e de latência e amplitude de todos os componentes dentro do padrão de normalidade apresentado pela literatura internacional.

ABSTRACT Purpose: Analyze the slope, latency and amplitude values of the waveforms V, A, C, D, E, F and O from Frequency-following Response (FFR) with speech stimulus in normal-hearing adults based on a recent international reference study. Method: Eleven normal-hearing adults aged 18-30 years, without hearing complaints, were evaluated in this study using an Intelligent Hearing Systems device. The speech stimulus /da/ was presented to the right ear via insertion phone and the responses were captured by electrodes placed on the vertex, right mastoid bone, and forehead (ground). Results: The descriptive latency values of the components were V 6.50, A 7.87, C 17.74, D 22.77, E 32.07, F 40.03 and O 48.07 ms. The mean amplitude measures of the waves were V 0.17, A -0.12, C -0.14, D -0.14, E -0.20, F -0.22 and O -0.14 µV. The mean slope value was 0.23. Comparison with an international study, Krizman et al. (2012), showed that most of the results are within positive and negative standard deviation values for the assessed age group for slope, latency and amplitude. Conclusion: The electrophysiological measures obtained from Frequency-following Response using the speech stimulus / da/ in normal-hearing adults without hearing complaints showed slope, latency and amplitude values of all FFR components within the normality standard described in the international literature.

Humans , Adolescent , Adult , Young Adult , Speech , Speech Perception , Evoked Potentials, Auditory, Brain Stem , Acoustic Stimulation , Hearing
Article in Chinese | WPRIM | ID: wpr-828683


OBJECTIVE@#To investigate the incidence of severe neonatal hyperbilirubinemia and the management on the treatment and follow-up of this disease in Jiangsu Province, China.@*METHODS@#The neonates with severe hyperbilirubinemia who were admitted to 13 hospitals in Jiangsu Province from January to December, 2018, were enrolled as subjects. A retrospective analysis was performed on their mediacal data and follow-up data.@*RESULTS@#In 2018, 740 neonates with severe hyperbilirubinemia were reported from the 13 hospitals in Jiangsu Province, accounting for 2.70% (740/27 386) of the total number of neonates admitted to the department of neonatology. Among these neonates, 620 (83.8%) had severe hyperbilirubinemia, 106 (14.3%) had extremely severe hyperbilirubinemia, and 14 (1.9%) had hazardous hyperbilirubinemia. Four neonates (0.5%) were diagnosed with acute bilirubin encephalopathy. A total of 484 neonates (65.4%) were readmitted due to severe hyperbilirubinemia after discharge from the delivery institution, with a median age of 7 days, among whom 214 (44.2%) were followed up for jaundice at the outpatient service before readmission, with a median age of 6 days at the first time of outpatient examination. During hospitalization, 211 neonates (28.5%) underwent cranial MRI examinations, among whom 85 (40.3%) had high T1WI signal in the bilateral basal ganglia and the globus pallidus; 238 neonates (32.2%) underwent brainstem auditory evoked potential examinations, among whom 14 (5.9%) passed only at one side and 7 (2.9%) failed at both sides. The 17 neonates with acute bilirubin encephalopathy or hazardous hyperbilirubinemia were followed up. Except one neonate was lost to follow-up, and there were no abnormal neurological symptoms in the other neonates.@*CONCLUSIONS@#Neonates with severe hyperbilirubinemia account for a relatively high proportion of the total number of neonates in the department of neonatology. Jaundice monitoring and management after discharge from delivery institutions need to be strengthened. For neonates with severe hyperbilirubinemia, relevant examinations should be carried out more comprehensively during hospitalization and these neonates should be followed up comprehensively and systematically after discharge.

Bilirubin , China , Evoked Potentials, Auditory, Brain Stem , Humans , Hyperbilirubinemia, Neonatal , Infant, Newborn , Retrospective Studies