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.

Restrição de participação social e satisfação com o uso de aparelho de amplificação sonora individual - um estudo pós-adaptação / Restriction in social participation and satisfaction with hearing aids - a study on post-fitting

RESUMO Introdução A integração social é dificultada pela perda auditiva. Objetivo Verificar o benefício, a satisfação e a percepção da restrição de participação social, em função da perda auditiva, em adultos e idosos usuários de aparelho de amplificação sonora individual (AASI), bem como averiguar a correlação entre essas medidas. Métodos O estudo incluiu indivíduos de ambos os sexos, acompanhados em hospital público. Solicitou-se aos participantes que atribuíssem uma nota de 1 a 10 para sua audição, antes e após adaptação de AASI. Aplicaram-se os seguintes instrumentos para mensuração da restrição de participação social e da satisfação com o uso de AASI: International Outcome Inventory for Hearing Aids (IOI-HA) e Hearing Handicap Inventory for Adults (HHIA), nos adultos, e Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S), nos idosos. O nível de significância estatística adotado foi de 5%. Resultados Dos 42 indivíduos participantes, 64,3% eram idosos. As pontuações dos instrumentos IOI-HA total, seus fatores 1 e 2 e o HHIE-S apresentaram correlação com a Escala de Classificação Numérica (ECN), antes da amplificação. Houve correlação entre o instrumento IOI-HA total e seu fator 2 com o HHIE-S, HHIA total e domínios emocional e social. Conclusão Adultos e idosos demonstraram satisfação com seus AASI e não houve diferença entre os grupos. Quanto mais acentuado o grau da perda auditiva, melhor foi a autopercepção da audição pós-adaptação de AASI. Quanto menor a restrição de participação, mais os benefícios do uso de AASI foram percebidos pelos usuários.

ABSTRACT Introduction Social integration is hampered by hearing loss. Purpose To identify the benefit and assess the satisfaction with the use of hearing aids and perception of limited social participation caused by hearing loss in adult and elderly hearing aids users. Another aim is to check whether there is a correlation between such measures. Methods The study included both male and female individuals who were assisted in a public hospital. The participants were asked to assign a score between 1 and 10 to their hearing level before and after starting to use hearing aids. They answered instruments that measure social participation restriction and satisfaction with use of hearing aids: the International Outcome Inventory for Hearing Aids (IOI-HA), the Hearing Handicap Inventory for Adults (HHIA) or the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S). Statistical analysis was performed. The level of statistical significance was 5%. Results Of the 42 individuals, 64.3% were elderly. IOI-HA total instrument scores, its factors 1 and 2 and HHIE-S presented a correlation with the Numerical Rating Scale (NRS) before amplification. There was correlation between the total IOI-HA instrument and its factor 2 with HHIE-S, total HHIA emotional and social domains. Conclusion Adults and elderly are satisfied with their hearing aid, and there was no difference between both groups. There is a directly inverse relationship between hearing loss levels and self-perception of hearing loss after hearing aid fitting. Also, the less restricted social participation is, the more benefits of using hearing aids are perceived by users.

Influência de fatores e hábitos pessoais na percepção do zumbido / Influence of factors and personal habits on the tinnitus perception

RESUMO Objetivo: investigar a localização e verificar a influência de fatores e hábitos na percepção do zumbido em pacientes com tal sintoma. Métodos: fizeram parte da amostra 740 indivíduos com queixa de zumbido, atendidos em ambulatório especializado de hospital universitário. Todos relataram a localização do zumbido em resposta a questionário, contendo também informações sobre fatores e hábitos causadores de melhora ou piora na percepção do zumbido. Os dados foram analisados estatisticamente. Resultados: o predomínio da localização foi em ambas as orelhas. A maior parte dos fatores investigados não modifica a percepção do zumbido para os pesquisados. Dentre os fatores que puderam ser relacionados à piora da percepção estão, principalmente, o silêncio e o período da noite, seguidos pela ansiedade. Por outro lado, ruído foi o fator mais referido como causador de diminuição da percepção do zumbido. Não foi verificada influência de idade e gênero. Conclusão: mais da metade dos sujeitos apresentaram queixa de zumbido bilateral e a maior parte das situações pesquisadas não provocam mudança na percepção do zumbido na população estudada. Destaca-se, contudo, que a presença de ruído ambiental auxilia na diminuição da sensação de incômodo ao zumbido, enquanto o silêncio, período da noite e a ansiedade contribuem para acentuá-la.

ABSTRACT Purpose: to investigate the location and to verify the influence of factors and personal habits in the tinnitus perception in patients with the symptom. Methods: 740 individuals with tinnitus, from an outpatient clinic of a university hospital were investigated. All of them reported the location in response to a questionnaire, also containing information about some factors and daily habits that causes improvement or worsening of tinnitus. The data were statistically analyzed. Results: the predominant location was in both ears. Most of the investigated factors does not change the perception of tinnitus for researched subjects. The silence, the nighttime and the anxiety were the factors that might be related to worsening of tinnitus perception. Moreover, the noise was referred as a factor that causes decrease of tinnitus perception. There was no influence of age and gender. Conclusion: more than half of the subjects had bilateral tinnitus and that most situations surveyed do not cause change in the tinnitus perception to the studied people. It is noteworthy, however, that the presence of ambient noise helps to reduce the feeling of tinnitus annoyance, as well as the silence, the period of night and the anxiety contribute to accentuate it.