Forward masking with frequency-following response analyses

ABSTRACT Purpose: to analyze forward masking in normally hearing young people, by using frequency-following responses. Methods: the synthetic syllable /da/ was used for the recordings of ten individuals, in the following conditions: /da/ with no masking, and /da/ after 4, 16, 32, and 64 milliseconds of masking. F-test (ANOVA) was applied for repeated measures with the Greenhouse-Geisser correction to compare testing conditions. For significant differences, multiple comparisons (between pairs of conditions) and Bonferroni correction were used. Data normality was verified by applying the Shapiro-Wilk test, and statistical significance was used at 5%. Results: wave latencies of all masking conditions were compared with those of no masking. A latency delay was observed in the transient region of the response (PV and A) in all masking conditions, except for 64 milliseconds. Latency delay also occurred for waves PW, PX, and PY, which corresponded to the sustained region of the response. Conclusion: forward masking was observed, by using frequency-following responses with /da/ syllable in four intervals (4, 16, 32, and 64 ms) of preceding masking. Forward masking was more evident in the transient region of the response than in the sustained one. This study highlights the importance of electrophysiological testing in temporal processing assessment.

Alteraciones de la altura tonal e intensidad vocal en niños de 4 a 6 años de las instituciones de educación inicial públicas del distrito de Magdalena del Mar en el año 2015 / Alterations of the tonal height and vocal intensity in children from 4 to 6 years old of the public institutions of initial education in Magdalena del Mar district in 2015

A lo largo del tiempo, las alteraciones de voz han incrementado su presencia significativamente, más aún en la población infantil, afectando muchas veces su comunicación y desarrollo personal, por lo que es importante generar una cultura de prevención. Objetivo: Determinar la frecuencia de las alteraciones de la altura tonal e intensidad vocal en niños de 4 a 6 años de las Instituciones de Educación Inicial Públicas del Distrito de Magdalena del Mar en el año 2015. Material y Métodos: Estudio descriptivo de tipo transversal. Se utilizaron dos instrumentos para la recolección de datos: Una Ficha de Recolección que fue respondida por los padres de familia sobre el género, la edad y el estado actual de la voz de su niño y un Software de análisis acústico PRAAT (Versión 5.4.06) con el cual se midió la altura tonal e intensidad vocal, permitiendo determinar si la voz era la adecuada o presentaba alguna alteración, al ser comparados los resultados obtenidos con los parámetros bibliográficamente establecidos. Resultados: De una muestra total de 128 niños, se recolectó 117 datos, el 22,22% de esta población presentó tanto la altura tonal como la intensidad vocal alterados, donde el 65,38% fueron de género femenino. Además los niños de 4 y 6 años presentaron su altura tonal alterada, con un 34,29% a su población, proporcionalmente. Conclusiones: El intensidad vocal, lo que indica un inadecuado uso vocal. (AU)

Over time, the voice alterations have increased their presence significantly, affecting frequently the communication and personal development of the child population. For this reason is important to generate a culture of prevention. Objective: To determinate the frequency of the alterations of the tonal height and vocal intensity in children from 4 to 6 years old of the public Institutions of Initial Education in Magdalena del Mar district in 2015. Material and Methods: Descriptive study of transverse type. Two instruments were used for data collection: A record collection sheet that was answered by parents about the gender, age and the actual state of the voice of their child. Also a software of acoustic analysis PRAAT (Version 5.4.06) which was used to measure the tonal height and vocal intensity. It allowed to determinate if the voice was suitable or presented any alteration when the results obtained were compared with the bibliographitly parameters established. Results: A total sample of 128 children was collected 117 data, the 22.22% of this population presented both the tonal height and the vocal intensity altered, where 65.38% was of female gender. Also children of 4 and 6 years old presented their pitch altered this represents a 34.29% of their population proportionately. Conclusions: The 55.56% of the sample presented an alteration of the level of the vocal intensity which indicated a vocal inappropriate use. (AU)

Autopercepção do zumbido: estudo pré e pós-adaptação de próteses auditivas / Self-perception of tinnitus: study before and after adaptation of hearing aids

RESUMO Objetivo Verificar benefícios do uso de próteses auditivas na autopercepção do zumbido em adultos e idosos sem experiência prévia de amplificação. Métodos O estudo incluiu indivíduos de ambos os sexos, com queixa de zumbido, acompanhados em hospital público. Aplicaram-se os seguintes exames e instrumentos para mensurar o zumbido e determinar o seu incômodo: pesquisa do pitch e loudness, Escala Visual Analógica (EVA), pesquisa do nível mínimo de mascaramento, inibição residual e Tinnitus Handicap Inventory (THI). As avaliações foram realizadas em duas etapas: antes da adaptação das próteses auditivas e após um mês de uso dos aparelhos. Resultados Dos 20 indivíduos participantes, 60% eram idosos. Verificou-se diferença na autopercepção do zumbido pré e pós-protetização, medido pelas escalas THI e EVA. Também se observaram diferenças nas medidas psicoacústicas, com exceção do pitch, antes e após a amplificação. Além disso, houve correlação entre o tempo de zumbido e a idade com os escores finais do THI. Conclusão O uso de próteses auditivas reduziu o incômodo provocado pelo zumbido, com alteração nas medidas psicoaústicas e no impacto na qualidade de vida.

ABSTRACT Purpose To verify the benefits of using hearing aids in self-perception of tinnitus in adults and elderly without previous experience of amplification. Methods The study included individuals of both gender, with tinnitus complaint, accompanied in public hospital. The following tests and instruments were used to measure tinnitus and determine its discomfort: pitch and loudness, Visual Analogue Scale (VAS), minimum masking level, residual inhibition and Tinnitus Handicap Inventory (THI). The evaluations were performed in two stages: before the adaptation of the hearing aids and after one month of use of the devices. Results Of the 20 participants, 60% were elderly. There was a difference in self-perception of tinnitus before and after hearing aid fitting, as measured by THI and VAS. Differences in psychoacoustic measures were also observed, with the exception of pitch, before and after amplification. In addition, there was a correlation between tinnitus time and age with final THI scores. Conclusion The use of hearing aids was determined to reduce the annoyance caused by tinnitus, with changes in psycho-acoustic measures and impact on quality of life.

Elaboration of an instrument to evaluate the recognition of Brazilian melodies in children / Criação de um instrumento para avaliar o reconhecimento de melodias brasileiras em crianças

Abstract Introduction: There is evidence pointing to the importance of the evaluation of musical perception through objective and subjective instruments. In Brazil, there is a shortage of instruments that evaluates musical perception. Objective: To develop an instrument to evaluate the recognition of traditional Brazilian melodies and investigate the performance of children with typical hearing. Methods: The study was carried out after approval of the research ethics committee (1.198.607). The instrument was developed in software format with website access, using the languages PHP 5.5.12, Javascript, Cascade style sheets and "HTML5"; database "MYSQL 5.6.17" on the "Apache 2.4.9" server. Fifteen melodies of Brazilian folk songs were recorded in piano synthesized timbre, with 12 seconds per melody reproduction and four second intervals between them. A total of 155 schooled children, aged eight to 11 years, of both sexes, with typical hearing participated in the study. The test was performed in a silent room with sound stimuli amplified by a sound box at 65 dBNA, positioned at 0 azimuth, and at one meter from the participant, the notebook was used for children to play with on the screen on the title and illustration of the melody they recognized they were listening to. The responses were recorded on their own database. Results: The instrument titled "Evaluation of recognition of traditional melodies in children" can be run on various devices (computers, notebooks, tablets, mobile phones) and operating systems (Windows, Macintosh, Android, Linux). Access: http://192.185.216.17/ivan/home/login.php by login and password. The most easily recognized melody was "Cai, cai balão" (89%) and the least recognized was "Capelinha de melão" (25.2%). The average time to perform the test was 3′15″. Conclusion: The development and application of the software proved effective for the studied population. This instrument may contribute to the improvement of protocols for the evaluation of musical perception in children with hearing aid and/or cochlear implants users.

Resumo Introdução: Há evidências que apontam para a importância da avaliação da percepção musical através de instrumentos objetivos e subjetivos. No Brasil, há escassez de instrumentos que avaliem a percepção musical. Objetivo: Desenvolver um instrumento para avaliar o reconhecimento de melodias tradicionais brasileiras e investigar o desempenho de crianças com audição típica. Método: O estudo foi desenvolvido após aprovação do comitê de ética em pesquisa (1.198.607). O instrumento foi desenvolvido em formato de software com acesso ao site, com as linguagens de programação PHP 5.5.12, Javascript, Cascade Style Sheets e HTML5; banco de dados MYSQL 5.6.17 no servidor Apache 2.4.9. Quinze melodias de canções folclóricas brasileiras foram gravadas com timbre sintetizado em piano, com 12 segundos de reprodução da melodia e quatro segundos de intervalo entre elas. Participaram do estudo 155 crianças, alfabetizadas, entre oito e 11 anos, de ambos os sexos, com audição típica. O teste foi feito em sala silenciosa com estímulo sonoro amplificado por uma caixa sonora a 65 dB NA, posicionada a 0 azimute e a um metro do participante e o notebook foi usado para que as crianças brincassem na tela com o título e a ilustração da melodia que eles reconheceram que ouviam. As respostas foram registradas em seu próprio banco de dados. Resultados: O instrumento intitulado "Avaliação do reconhecimento de melodias tradicionais em crianças" pode ser executado em vários dispositivos (computadores, notebooks, tablets, telefones celulares) e sistemas operacionais (Windows, Macintosh, Android, Linux). Acesse: http://192.185.216.17/ivan/home/login.php através de login e senha. A melodia mais facilmente reconhecida foi "Cai cai balão" (89%) e a menos reconhecida foi "Capelinha de melão" (25,2%). O tempo médio para fazer o teste foi de 3′15″. Conclusão: O desenvolvimento e a aplicação do software se mostraram eficazes para a população estudada. Esse instrumento pode contribuir para o aprimoramento de protocolos de avaliação da percepção musical em crianças usuárias de próteses auditivas e/ou usuárias de implante coclear.

Mismatch Negativity in Childrenwith Cochlear Implant

Abstract Introduction The mismatch negativity (MMN) is a negative long-latency auditory potential elicited by any discriminable change in a repetitive aspect of auditory stimulation. This evoked potential can provide cortical information about the sound processing, including in children who use cochlear implants. Objective To identify MMN characteristics regarding latency, amplitude, and wave area in cochlear implanted children and to identify associations among language development, speech perception and family involvement. Methods This is a descriptive, observational, cross-sectional study, which compared two groups: study group-children with cochlear implant, and control group-hearing children. The children were submitted to MMN evaluation with non-verbal tone burst stimulus, differing in frequency in sound field at 70 dBHL, with SmartEP equipment (Intelligent Hearing Systems, Miami, FL, USA). Speech perception and language development questionnaires were also applied, and the family participation in the rehabilitation process was classified. Results The occurrence ofMMNwas 73.3% for the control group and 53.3% for the study group. Values of latency, amplitude and area of MMN of children using cochlear implants were similar tothose ofhearingchildren, anddidnot differbetweengroups. The occurrence of MMN was not correlated to the variables of hearing, language and family categories. Conclusion Children with cochlear implants showed similar MMN responses to those of the children in the control group, withmean latency, amplitude andarea of 208.9ms (±12.8), -2.37 μV (±0.38) and 86.5 μVms (±23.4), respectively. There was no correlation between the presence of MMN and children's performance in the auditory and language development tests or family involvement during rehabilitation.

A Review of Music Perception with Cochlear Implantation / 대한이비인후과학회지

With a high sound quality stimulated by the electrical device and a large inclusion in medical insurance, the number of cochlear implant recipients has been rapidly increased in Korea. Today, it is not surprising that early implanted young children with congenital deafness show a similar performance to their normal hearing peers in speech perception. However, the cochlear implant users still have a trouble to enjoy music. This review study aims to introduce briefly about acoustic components that required to perceive the music and understand a relationship between cochlear implantation and temporal fine structure. For the pediatric implant users who have less experience on acoustical sound features but are much familiar with the electrically stimulated sound, perceiving the music seems to be challengeable due to the lack of temporal fine resolution related to pitch and timbre among various components of music. Four representative test batteries for evaluating the recipients' ability of the music perception were mentioned and effective auditory music trainings were discussed with analysis of related investigations. Unlike hearing aids users who usually depend on fitting algorism for better music quality, the cochlear implant users need systematic training to improve their music perception ability. In conclusion, advancement of speech processing technology which can provide accurate information about the temporal fine structure of incoming music to the recipients needs to be developed. Also, a practical application of music training should be recommended as a part of auditory training for the cochlear implant users.

Caracterização do perfil auditivo de frentistas de postos de combustível / Characterization of hearing profile of gas station attendants

RESUMO Introdução Pesquisas voltadas para as populações com baixas exposições a solventes, ou exposições dentro dos níveis de tolerância permitidos em âmbito ocupacional ainda são restritas. Objetivo Caracterizar o perfil auditivo de frentistas de postos de combustíveis. Métodos Estudo transversal, constituído por dois grupos, pareados por gênero e idade: Grupo Controle - 23 indivíduos sem exposição a ruído ou agentes químicos; Grupo Experimental - 21 frentistas de postos de combustíveis. Foi realizada avaliação audiológica, composta por audiometria tonal liminar, logoaudiometria e medidas de imitância acústica. A análise estatística utilizou cálculo de média, desvio padrão, valor mínimo e máximo, teste Qui-quadrado e coeficiente de correlação de Pearson. O nível de significância adotado foi de 5%. Resultados Foram verificadas alterações auditivas nos frentistas, caracterizadas por comprometimento no sistema auditivo periférico, sugerindo ação tóxica da exposição a combustíveis. Houve correlação entre idade e tempo de exposição a solvente. Na comparação entre os grupos, o reflexo acústico demonstrou maior número de alterações no grupo experimental, com diferença para os reflexos acústicos ipsilaterais da orelha direita e contralaterais da orelha esquerda. Conclusão Não houve diferença entre os grupos para os limiares auditivos, porém, a diferença verificada nos reflexos acústicos ipsilaterais e contralaterais no grupo experimental sugere comprometimento retrococlear. Diante das evidências observadas neste estudo, considera-se relevante incluir a pesquisa do reflexo acústico na avaliação auditiva dos frentistas, bem como a integração desta categoria profissional aos programas de prevenção de perda auditiva.

ABSTRACT Introduction Researches into populations with low solvent exposures, or exposures within tolerance levels allowed in the occupational field are still restricted. Purpose To characterize the hearing profile of gas station attendants. Methods Cross-sectional study, constituted of two groups, matched by gender and age: Control Group - 23 subjects without exposure to noise or chemicals; Experimental Group - 21 gas station attendants. An audiological evaluation was performed, composed by pure tone audiometry, speech audiometry and acoustic impedance tests. The statistical analysis used average calculation, standard deviation, minimum and maximum value; Chi-square Test and Pearson’s correlation coefficient. The significance level was 5%. Results Hearing loss was verified in gas station attendants characterized by impairment of the peripheral auditory system, suggesting toxic effects of exposure to fuels. There was a correlation between age and solvent exposure time. Comparing the groups, the acoustic reflex showed more alterations in the experimental group, with a difference for the ipsilateral acoustic reflexes of the right ear and contralateral ones of the left ear. Conclusion There was no difference between the groups for the hearing thresholds; however, the difference observed in the ipsilateral and contralateral acoustic reflexes in the experimental group suggests retrocochlear impairment. Due to the evidence observed in this study, it is considered relevant to include the acoustic reflex research in the auditory evaluation of the gas station attendants, as well as the integration of this professional category into hearing loss prevention programs.

Poluição sonora urbana: a influência de modificações em escapamentos de motocicletas na emissão de ruído / Urban noise pollution influence of modifications on exhaust systems for noise emission

A poluição sonora urbana, em especial a gerada por motocicletas com escapamentos modificados, afeta indistintamente a saúde de toda população de diversas maneiras e tende a aumentar, ao contrário da emissão de gases, que vem se reduzindo ao longo dos anos. Com o objetivo de conter o ruído gerado pelo tráfego urbano, vários países desenvolvem procedimentos, leis e ações mitigatórias como barreiras acústicas e asfaltos fonoabsorventes, porém há grande quantidade de motocicletas, veículo tipicamente de alto potencial de incômodo e ruidoso, que circulam com sistemas de escapamento adulterados e emitem ainda mais excesso de ruído. A inspeção veicular é ferramenta importante no controle de emissões de gases poluentes de veículos em uso, mas falha em restringir aqueles que ultrapassam os limites legais de ruído e, somado a isto, há o agravante de o condutor submeter-se a poluição sonora que ele mesmo produz. A fiscalização de rua surge como alternativa de controle ambiental, mas algumas vezes é contestada por ser subjetiva ou por faltar uma metodologia simples, confiável e eficaz

The urban noise pollution, in particular the one produced for motorcycles with tampered exhaust systems, affects indistinctly the health of all people in many ways and tends to grow up, in opposite to gaseous emissions, that is getting down through years. With the goal of mitigate noise generated from urban traffic, many countries develop procedures, laws and actions as acoustic barrier and phono absorbent asphalt, but there are still a great amount of motorcycles, typically a high annoying and noisy vehicle, running with tampered mufflers and producing excessive noise. In use vehicle inspection is an important tool on gaseous emissions control but fails to restrain excessive noise, a problem that get worse up due the rider is subjects him-herself to the own sound pollution. Roadside control comes as an alternative but sometimes is rejected as subjective or due a lack of a simple, easy, trustable method. This research looks for the relationship between increased sound level of modified motorcycles in traffic and noise emission in inspection mode, also known as stationary noise, to bring subsidies to develop more efficient control methods. For this, it were evaluated motorcycles for traffic and stationary noise emission and the results point that modified exhaust systems have a very higher sound level than original mufflers, with strong relationship between these two measurement methods

Tone recognition ability for post-lingually deafened cochlear implant users using pitch information / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The present study was aimed to assess the ability of tone recognition performance for postlingually deafed cochlear implanted adults using no-duration tone test materials.@*METHOD@#Sixteen cochlear implanted users have used their devices at least six months. Ten monosyllabic syllables were selected, and combined with four lexical tones which were made up of 40 tone tokens. Then, these original words were recorded using one adult male and one adult female native Beijing Mandarin speaker. The speakers were asked to record these 40 monosyllabic words multiple times, and the 80 tokens in which the durations of four tones in each monosyllabic word were within 5 ms precision were chosen as the original tone tokens. The subjects were asked to perform a four alternative forced-choice study and select the tone they had heard.@*RESULT@#The mean score of lexical tone perception tasks for 16 cochlear implanted users is (70.7 ± 22.0)%, and Tone 4 was the easiest to perceive, while Tone 2 was the hardest for cochlear implanted subjects to perceive. Tone 1 was more often misperceived as Tone 2 relative to other tones. Tone 2 was more often misperceived as Tone 1 and 3. Tone 3 was more often misperceived as Tone 2. The tone perception performance was positively correlated with duration of hearing aid use.@*CONCLUSION@#Duration cues may impact on the ability of tone recognition performance for cochlear implant subjects, especially for tone 3. Due to the limited ability for cochlear implant subjects on pitch perception, tone l and tone 2, and tone 2 and tone 3 are most often confused with each other without duration cues. The experience of hearing aid use may benefit for postlingual deafness cochlear implant recipients on tone perception performance.

Trastornos de la percepción musical / Musical perception disorders

La percepción musical es una experiencia que no sólo involucra componentes cognitivos, sino también respuestas emocionales acorde a la experiencia y cultura del sujeto. El procesamiento musical se inicia a nivel periférico en el sistema auditivo, y a nivel central se divide en diferentes regiones cerebrales que se ocupan del análisis de la organización melódica y temporal, además del análisis del repertorio. Por lo tanto, es necesaria una gran red neuronal córtico-subcortical ascendente y descendente, entre ambos hemisferios y además conexiones hacia el cerebelo, que permiten la creación de la percepción musical. Los trastornos de la percepción musical se pueden clasificar a grandes rasgos, en amusia y alucinaciones musicales. La amusia, en términos generales, es la pérdida específica de la percepción musical, que puede ser congénita o adquirida. Un grupo creciente de pacientes con amusia adquirida son la mayoría de los usuarios de implante coclear. Por otro lado, las alucinaciones musicales son descripciones verbales de experiencias sensoriales acústicas de tipo musical que no están explicadas por un estímulo externo y están presentes en pacientes con patología neurológica y psiquiátrica, pero también en personas con sordera profunda bilateral. Actualmente, existen disponibles algunos instrumentos para evaluar las alteraciones de la percepción musical, siendo la batería de Montreal para la evaluación de amusia, una de las pruebas musicales más utilizadas que permite estimar las habilidades perceptuales y de memoria en adultos y recientemente también en niños. Los trastornos de la percepción musical son patologías emergentes con impacto en la calidad de vida de los pacientes.

Music perception is an experience that involves cognitive and emotional sensations according to the cultural background of the subject. The musical processing begins at the periphery in the auditory system and then in the central level is divided in melodic and temporal processing including the musical repertory. An extensive cortical and subcortical neuronal network is needed for the creation of the musical experience including ascending and descending pathways, both cerebral hemispheres and the cerebellum. Musical perception disorders can be classified in two main groups; amusia and musical hallucinations. Amusia corresponds to the inability to recognize musical tones that can be congenital or acquired. A growing group of acquired amusia patients is the majority of cochlear implant users. On the other hand musical hallucinations are the perception of music without an external stimulus, which can be produced by neurologic and psychiatric states, but also in persons with profound bilateral deafness. Nowadays the Montreal battery of evaluation of amusia is available to evaluate the perceptual skills and memory in adults and child; this test allows the detection of musical perception disorders that are seen as an emerging group of diseases with an important impact in life quality of our patients.

Estudo da função auditiva em indivíduos com HIV/AIDS submetidos e não submetidos à terapia antirretroviral / Study of hearing functions in individuals with HIV/AIDS submitted and not submitted to antiretroviral therapies

OBJETIVO: Caracterizar as manifestações audiológicas em indivíduos com HIV/AIDS (Vírus da Imunodeficiência Humana/Síndrome da Imunodeficiência Adquirida) submetidos e não submetidos à terapia antirretroviral. MÉTODOS: A avaliação audiológica foi realizada em 28 indivíduos do Grupo Pesquisa I (GPI) com HIV/AIDS, submetidos à terapia antirretroviral; 24 indivíduos do Grupo Pesquisa II (GPII) com HIV/AIDS, não submetidos à terapia antirretroviral e 45 indivíduos saudáveis do Grupo Controle (GC). Os exames audiológicos que compuseram esta pesquisa foram: Audiometria Tonal Convencional, Logoaudiometria e Audiometria em Altas Frequências. RESULTADOS: Houve diferença nos grupos GPI e GPII, para os resultados obtidos tanto na avaliação audiológica convencional, como na avaliação em altas frequências, observando-se limiares auditivos mais elevados quando comparados aos indivíduos do GC, porém sem diferença significativa entre GPI e GPII. CONCLUSÃO: Indivíduos com HIV/AIDS apresentam mais alteração na Audiometria Tonal Convencional e na Audiometria em Altas Frequências quando comparados a indivíduos saudáveis (GC) sugerindo comprometimento do sistema auditivo, sendo observada maior ocorrência de perda auditiva na Audiometria em Altas Frequências quando comparada à Audiometria Tonal Convencional nos grupos GPI e GPII. Não houve diferença entre indivíduos com HIV/AIDS submetidos (GPI) e não submetidos (GPII) à terapia antirretroviral para a Audiometria Tonal Convencional e Audiometria em Altas Frequências.

PURPOSE: To characterize the audiologic manifestations in individuals with HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) submitted and not submitted to antiretroviral therapy. METHODS: The audiologic evaluation was carried out in 28 individuals in Research Group I (RGI) with HIV/AIDS submitted to antiretroviral therapy; 24 individuals in Research Group II (RGII) with HIV/AIDS not submitted to antiretroviral therapy, and 45 healthy individuals in the Control Group (CG). The audiologic tests that comprised this study were: Conventional Pure Tone Audiometry, Speech Audiometry and High Frequency Audiometry. RESULTS: There were differences between groups RGI and RGII regarding conventional audiologic evaluation and high frequency audiometry. There were higher thresholds for both Conventional and High Frequency Audiometries when compared with CG subjects, however without significant difference among RGI and RGII. CONCLUSION: Individuals with HIV/AIDS present more abnormal results in Conventional Pure Tone Audiometry and High Frequency Audiometry than healthy individuals (CG), which indicates impairment in the hearing system. Individuals with HIV/AIDS present more abnormal findings in High Frequency Audiometry when compared to Conventional Pure Tone Audiometry. There was no difference between individuals with HIV/AIDS submitted (RGI) and not submitted (RGII) to antiretroviral therapy regarding Conventional Pure Tone Audiometry and High Frequency Audiometry.

Effect of singing training on total laryngectomees wearing a tracheoesophageal voice prosthesis

PURPOSE: To assess the effect of a program of singing training on the voice of total laryngectomees wearing tracheoesophageal voice prosthesis, considering the quality of alaryngeal phonation, vocal extension and the musical elements of tunning and legato. METHODS: Five laryngectomees wearing tracheoesophageal voice prosthesis completed the singing training program over a period of three months, with exploration of the strengthening of the respiratory muscles and vocalization and with evaluation of perceptive-auditory and singing voice being performed before and after 12 sessions of singing therapy. RESULTS: After the program of singing voice training, the quality of tracheoesophageal voice showed improvement or the persistence of the general degree of dysphonia for the emitted vowels and for the parameters of roughness and breathiness. For the vowel "a", the pitch was displaced to grave in two participants and to acute in one, and remained adequate in the others. A similar situation was observed also for the vowel "i". After the singing program, all participants presented tunning and most of them showed a greater presence of legato. The vocal extension improved in all participants. CONCLUSION: Singing training seems to have a favorable effect on the quality of tracheoesophageal phonation and on singing voice.

Avaliação do ruído e seus efeitos em professores e alunos de academias de ginástica / Evaluation of noise and its effects on gym teachers and students

O ruído encontra-se cada vez mais relacionado à atividade de lazer no Brasil, inclusive em academias de ginástica, onde milhares de professores e alunos estão expostos a elevados níveis de pressão sonora durante várias horas por dia, sem qualquer tipo de proteção, sendo necessária a preocupação com a saúde mental e corporal desta população. Esta pesquisa teve como objetivo avaliar os níveis de ruído em academias de ginástica nas cidades de Curitiba-PR e Irati-PR, através das medições dos níveis de pressão sonora - nível sonoro equivalente (Leq), níveis mínimos (Lmin) e máximos (Lmax), simulações dos parâmetros acústicos (tempo de reverberação - TR e índice de transmissão da fala - STI) e identificação dos efeitos causados pelo ruído nos professores e alunos. Para a coleta de dados, foi utilizado um medidor sonoro classe I da marca Brüel & Kjær, modelo 2238, as simulações computacionais foram realizadas com o software Odeon Combined versão 9.2 e para a identificação dos efeitos, foram aplicados questionários nos alunos e professores. Na análise estatística foi utilizado o software R versão 2.11.1, considerado o nível de significância igual a 5% (p ? 0,05). Os resultados mostraram que os níveis de pressão sonora (Leq) variaram entre 80,1 e 100,1 dB(A), atingindo o valor máximo (Lmax) 117,2 dB(A), ultrapassando os valores limites estabelecidos pela legislação. Verificou-se que as modificações realizadas nas academias de ginástica reduziram o tempo de reverberação e alteraram a classificação do índice de transmissão da fala de pobre para satisfatório, melhorando assim as condições acústicas das academias de ginásticas. Os efeitos mais relatados pelos alunos e professores foram cansaço e fadiga vocal. Diversas alterações vocais foram apontadas pelos professores no final se sua jornada de trabalho, sendo que a mais relatada foi rouquidão. Conclui-se que o ambiente da academia de ginástica onde as pessoas buscam a promoção da saúde e lazer apresentou, incoerentemente, altos níveis de pressão sonora que são encontrados em ambientes industriais, gerando assim extrema preocupação com relação à saúde de seus alunos e, especialmente, dos professores atuantes. Diante dos resultados encontrados neste estudo, fica evidente a necessidade de ações que minimizem e controlem a ação prejudicial do ruído nas academias de ginástica, podendo ser realizadas através de medidas de controle da exposição do ruído na fonte, na trajetória e no indivíduo.

Noise is increasingly related to leisure activities in Brazil, including those carried out in fitness gyms where thousands of instructors and users are exposed to high sound pressure levels during several hours a day without any kind of protection, a situation in which it becomes necessary the concern about the mental and physical health of this population. The objective of this research was to evaluate the noise levels in fitness gyms in the cities of Curitiba and Irati in the State of Paraná through the measurements of sound pressure levels - equivalent continuous sound pressure level (Leq), minimum (Lmin) and maximum (Lmax) levels, simulations of the acoustic standards (reverberation time - RT and speech transmission index - STI) and the identification of effects caused by noise in instructors and users. A sound meter class I, model 2238 from the make Brüel e Kjær was used to collect the data and the software Odeon Combined version 9.2 was used for the computational simulations. In addition, a questionnaire was submitted to instructors and users aiming at identifying the effects of the high sound pressure levels on them. The software R version 2.11.1 was employed for the statistical analysis considering the significance level as 5% (p ? .05). The results showed that the sound pressure levels (Leq) varied between 80.1 and 100.1 dB(A), reaching the maximum value (Lmax) at 117.2 dB(A), surpassing the limits established by law. It was verified that the modifications made in the fitness gyms reduced the reverberation time and changed the speech transmission index classification from poor to fair improving the acoustic conditions of the gyms. The most reported effects by users and instructors were tiredness, and vocal fatigue. Several vocal alterations were pointed out by instructors in the end of their workday, being hoarseness the most reported one. The conclusion is that the fitness gym environment, despite being a place where people seek health improvement and leisure time, shows high sound pressure levels similar to the ones found in industrial environments, which creates an extreme concern in relation to the health of its users, and especially its instructors. In face of the results found in this research it seems unmistakable the need of efforts which minimize and control the hazardous action of noise in fitness gyms, which can be done through control measures of the noise exposure in the source, in the trajectory and in the individual.

A study on the normal values of musical sounds in cochlear implants test battery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To establish music reference values for normal-hearing (NH) person in China, in order to give convenience in clinical application.@*METHOD@#The NH participant group included 39 subjects, of which 21 females and 18 males. Musical Sounds in Cochlear Implants test battery was used to assess the music perception ability for normal-hearing participants.@*RESULT@#The median pitch difference NH participants could discriminate for string was 2.5 semitones and 0.5 for flute. The average scores of rhythm discrimination, melody discrimination, chord discrimination, instrument identification and instrument number detection test were 86.1% (SD = 11.2), 76.5% (SD = 11.1), 75.6% (SD = 11.4), 89.9% (SD = 13.0) and 74.1% (SD = 20.7), respectively.@*CONCLUSION@#The MuSIC test could be a test for music perception ability for China users and in further study the material that more suited for our culture should be added into it.

Speech and pitch perception with the new fine structure speech coding strategy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the performance of the new fine structure processing strategy(FS4) compared to the previous generation coding strategy HDCIS.@*METHOD@#Twelve post-lingual hearing-impaired cochlear implant users were included. FS4 and HDCIS were compared in music pitch perception and speech perception test.@*RESULT@#Acute comparison between FS4 and HDCIS showed that FS4 performed as well as HDCIS in speech perception tests, and outperformed HDCIS in music pitch perception.@*CONCLUSION@#Results indicate that FS4 performs better than HDCIS in music perception. Differences between the two strategies were not significant for speech test.

Efectos de la variación de la intensidad de los tonos primarios sobre las amplitudes de Emisiones Otoacústicas Producto de Distorsión (EOApd) en sujetos con audición dentro de rangos de normalidad / Effects of varying the intensity of the primary tones on the amplitudes of Distortion Product Otoacoustic Emissions (OAEdp) in patients with normal hearing

Introducción: Las emisiones otoacústicas (EOA) son sonidos generados por las células ciliadas externas (CCE). Se ha visto que la generación y registro de las EOA evocadas depende de factores técnicos de evaluación como el nivel de intensidad de los tonos primarios, relación frecuencial entre los tonos, etc. Objetivos: Estudiar el efecto de la variación de la intensidad de los tonos primarios en la amplitud de la respuesta de las EOA producto de distorsión (pd) en individuos con audición normal. Material y método: Se evaluaron 35 individuos a los cuales se les midieron EOApd utilizando diferentes intensidades de tonos primarios: Intensidad baja (I1=50dBSPL e I2=50dBSPL), intensidad media (I1=55dBSPL e I2=65dBSPL) e intensidad alta (I1=70dBSPL e I2=70dBSPL). Resultados: Se observó que para tonos primarios a bajas intensidades (I1=50dBSPL e I2=50dBSPL) existe una disminución tanto en amplitud y presencia de las EOApd, mientras que para tonos primarios a intensidades mayores (I1=55dBSPL e I2=65dBSPL - I1=70dBSPL e I2=70dBSPL) se evidenció un aumento en amplitud y presencia de EOApd en los sujetos estudiados. Conclusión: Se evidencian diferencias estadísticamente significativas en la amplitud de las EOApd al variar la intensidad de los tonos primarios. Por lo cual se puede establecer que las intensidades medias-altas son las más adecuadas para la evaluación de EOApd en sujetos con audición normal.

Introduction: Otoacoustic emissions (OAE) are sounds produced by outer hair cells. The generation and recording of evoked OAE depends on technical factors such as level of intensity of primary tones, frequency relationship between the tones, etc. Aim: To study the effect of varying the intensity of primary tones in the amplitude of the response of Distortion Product OAE (DP) in individuals with normal hearing. Material and method: 35 individuals were measured using different intensities OAEdp primary tones: Low Intensity (I1= I2 =50dBSPL 50dBSPL e), Medium Intensity (11= I2 =65dBSPL 55dBSPL e) and High Intensity (I1 =70dBSPL and I2 =70dBSPL). Results: Using Low primary tones (I1 =I2 =50dBSPL 50dBSPL) there is a decrease in amplitude and presence of DPOAE, while for primary tones at higher intensities (I1 and I2 = = 55dBSPL 65dBSPL -11 =70dBSPL and I2 =70dBSPL) an increase in amplitude and presence of OAEdp in subjects with normal hearing was observed . Conclusion: There are statistically significant differences in OAEdp amplitude by varying the intensity of the primary tones. Therefore medium-high intensities are best suited for the evaluation of OAEdp in subjects with normal hearing.

Avaliação do benefício com o uso da amplificação sonora em crianças e adolescentes / Evaluation of the benefit with the use of the sound amplification inchildren and teenagers

OBJETIVO: Avaliar o benefício proporcionado pela amplificação sonora em crianças e adolescentes atendidos pelo programa de atenção à saúde auditiva da Universidade Federal de Santa Maria (UFSM). MÉTODO: Participaram deste estudo 63 indivíduos com idade entre 03 e 14 anos e seus familiares. Para avaliar o benefício proporcionado pela amplificação sonora foi aplicada a Escala de Integração Auditiva Significativa para Crianças Pequenas (IT-MAIS), para as crianças com menos de 04 anos; a Escala de Integração Auditiva Significativa (MAIS), para as crianças de 04 a 07 anos e o questionário de avaliação do benefício em crianças e jovens, para os indivíduos de 08 a 14 anos. RESULTADOS: Somente um indivíduo pôde ser avaliado através da escala IT-MAIS, o qual obteve a pontuação 0 (zero), indicando ausência dos comportamentos auditivos avaliados. Dez indivíduos foram avaliados através da escala MAIS, sendo que a pontuação média encontrada na avaliação dos comportamentos auditivos foi de 19,9. Foram avaliados 52 indivíduos através do questionário de avaliação do benefício em crianças e jovens, sendo que as respostas positivas relacionadas ao benefício proporcionado pelas próteses em diferentes situações foram as mais encontradas em todos os itens. CONCLUSÃO: Foi verificado benefício proporcionado pela amplificação sonora, em diferentes situações da vida diária, tanto pela ótica do paciente, quanto de sua família. Em alguns casos, onde foi encontrado pouco ou nenhum benefício, houve influência de outras alterações clínicas, além da perda auditiva, influenciando no uso efetivo das próteses auditivas.

OBJECTIVE: Evaluate the proportionate benefit by the sound amplification in children and teenagers attended by the program of hearing health attention by the Federal University of Santa Maria (UFSM). METHOD: Participated from these study 63 individuals with age between 3 and 14 years and their family. For the evaluate the benefit proportionate by the sound amplification was applied the Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS), for children with less than 4 years old; the Meaningful Auditory Integration Scale (MAIS), for infants from 4 to 7 years and the questionnaire of evaluation from the benefit in infants and young, for the individuals from 8 to 14 years. RESULTS: Only one individual could be evaluated through the MAIS scale, and the average punctuation found in the evaluation of the hearing behaviors was of 19,9. Were evaluated 52 individuals through the questionnaire of evaluation of benefit in infants and teenagers, and the positive answers related to the benefit proportionate by the prosthesis in different situations were the most found in all items. CONCLUSIONS: Was verified the benefit proportionate by the sound amplification, in different situations of daily life, such as from the patient's perspective as from his family. In some cases, where were found little or none benefit, there were influence of others clinical alterations, besides the hearing loss, influencing the effective use of the hearing aids.

Evaluation of rhythmic and timbral perception by normal-hearing and postlingually deafened adult cochlear implant users / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To assess the rhythmic and timbral perception ability in musical activities for postlingually deafened adult cochlear implant users.</p><p><b>METHODS</b>Twelve normal-hearing and 12 adult cochlear implant users were recruited in this study. Rhythm discrimination, instrument identification, and instrument number detection measurements in Musical Sounds in Cochlear Implants (MuSIC) test battery were used to assess the rhythmic and timbral perception ability for both normal-hearing and cochlear implant users.</p><p><b>RESULTS</b>Cochlear implant subjects achieved 84.4% correct in rhythm discrimination test on average, which was not significantly different from the performance of normal-hearing subjects (85.1%) (t = 0.116, P > 0.05). The average score of instrument identification and instrument number detection test for cochlear implant subjects were 72.3% and 39.2%, respectively. The performance of cochlear implant subjects in both of two tests were significantly poorer than those of normal-hearing subjects with 88.3% and 73.5% correct, respectively (t = 2.498 and 4.673, P < 0.05).</p><p><b>CONCLUSION</b>Postlingually deafened cochlear implant subjects, on average, performed significantly poorer in timbral perception tasks relative to normal hearing subjects, while close to the ability of normal hearing subjects in rhythmic perception.</p>

A review of research on music perception ability for adult cochlear implant users / 临床耳鼻咽喉头颈外科杂志

A cochlear implant (CI) is a kind of surgically implanted electronic device that provides a sense of sound to a person who has severe to profound sensorineural hearing impairment. However, studies have shown that the performance in music perception for CI users has not been achieved to an ideal level. It is important to evaluate the ability to perceive music using well designed music perception test materials, in order to improve the quality of life for cochlear implant users. This paper reviewed the studies on assessing music perception ability for adult cochlear implant users from the existing literature.

Emotional response to music by postlingually-deafened adult cochlear implant users / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the emotional response to music by postlingually-deafened adult cochlear implant users.@*METHOD@#Munich music questionnaire (MUMU) was used to match the music experience and the motivation of use of music between 12 normal-hearing and 12 cochlear implant subjects. Emotion rating test in Musical Sounds in Cochlear Implants (MuSIC) test battery was used to assess the emotion perception ability for both normal-hearing and cochlear implant subjects. A total of 15 pieces of music phases were used. Responses were given by selecting the rating scales from 1 to 10. "1" represents "very sad" feeling, and "10" represents "very happy feeling.@*RESULT@#In comparison with normal-hearing subjects, 12 cochlear implant subjects made less active use of music for emotional purpose. The emotion ratings for cochlear implant subjects were similar to normal-hearing subjects, but with large variability.@*CONCLUSION@#Post-lingually deafened cochlear implant subjects on average performed similarly in emotion rating tasks relative to normal-hearing subjects, but their active use of music for emotional purpose was obviously less than normal-hearing subjects.