Umbrales auditivos en pacientes con enfermedad de Méniere manejados con corticoides transtimpánicos / Hearing thresholds in Ménière's disease patients managed with transtympanic dexametasone

Introducción: Pese a que el uso de corticoides transtimpánicos en pacientes con enfermedad de Méniere es habitual en muchos centros, la evidencia respecto de su efecto sobre los umbrales auditivos es aún controversial. Objetivo: Estudiar los umbrales auditivos de pacientes con enfermedad de Méniere que recibieron corticoides transtimpánicos en el Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile. Material y Método: Estudio retrospectivo de pacientes con enfermedad de Méniere que consultaron entre los años 2015 y 2021. Se estudiaron los umbrales auditivos, antes y después de 3 inyecciones de dexametasona transtimpánica. Resultados: Se obtuvieron datos completos de 27 pacientes. Al comparar el promedio tonal puro antes y después del tratamiento, no se observaron diferencias significativas. A nivel individual, la variación de cambio de los umbrales auditivos con dexametasona se correlaciona en forma significativa con los umbrales auditivos previos a las inyecciones y con el tiempo transcurrido desde la última inyección, pero no con la edad. Conclusión: La terapia con dexametasona transtimpánica en pacientes con enfermedad de Méniere no altera los umbrales auditivos. Sin embargo, se requieren más estudios, para comprobar, si existe un efecto transitorio en los umbrales auditivos de los primeros días posterior al procedimiento.

Introduction: Although transtympanic corticosteroids are proposed in Méniere's disease patients refractory to standard medical therapy, the evidence regarding the effect of transtympanic corticosteroids on hearing thresholds is still controversial. Aim: To study the hearing thresholds of patients with Méniere's disease who were administrated with transtympanic corticosteroids at the Otorhinolaryngology Service of the University of Chile's Clinical Hospital. Material and Method: Retrospective study of Méniere's disease patients who consulted between 2015 and 2021. Demographic variables and hearing thresholds were studied before and after three transtympanic injections of dexamethasone. Results: A total of 27 patients were studied. There were non-significant differences in pure-tone hearing threshold averages before and after the injections. Individual variation in hearing thresholds correlates significantly with the pre-injection hearing thresholds and the period since the last injection, but not with age. Conclusion: Transtympanic dexamethasone therapy in patients with Meniere's disease does not alter hearing thresholds. However, more studies are needed to verify whether there is a transitory effect on hearing thresholds in the first days after the procedure.

Implantación coclear en pacientes de edad avanzada: Resultados auditivos / Cochlear implantation in elderly patients: Hearing results

Introducción: El envejecimiento de la población, así como la ampliación en las indicaciones de implantación, hace que cada día haya más pacientes implantados mayores de 65 años, lo que supone un reto a nivel de ajuste y optimización auditiva. Se ha constatado que la implantación coclear en pacientes de edad avanzada generalmente conduce a una mejoría, tanto auditiva como en la neurocognición, la depresión, el aislamiento social, la actividad física y la calidad de vida. Objetivo: Los objetivos de este estudio son valorar las características de los pacientes implantados a partir de 65 años en un centro terciario, analizar los beneficios e identificar particularidades clínicas en este grupo de pacientes. Material y Método: Se llevó a cabo un estudio retrospectivo con un seguimiento de 5 años postcirugía de pacientes con implante MED-EL y se realizó una visita preoperatoria y un seguimiento con audiometría en campo libre y audiometría verbales postquirúrgica al año, 3 años y 5 años postquirúrgico. Resultados: Se incluyó a 16 pacientes implantados unilateralmente. La edad media inicio pérdida fue de 36,75 años. La edad media de cirugía fue de 71,44 años. Los resultados auditivos fueron satisfactorios, con una media de audiometría en campo libre de 44,33 dB al año, 43,33 dB a los 3 años y 41,66 dB a los 5 años. El resultado en las audiometrías verbales (test de bisílabos y test de frases) fue mejor en el grupo de pacientes con adaptación bimodal. Conclusión: En nuestra experiencia, la implantación coclear en ≥65 años sí que logra mejorar las capacidades auditivas medidas, tanto en audiometría de campo libre como en pruebas verbales. La adaptación bimodal mejora los resultados auditivos, a pesar de la dificultad de procesamiento de los dos estímulos diferentes.

Introduction: The aging of the population, as well as the expansion in the indications for implantation means that every day there are more implanted patients over 65 years of age, which represents a challenge in terms of hearing adjustment and optimization. Cochlear implantation in elderly patients has been found to generally lead to improvements in hearing and neurocognition, depression, social isolation, physical activity, and quality of life. Aim: The objectives of this study are to assess the characteristics of patients over 65 years of age implanted in a tertiary center, analyze the benefits and identify clinical particularities in this group of patients. Material and Method: A retrospective study was carried out with a 5-year post-surgery follow-up of patients with a MED-EL implant, and a preoperative visit and follow-up with free-field audiometry and post-surgical speech audiometry were performed at one year, 3 years and 5 years post-surgery. Results: Sixteen unilaterally implanted patients were included. The mean age at onset of loss was 36.75 years. The mean age at surgery was 71.44 years. Hearing results were satisfactory, with a mean free field audiometry of 44.33 dB at one year, 43.33 dB at 3 years, and 41.66 dB at 5 years. The result in the verbal audiometries (disyllable test and sentence test) was better in the group of patients with bimodal adaptation. Conclusión: In our experience, cochlear implantation in patients ≥ 65 years of age does manage to improve hearing capacities measured both in free-field audiometry and in verbal tests. Bimodal adaptation improves auditory results, despite the difficulty ofprocessing the two different stimuli.

Aspectos audiológicos e cognitivos em adultos com Diabetes Mellitus tipo 2 / Auditory and cognitive aspects in adults with type 2 Diabetes Mellitus / Aspectos auditivos y cognitivos en adultos con Diabetes Mellitus tipo 2

Introdução: A Diabetes Mellitus (DM) é um distúrbio metabólico causado pela ausência ou diminuição da secreção de insulina ou por alterações do funcionamento deste hormônio no organismo, podendo envolver alterações físicas e cognitivas. Objetivo: Analisar os aspectos audiológicos e cognitivos de adultos com Diabetes Mellitus tipo 2. Método: Estudo transversal realizado em pessoas com idade entre 18 e 59 anos, de ambos os gêneros. Os participantes foram divididos em dois grupos: Grupo Estudo (GE) - pessoas com diagnóstico de Diabetes Mellitus e o Grupo Controle (GC) - pessoas sem Diabetes. Todos foram submetidos à avaliação glicêmica, cognitiva e audiológica. Para análise estatística foi utilizado o teste de Mann-Whitney, sendo estipulado o nível de significância de 0,05. Resultados: Participaram do estudo 32 indivíduos sendo 19 (59,4%) no GE e 13 (40,6%) no GC. A média de idade dos participantes foi de 46,8 ± 8,3 anos, com escolaridade média de 6,8 ± 6 anos, sendo 25 (78,1%) do gênero feminino e 7 (21,9%) do masculino. Foi observada diferença estatisticamente significativa entre os grupos para a pontuação referente à atenção e cálculo, recordação e escore total do MEEM, com pior desempenho no GE. Não foi observada diferença estatisticamente significante entre os grupos nos aspectos audiológicos avaliados. Conclusão: Indivíduos com Diabetes Mellitus tipo 2 não apresentaram riscos para alterações audiológicas com os instrumentos utilizados, entretanto apresentaram um alto risco para alterações cognitivas. Os achados demonstram que o acompanhamento fonoaudiológico constante é essencial para identificar as alterações precocemente.

Introduction: Diabetes Mellitus (DM) is a metabolic disorder caused by the absence or reduction of insulin secretion or by changes in the functioning of this hormone in the body, which may involve physical and cognitive changes. Objective: To analyze the audiological and cognitive aspects of type 2 Diabetes Mellitus in adults. Method: Cross-sectional study carried out in people aged between 18 and 59 years, of both genders. Participants were divided into two groups: Study Group (SG) - people diagnosed with Diabetes Mellitus and the Control Group (CG) - people without Diabetes. All underwent glycemic, cognitive and auditory assessment. Mann-Whitney's test was used for statistical analysis, with a significance level of 0.05. Results: 32 individuals participated in the study, 19 (59.4%) in the EG and 13 (40.6%) in the CG. The mean age of the participants was 46.8 ± 8.3 years, with a mean education of 6.8 ± 6 years, with 25 (78.1%) females and 7 (21.9%) males. A statistically significant difference was observed between the groups for the score related to attention and calculation, recall and total Mini-Mental State Examination (MMSE) score, with worse performance in the EG. There was no statistically significant difference between the groups regarding the audiological aspects evaluated. Conclusion: Individuals with type 2 Diabetes Mellitus did not present risks for audiological alterations, however they presented a high risk for cognitive alterations. the findings demonstrate that constant speech therapy monitoring is essential to identify changes early.

Introducción: La Diabetes Mellitus (DM) es un trastorno metabólico causado por la ausencia o reducción de la secreción de insulina o por alteraciones en el funcionamiento de esta hormona en el organismo que puede implicar alteraciones físicas y cognitivas. Objetivo: Analizar los aspectos audiológicos y cognitivos de adultos con Diabetes Mellitus tipo 2. Método: Estudio transversal realizado en personas de entre 18 y 59 años, de ambos sexos. Los participantes se dividieron en dos grupos: Grupo de Estudio (GE) - personas diagnosticadas con diabetes mellitus y Grupo Control (GC) - personas sin Diabetes. Todos se sometieron a evaluación glucémica, cognitiva y audiológica. Para el análisis estadístico se utilizó la prueba de Mann-Whitney, con un nivel de significancia de 0.05. Resultados:Treinta y dos individuos participaron en el estudio, 19 (59,4%) en el GE y 13 (40,6%) en el GC. La edad media de los participantes fue de 46,8 ± 8,3 años, con una educación media de 6,8 ± 6 años, con 25 (78,1%) mujeres y 7 (21,9%) hombres. Se observó diferencia estadísticamente significativa entre los grupos para la puntuación relacionada con atención y cálculo, recuerdo y puntuación total del MEEM, con peor desempeño en el GE. No hubo diferencia estadísticamente significativa entre los grupos en los aspectos audiológicos evaluados. Conclusión: Los individuos con Diabetes Mellitus tipo 2 no presentaban riesgo de alteraciones audiológicas, sin embargo presentaban un alto riesgo de alteraciones cognitivas. Los resultados demuestran que el monitoreo constante de la terapia del habla es esencial para identificar cambios temprano.

Utilidad diagnóstica de la audiometría de alta frecuencia en sujetos expuestos a ruido recreacional / Diagnostic utility of high frequency audiometry in subjects exposed to recreational noise

INTRODUCCIÓN: Recientes investigaciones mencionan que, debido a los altos niveles de ruidos, el 75% de los habitantes en las ciudades industrializadas padecen algún tipo de deficiencia auditiva. La audiometría de alta frecuencia es un examen complementario importante para detectar tempranamente la pérdida de audición. OBJETIVO: Determinar la utilidad diagnóstica de la audiometría de alta frecuencia en la detección temprana de la hipoacusia en sujetos expuestos a ruido recreacional. MATERIAL Y MÉTODO: Estudio analítico de corte transversal. Se evaluaron 87 estudiantes de fonoaudiología. Se aplicó una audiometría convencional y de alta frecuencia mediante audiómetro clínico. RESULTADOS: La audiometría de alta frecuencia presenta una sensibilidad del 100%, especificidad del 64,60%. El valor predictivo (+) es de 14,70%, mientras que el valor predictivo (-) es del 100%. La razón de verosimilitud (+) es de 2,28, y para la razón de verosimilitud (-) es de 0,0. CONCLUSIÓN: La audiometría de alta frecuencia puede ser utilizada para monitorizar la audición de los sujetos, comprobando que efectivamente los umbrales auditivos de alta frecuencia se encuentren dentro de rangos normales. Lo anterior, dado por sus valores de sensibilidad, valor predictivo negativo, razón de verosimilitud negativa y por el aumento entre la probabilidad preprueba y posprueba.

INTRODUCTION: Recent research mentions that, due to the high noise levels, 75% of the habitants in industrialized cities suffer from some type of hearing impairment. High frequency audiometry is an important complementary test to detect early hearing loss. AIM: To determine the diagnostic utility of high frequency audiometry in the early detection of hearing loss in subjects exposed to recreational noise. MATERIAL AND METHODS: Study analytical type and cross section. 87 speech therapy students were evaluated. A conventional and high frequency audiometry was applied, using a clinical audiometer. RESULTS: High frequency audiometry has a sensitivity of 100%, specificity of 64,60%. The predictive value (+) is 14,70%, while the predictive value (-) is 100%. The likelihood ratio (+) is 2,28, and for the likelihood ratio (-) it is 0,0. CONCLUSION: High frequency audiometry can be used to monitor the hearing of the subjects, checking that effectively the high frequency hearing thresholds are within normal ranges. The above, given by their values of sensitivity, negative predictive value, negative likelihood ratio and the increase between the pre-test probability and the posttest probability.

Asociaciones entre clase social e hipoacusia laboral / Associations between social class and labor hipoacusia

Introducción: la exposición a ruidos forma parte de nuestros hábitos cotidianos, culturales y de ocio. En el entorno de trabajo aparecen diferentes sonidos que puedenser perjudiciales para los oídos. El presente escrito trata de identificar la influencia que existe entre clase social e hipoacusia laboral en trabajadores de la ciudad de Cú-cuta, en edades comprendidas entre los 17 y los 70 años. Métodos: observacional, analítico y transversal; la población estudiada incluyó tra-bajadores del sector público y privado del municipio de Cúcuta, a quienes se les reali-zó un examen audiométrico ocupacional por parte del programa de Fonoaudiología. Resultados: se encontró que la mayoría de los trabajadores, un 54.05%, pertenece a una clase social baja; el 65% se expone a ruido en el trabajo, el 60% no utiliza ele-mentos de protección personal y el 30% presenta hipoacusia.Análisis y discusión: hay una asociación significativa entre la actividad laboral y la actividad extra laboral del grupo etario. Predomina el sexo masculino con una representación del 63%. Esto puede explicarse dado el contexto cultural en el que se realizó el estudio.Conclusiones: en Colombia, existe escasa información sobre la relación entre clase social e hipoacusia laboral. Se debe realizar un análisis de segregación socio-espacial tanto de los hogares como de la enfermedad, para así determinar qué enfermedades se asocian con la actividad laboral

Introduction: exposure to noise is part of our daily, cultural and leisure habits. In the work environment different sounds can be harmful to the ears. The present text tries to identify the influence that exists between social class and work-related hearing loss in the city of Cúcuta, aged between 17 and 70 years Methods: It is observational, analytical and cross-sectional. The studied population consisted of individuals working in the public and private sector of the municipality of Cúcuta. They underwent an occupational audiometric examination by the Speech-Audiology program.Results: It was determined that most of the workers, 54.05%, are members of a low social class; 65% of workers are exposed to noise at work, 60% of workers do not use personal protection elements and 30% of evaluated workers have hearing loss. Analysis and discussion: there is a significant association between work activity and non-work activity of the age group, predominant in males with a representation of 63%, this can be explained given the cultural context in which the study was conducted. Conclusions: in Colombia, there is little information on social class and work-related hearing loss. An analysis of socio-spatial segregation of both households and the disease must be carried out in order to determine which diseases are associated to work activity

Perfil clínico e implicações do zumbido em indivíduos com e sem perda auditiva / Clinical profile and implications of tinnitus in individuals with and without hearing loss

RESUMO Objetivo comparar as características clínicas do zumbido e interferência na qualidade de vida em indivíduos com e sem perda auditiva associada, bem como discutir a associação de mensurações quantitativas e instrumentos qualitativos de avaliação. Método estudo quantitativo, descritivo e de corte transversal aprovado pelo Comitê de Ética em pesquisa (nº 973.314/2016 CAEE: 41634815.3.0000.0106). Foram comparadas as respostas da avaliação psicoacústica do zumbido (pesquisa de intensidade, frequência, nível mínimo de mascaramento e limiar de desconforto para tom puro e fala), bem como questionário Tinnitus Handicap Inventory (THI) e escala visual analógica (EVA) de 15 sujeitos portadores de zumbido e perda auditiva periférica (grupo GI) e 16 indivíduos normo-ouvintes (grupo GII). Resultados O escore médio na EVA e THI no GI foi, respectivamente, de 5,1(+1,5) e 42,3(+18) e no GII de 5,7(+2.6) e 32,7(+25), sugerindo incômodo moderado no GI e moderado/leve no GII (p>0,005). Verificou-se correlação moderada entre o THI e EVA apenas no GII. Na avaliação psicoacústica, observaram-se diferenças significantes entre os grupos referentes à medida da loudness (*p=0,013) e ao nível mínimo de mascaramento (*p=0,001). Conclusão a perda auditiva parece não se constituir em um fator determinante para o maior ou menor impacto do zumbido na qualidade de vida do sujeito. Já as diferenças encontradas entre os grupos, referentes às medidas psicoacústicas, podem ser justificadas pela presença do dano coclear em si. A mensuração objetiva do zumbido, independentemente da presença ou não da perda auditiva periférica, caracteriza-se como um importante instrumento complementar às medidas de auto avaliação.

ABSTRACT Purpose To compare clinical characteristics of tinnitus and interference in quality of life in individuals with and without associated hearing loss, as well as to discuss the association of quantitative measurements and qualitative instruments. Methods A quantitative, cross-sectional and comparative study approved by the Research Ethics Committee (No. 973.314/CAEE: 41634815.3.0000.0106) was carried out. The responses of the psychoacoustic assessment of tinnitus (intensity, frequency, minimum masking level and loudness discomfort level for pure tone and speech), as well as the Tinnitus Handicap Inventory (THI) questionnaire, and the visual analogue scale (VAS) were compared between 15 patients with tinnitus and peripheral hearing loss (group I) and 16 adults with normal hearing (group II). Results The mean VAS and THI scores obtained in GI were 5.1 (+1.5) and 42.3 (+18), and in GII, 5.7 (+2.6) and 32.7 (+25), respectively. This result suggests moderate GI annoyance and moderate/mild GII annoyance (p>0.005). There was a positive and moderate correlation between THI and VAS only in GII. In the psychoacoustic evaluation, significant differences were observed between the groups regarding the measurement of loudness (*p=0.013) and the minimum masking level (*p=0.001). Conclusion There was no direct influence of the presence of hearing loss in relation to the impact of tinnitus. The differences found between the groups regarding the psychoacoustics measures can be justified by the presence of cochlear damage. The objective measurement of tinnitus, regardless of the presence or absence of peripheral hearing loss, is an important instrument to be used along with self-evaluation measures.

Análise comparativa dos métodos prescritivos NAL-NL2 e DSL v5. 0a na adaptação do AASI em idosos / Comparative analysis of the NAL-NL2 and DSL v5. 0a prescription procedures in the adaptation of hearing aids in the elderly

RESUMO Objetivo Analisar comparativamente os métodos prescritivos NAL-NL2 e DSL v5.0a de acordo com programação individualizada do AASI para o indivíduo idoso com deficiência auditiva. Método Participaram do estudo 60 indivíduos idosos com deficiência auditiva, submetidos à mensuração da RECD (Real Ear to Coupler Difference) e programação individualizada do AASI com os métodos prescritivos NAL-NL2 e DSL v5.0a. A verificação do desempenho com cada prescrição foi realizada por meio das medidas da REAR (Real Ear Aided Response), cálculo do SII (Speech Intelligibility Index) e teste HINT (Hearing In Noise Test). A análise estatística comparativa foi realizada por meio do teste "t" pareado. Resultados O método NAL-NL2 apresentou melhor desempenho na avaliação da REAR em frequências baixas e altas para sons de média e forte intensidade, em frequências altas para sons de fraca intensidade, e no cálculo do SII para sons fracos. O método DSL v5.0a apresentou melhores resultados na avaliação da REAR em frequências médias para sons médios, em frequências baixas e médias para sons fracos, no cálculo do SII para sons médios e fortes, e no teste HINT no silêncio e ruído. Conclusão Os achados deste estudo apontam para um desempenho equivalente entre os métodos DSL v5.0a e NAL-NL2 na adaptação do AASI em idosos com deficiência auditiva. A amplificação calculada pela DSL v5.0a forneceu melhor percepção de fala no silêncio.

ABSTRACT Purpose To comparatively analyze the NAL-NL2 and DSL v5.0a prescriptive methods according to the hearing aids individualized programming for the elderly with hearing loss. Methods The study included 60 elderly individuals with hearing loss, who underwent RECD (Real Ear to Coupler Difference) measurement and hearing aids individualized programming by NAL-NL2 and DSL v5.0a prescriptive methods. The performance verification for each prescription was performed using REAR measurements (Real Ear Aided Response), SII calculation (Speech Intelligibility Index) and HINT (Hearing In Noise Test). The comparative statistical analysis was performed using the paired t-test. Results The NAL-NL2 method presented a better performance in the REAR evaluation in low and high frequency bands for medium and loud intensity input sounds, in the high frequency range for low intensity input sounds, and in the SII calculation for soft input sounds. The DSL v5.0a presented better results in the REAR evaluation in medium frequencies for medium input sounds, in low and medium frequencies for soft input sounds, in the SII calculation for medium and loud input sound, and in the HINT test in silent and noisy situations. Conclusion The findings of this study point to an equivalent performance between the DSL v5.0a and NAL-NL2 procedures in the adaptation of hearing aids in the elderly with hearing loss. The amplification calculated by DSL v5.0a provided better speech perception in silence.

Exploración de los conductos semicirculares verticales con estimulación rotatoria inducida / Exploration of vertical semicircular ducts with induced rotatory stimulation

Las pruebas rotatorias han sido utilizadas durante más de un siglo para el estudio de la función vestibular por ser un estímulo fisiológico controlado muy efectivo sobre el laberinto posterior, habitualmente son los conductos semicirculares horizontales los que se exploran, pues se afectan con más frecuencia y son más fáciles de estudiar, sin embargo en ocasiones son los verticales los lesionados y por tanto deben emplearse otras alternativas para llegar a un diagnóstico certero. Se presenta un caso donde se evalúa la función fisiológica de los conductos semicirculares verticales a través de la electronistagmografía con estimulación rotatoria, empleando la técnica de estimulación tiempo-velocidad, con fases sucesivas de aceleración, velocidad constante, desaceleración y parada brusca, con una silla rotatoria computarizada, acoplada a un electronistagmógrafo. Se obtuvo arreflexia del canal vertical anterior derecho. A velocidades inferiores a 1 Hz es posible evaluar el reflejo vestíbulo ocular en los conductos semicirculares verticales, a pesar de que la frecuencia del estímulo está por debajo del nivel en que este reflejo funciona en las actividades diarias(AU)

Rotatory tests have been used for over a century for the study of vestibular function because it is a very effective physiological controlled stimulus on the posterior labyrinth, usually the horizontal semicircular ducts that are explored, since they are affected more frequently and are more easy to study, however sometimes the injured are vertical and therefore other alternatives must be used to arrive at a correct diagnosis. The aim of this study is to evaluate the range of physiological function of vertical semicircular ducts using electronystagmography and rotary stimulation. The method used was the technique of time - speed stimulation, with successive phases of acceleration, constant speed, deceleration and abrupt stop, with a computerized rotating chair. Vestibulo-ocular arreflexia of the right anterior vertical channel. It was shown that at speeds lower than 1 Hz it is possible to evaluate the Ocular Lobe Reflex in the vertical semicircular ducts, although the frequency of the stimulus is below the level at which this reflex works in daily activities(AU)

Hábitos auditivos recreacionales y umbral tonal en la frecuencia audiométrica 6. 000 Hz en jóvenes universitarios / Recreational hearing habits and pure tone threshold at 6. 000 Hz frequency in university students

RESUMEN Introducción: La Organización Mundial de la Salud (OMS) (2013) define entre las causas de pérdida auditiva, la exposición a ruido. Una fuente de este ruido son los reproductores personales de música, cuyo uso representa una conducta de riesgo emergente. Es así como, existen estudios que registran daño auditivo inducido por ruido en los usuarios de reproductores personales en comparación con los no usuarios. Objetivo: Investigar la relación entre hábitos auditivos recreacionales y el rendimiento audiométrico en la frecuencia 6.000 Hz en jóvenes universitarios. Material y método: Se evaluaron 50 sujetos entre 18 y 26 años sin antecedentes otológicos. Se aplicó el Cuestionario CHAR y se realizó una audiometría tonal por vía aérea de 125 Hz a 8.000 Hz. Resultados: El análisis audiométrico, determinó la existencia de escotoma en el umbral auditivo de la frecuencia 6.000 Hz en 52% de los sujetos evaluados. Además se encontraron diferencias estadísticamente significativas entre los grupos con umbral bajo y sobre 20 dB en dicha frecuencia, relacionado con los años de exposición y volumen de uso del dispositivo. Conclusión: La exposición a ruido recreacional puede producir daño auditivo a temprana edad, generando la necesidad de planes para prevenir el daño prematuro de la audición en jóvenes.

ABSTRACT Introduction: Noise exposure is one of most common causes of hearing loss according to the World Health Organization (WHO). The use of personal music players is one of the sources of this harmful noise, which has been demonstrated to constitute a risky habit. Previous studies have found hearing loss produced by noise in users of music players compared to subjects who do not used them. Aim: The present study aimed to investigate the relationship between recreational hearing habits and hearing performance at 6000 Hz frequency in university students. Material and method: Fifty subjects (age range of 18-26 years), without history of otologic disorders were assessed. The CHAR questionnaire and an air conduction pure tone audiometry (125 Hz-8000 Hz) were administered to each participant. Results: Findings from pure tone audiometry demonstrated the presence of hearing scotoma at 6000 Hz frequency in fifty-two percent of subjects. Moreover, statistically significant differences were found when comparing subjects with normal threshold and subjects with threshold greater than 20 dB at 6000 Hz. This was related to years and intensity of noise exposure. Conclusion: Recreational noise exposure may cause hearing loss in early stages of lifespan. Prevention strategies to avoid early hearing loss in young subjects are required.

Morfología de la curva audiométrica en la enfermedad de Ménière al momento del diagnóstico / Audiometric curve configurations in Ménière disease at the first visit / Morfologia do desenho audiometrico na doença de Ménière no momento do diagnostico

INTRODUCCIÓN: La enfermedad de Ménière es una vestibulopatía frecuente que se manifiesta con crisis de vértigo, acúfenos, plenitud aural y pérdida auditiva neurosensorial. La hipoacusia es un síntoma fundamental para realizar el diagnóstico y se puede presentar de diversas formas. OBJETIVO: Describir las morfologías de las curvas audiométricas de los pacientes con enfermedad de Méniére al momento del diagnóstico. MATERIAL Y MÉTODOS: Estudio retrospectivo. Se evaluaron 99 pacientes. Se les realizaron estudios audiométricos y se registró el umbral tonal medio, el estadio correspondiente, la presencia de hipoacusia conductiva y la morfología de la curva audiométrica...

INTRODUCTION: Ménière disease is a frequent vestibular desorder that causes vertigo attacks, tinnitus, aural fullness and sensorineural hearing loss. Hearing loss is an essential symptom to get certain diagnosis and it can appear in several shapes. OBJECTIVE: to describe the configurations of the audiometric curves of patients with Ménière desease at the first visit. MATERIAL AND METHODS: A retrospective study included 99 patients. Audiometric studies were performed and mean tonal thresholds, corresponding stage, conductive hearing loss and audiometric curve configurations were recorded…

INTRODUÇÃO: A doença de Ménière é uma vestibulopatia freqüente que se manifesta com crise de vertigem, zumbido, plenitude aural e perda auditiva neurossensorial. A perda de audição é um sintoma fundamental para fazer o diagnóstico mais pode se apresentar com muitas formas. OBJETIVO: Descrever as morfologias das curvas audiométricas em pacientes com doença de Méniére no momento do diagnóstico. MATERIAL E MÉTODOS: Estudo retrospectivo. 99 pacientes foram avaliados. Estudos audiológicos foram feitos e o limiar tonal meia, o estágio, a presença de perda auditiva condutiva e o desenho da curva audiométrica foram analisados...

Percepção da perda auditiva: utilização da escala subjetiva de faces para triagem auditiva em idosos / Perception of hearing loss: use of the subjective faces scale to screen hearing among the elderly

Resumo A presbiacusia é uma alteração prevalente na população idosa, porém subdiagnosticada, desta forma, é importante aprimorar instrumentos de triagem simples. A escala subjetiva de faces foi proposta como forma de avaliar a autopercepção auditiva do idoso e sua correlação com exames audiológicos. Foram avaliados todos os pacientes encaminhados para o serviço de audiologia de um centro de referência de atenção à saúde do idoso no período de fevereiro a novembro de 2013. Os pacientes foram examinados por meatoscopia, audiometria tonal e vocal e responderam a escala subjetiva de faces e o teste do sussurro. Participaram 164 idosos com média de idade de 77 anos. Encontrou-se boa correlação entre a escala subjetiva de faces e o limiar audiométrico (r = 0,66). Houve correspondência entre as faces e o grau da perda auditiva, sendo a face 1 correspondente a audição normal, face 2 a perda auditiva leve e face 3 a perda auditiva moderada grau I. Ao avaliar as qualidades psicométricas da escala subjetiva de faces, verificou-se que as faces 2 e 3 apresentam bons índices de sensibilidade e especificidade, com área sob a curva ROC de 0,81. A escala subjetiva de faces parece ser um bom instrumento complementar de triagem auditiva em serviços gerontológicos, de fácil aplicação e baixo custo.

Abstract Presbycusis is a disorder present among the elderly. However, it is under-diagnosed, making it important to develop and enhance simple screening tools. Objective: The subjective faces scale has been proposed as a method to assess auditory self-perception among the elderly, and its correlation with audiological tests. Methods: We looked at elderly patients referred to the audiology service of a reference center for the care of the elderly in a public university hospital between February and November 2013. Patients were submitted to meatoscopy, tonal and vocal audiometry and the whisper test. They also answered the subjective faces scale. A total of 164 elderly individuals participated, and the average age was 77. Results: We found a good correlation between the subjective faces scale and audiometry thresholds (r = 0.66). Our results show that the faces and hearing loss correlate, with face 1 corresponding to normal hearing, face 2 to mild hearing loss, and face 3 to Grade I moderate hearing loss. When evaluating the psychometric qualities of the subjective faces scale, we found that faces 2 or 3 have good sensitivity and specificity, with the area under the ROC curve being 0.81. Conclusion: The subjective faces scale seems to be a good, low-cost and easy to use supplementary tool for auditory screening in geriatric services.

The importance of audiometric monitoring in patients with multidrug-resistant tuberculosis

Abstract INTRODUCTION: A total of 771 cases of multidrug-resistant tuberculosis (MDR-TB) were reported in Brazil in 2014. Treatment of MDR-TB with aminoglycosides can produce serious side effects such as permanent and irreversible hearing loss, which occurs in 5-64% of cases, and severely compromise patient quality of life. The goal of this research was to evaluate auditory and vestibular side effects in patients treated for MDR-TB and to identify associations between these complaints and the type of aminoglycoside used. METHODS: We performed a retrospective review of 599 medical records from patients with MDR-TB who were treated at the Hélio Fraga/Fiocruz Reference Center between 2006 and 2010. Cases without auditory or vestibular complaints and patients who were not treated with aminoglycoside drugs were excluded from the study. RESULTS: Of 164 eligible cases, 55 (33.5%) reported an auditory or vestibular complaint and medication was subsequently suspended, although hearing damage was not confirmed in all cases. Audiometric testing confirmed hearing loss in 11 (21.7%) of 12 cases submitted for evaluation. Hearing loss related to ototoxicity was confirmed in 15 (62.5%) cases. Tinnitus was significantly associated with the use of amikacin and streptomycin. CONCLUSIONS: Evaluations of ototoxicity symptoms were not usually reported in the routine care of patients with MDR-TB. Complaints of tinnitus were associated with amikacin and streptomycin use. These results require confirmation in future studies.

Relação entre o desempenho em aritmética e a memória de trabalho fonológica em crianças / Relation between arithmetic performance and phonological working memory in children

RESUMO Objetivo Comparar os resultados da Memória de Trabalho - Alça Fonológica (MTAF) em crianças com dificuldades específicas em aritmética. Método O estudo foi realizado com 30 crianças, com idade entre sete e nove anos que frequentavam a segunda ou terceira série do Ensino Fundamental da rede pública de ensino. Foram excluídas da pesquisa as crianças com sinais sugestivos de perda auditiva, alterações neurológicas, baixo desempenho na prova de compreensão leitora ou em acompanhamento fonoaudiológico. As crianças incluídas na pesquisa foram submetidas ao subteste de aritmética do Teste de Desempenho Escolar para divisão em dois grupos (G1 e G2). O G1 foi composto por crianças com baixo desempenho em aritmética e o G2, por crianças com desempenho médio/superior em aritmética. Todas as crianças foram submetidas à avaliação da MTAF por meio da prova de repetição de palavras sem significado. Para análise estatística, foi utilizado o teste de Mann-Whitney, considerados significativos os valores de p-valor <0,05. Resultados Participaram do estudo 20 meninas e 10 meninos, com idade média de 8,7 anos. O G1 foi composto por 17 crianças e o G2, por 13 crianças. Houve diferença estatisticamente significativa entre os grupos estudados para a repetição de palavras sem significado com três e quatro sílabas, com pior desempenho para o G1. Conclusão Os resultados deste estudo fornecem suporte para a hipótese de que a alteração na MTAF está relacionada com dificuldades em aritméticas.

ABSTRACT Purpose To compare the results of Loop Phonological Working Memory (LPWM) in children without global learning alterations, with lower and average/higher arithmetic performance. Methods The study was conducted with 30 children, between the ages of seven and nine years old, who attended the second or third grade of elementary school in the public network. Exclusion criteria were children with suggestive signs of hearing loss, neurological disorders, poor performance in the reading comprehension test or in speech therapy. The children included in the study were submitted to the subtest of arithmetic of Academic Achievement Test for division into two groups (G1 and G2). The G1 was composed of children with low performance in arithmetic and G2 for children with average/higher performance in arithmetic. All children were submitted to PWM assessment through the repetition of pseudowords test. Statistical analysis was performed using the Mann-Whitney test and a p-value <0.05 was considered significant. Results The study included 20 girls and 10 boys, mean age 8.7 years. The G1 was composed of 17 children and G2 of 13 children. There was a statistically significant difference between the groups studied for the repetition of pseudowords with three and four syllables. Conclusion The results of this study provide support for the hypothesis that changes in phonological working memory are related to difficulties in arithmetic tests.

Medidas de imitância acústica de banda larga em indivíduos com otosclerose / Wideband acoustic immittance measurements in subjects with otosclerosis

Na prática clínica, nota-se uma dificuldade em identificar a rigidez do sistema tímpano-ossicular decorrente da Otosclerose por meio dos métodos de avaliação rotineiramente empregados. Assim, as medidas de imitância acústica de banda larga podem fornecer mais informações sobre a condição do sistema tímpano-ossicular por avaliarem uma ampla faixa de frequência. O objetivo do estudo foi caracterizar as medidas de imitância acústica de banda larga com os estímulos tom puro e chirp em indivíduos com diagnóstico de Otosclerose submetidos à estapedectomia ou estapedotomia. Foram avaliados 40 indivíduos na faixa etária de 33 a 80 anos, totalizando 54 orelhas operadas e 22 orelhas não operadas. A avaliação audiológica foi realizada por meio da otoscopia, audiometria tonal liminar, logoaudiometria e imitanciometria. As medidas de imitância acústica de banda larga foram obtidas por meio do sistema de medidas Middle-Ear Power Analyzer MEPA3, versão 5.0 (Mimosa Acoustics), utilizando os estímulos tom puro e chirp. Os dados obtidos foram submetidos à análise estatística descritiva e inferencial, com nível de significância de 0,05. As orelhas com Otosclerose apresentaram maior absorvância em 750 Hz, uma tênue diminuição até 3000 Hz, acentuando-se a partir desta frequência. A magnitude da admitância foi maior na faixa de frequência de 1992 a 4008 Hz, assim como a magnitude da impedância foi maior nas frequências baixas com diminuição até 4008 Hz e aumento em 6000 Hz. Estas orelhas foram dominadas pela rigidez nos sons graves e médios, por resistência entre 3000 e 4008 Hz e a partir desta frequência pela massa. A fase da impedância foi maior em 258 Hz e o delay da reflectância (slope) apresentou uma variação de comportamento entre as frequências, não sendo possível caracterizar um padrão de resposta. Conclui-se que há diferenças nas medidas obtidas nas orelhas com Otosclerose submetidas à cirurgia, quando analisadas as frequências baixas e médias, o que demonstra o impacto positivo da intervenção cirúrgica na funcionalidade do sistema tímpano-ossicular.(AU)

In clinical practice, there is a difficulty in identifying the rigidity of the tympano-ossicular system resulting from Otosclerosis through the routinely employed evaluation methods. Thus, wideband acoustic immitance measurements can provide more information on the condition of the tympanic-ossicle system by evaluating a wide frequency range. This study aimed at characterizing the wideband acoustic immitance measurements with the pure tone and chirp stimuli in individuals diagnosed with Otosclerosis submitted to stapedectomy or stapedotomy. Forty individuals aged 33 to 80 years were evaluated, totaling 54 operated and 22 non-operated ears. Audiology assessment was performed through otoscopy, pure-tone audiometry, logoaudiometry and imitanciometry. Wideband acoustic immitance measurements were obtained using the Middle-Ear Power Analyzer (MEPA3), version 5.0 (Mimosa Acoustics), by means of pure tone and chirp stimuli. Data were submitted to descriptive and inferential statistical analysis, with a significance level of 0.05. The ears with Otosclerosis presented a greater absorbance in 750 Hz, a slight diminution until 3000 Hz, being accentuated from this frequency. The admittance magnitude was higher in the frequency range from 1992 to 4008 Hz, as well as the impedance magnitude was higher in the low frequencies with a decrease up to 4008 Hz and an increase in 6000 Hz. These ears were dominated by rigidity in the low and medium sounds, by resistance between 3000 and 4008 Hz, and from this frequency, by the mass. The impedance phase was higher at 258 Hz and the reflectance delay (slope) showed a behavioral variation between the frequencies, a response not being characterized. It can be concluded that there are differences in the measurements obtained in Otosclerosis ears submitted to surgery, when the low and medium frequencies were analyzed, which demonstrates the positive impact of the surgical intervention on the tympano-ossicle system.(AU)

The audiological profile of adults with and without hypertension

OBJECTIVE: To determine whether there is any influence of systemic arterial hypertension on the peripheral auditory system. METHODS: This was a cross-sectional study that investigated 40 individuals between 30 and 50 years old, who were divided into groups with and without systemic arterial hypertension, using data from high-frequency audiometry, transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions. The results were compared with those from groups of normal-hearing individuals, with and without systemic arterial hypertension, who underwent the pure-tone audiometry test. All individuals also underwent the following procedures: otoscopy, acoustic immittance measures, pure-tone audiometry at frequencies from 250 to 16000 Hz, transient-evoked otoacoustic emissions test and distortion-product otoacoustic emissions test. RESULTS: No statistically significant difference was observed between the groups with and without systemic arterial hypertension in either conventional or high-frequency audiometry. Regarding transient-evoked otoacoustic emissions, there was a trend toward statistical significance whereby the systemic arterial hypertension group showed lower results. Regarding distortion-product otoacoustic emissions, the systemic arterial hypertension group showed significantly lower results at the following frequencies: 1501, 2002, and 3003 Hz. A discriminant analysis indicated that the distortion-product otoacoustic emissions variables best distinguished individuals with and without systemic arterial hypertension. CONCLUSION: Data from this study suggest cochlear dysfunction in individuals with systemic arterial hypertension because their otoacoustic emission results were lower than those in the systemic arterial hypertension group.

Avaliação audiológica infantil: a utilização da audiometria com reforço visual com estímulos de fala / Pediatric hearing evaluation: visual reinforcement audiometry with speech sounds

Algumas teorias propõem que a percepção auditiva para sons complexos, como a fala e sons simples, ocorre de maneira distinta. Teorias sobre a existência de uma rota especial para decodificação da fala, com distinções desde a detecção do espectro acústico, a despolarização não linear das fibras do nervo auditivo, até a localização de neurônios especializados para interpretar sons de fala a nível cortical. Seria possível esta habilidade específica de percepção de fala um fator que modificaria as respostas de crianças entre 6 a 24 meses durante uma avaliação comportamental? Para avaliação audiológica nesta faixa etária, a Audiometria com Reforço Visual (VRA) é o exame indicado para obter níveis mínimos de audição (NMA). Diversos estudos apresentam as indicações da técnica do VRA para obter respostas confiáveis do sistema auditivo. Diante destas perguntas, determinou-se realizar um estudo comparativo do VRA com dois estímulos: warble nas frequências de 0.5, 1, 2 e 4kHz, e estímulos de fala, os seis sons de Ling /a/, /i/, /u/, /s/, /?/, /m/. Os dois exames foram aplicados em crianças com e sem deficiência auditiva, com os objetivos de determinar os NMA, o tempo de teste, número de sessões e os comportamentos observados durante a avaliação. Além da investigação quantitativa, foi elaborado um guia de orientações para realização do VRA. Foram avaliadas 123 crianças, as quais 57 foram inclusas na pesquisa, os principais motivos de exclusão foram: timpanogramas alterados, deficiências múltiplas, atraso motor e desordem do espectro da neuropatia auditiva. Participaram do grupo controle (GC) 33 crianças sem deficiência auditiva, idade média de 12 meses, e 24 com deficiência auditiva do grupo experimental (GE), idade média de 18 meses. No total foram obtidos 718 NMA considerando as 57 crianças e os 10 estímulos avaliados. Para o GC a média do VRA-warble foi de 17,05 dBNA e para o VRA-Ling de 13,60 dBNA; no GE as médias foram respectivamente, 95,51 dBNA e 85,88 dBNA, ou seja, estatisticamente os valores obtidos com os sons de Ling foram menores do que os obtidos com o estímulo warble. Os tempos médios para obtenção de pelo menos um NMA ou todos os NMA com o Ling e warble, não se diferiram na comparação intra grupos, assim como o número de sessões realizadas. No entanto, observou-se na comparação entre grupos, que o número de sessões, o número de NMA obtidos e o tempo de teste na realização do VRA-warble, foram maiores no GE. Outros comportamentos foram observados durante o decorrer do VRA: atenção, reflexo de orientação, imitação do estímulo auditivo, apontar para o fone, olhar para avaliadora/mãe. Considerando os resultados obtidos: o protocolo de teste utilizado mostrou-se eficaz para obtenção dos NMA nos dois grupos estudados; os sons de Ling podem ser utilizados na avaliação audiológica infantil de forma a complementar os achados com os estímulos de frequência específica. Porém, uma vez que os sons de Ling possuem uma ampla faixa de frequência, outros estudos que correlacionem os NMA para os sons de Ling nas diferentes configurações audiométricas são necessários.

Some theories postulate the auditory perception to complex sounds and simple sounds, occur differently. Theories about the existence of a special route for decoding speech, with distinctions from the detection of the acoustic spectrum, nonlinear depolarization of the auditory nerve fibers to the location of specialized neurons to interpret speech sounds at the cortical level. Is it possible this specific skill of speech perception a factor that would change the responses of children aged 6 to 24 months during a behavioral assessment? For audiological evaluation in this age group, with Visual Reinforcement Audiometry (VRA) is the test to obtain minimum response levels (MRL) or thresholds. Faced with these questions, determined to carry out a comparative study of the VRA with two stimuli: warble tones in the frequencies of 0.5, 1, 2 and 4 kHz, and speech stimuli, the six Ling sounds /a/, /i/, /u/, /s/, /?/, /m/. Both tests were applied in children with and without hearing impairment with the objective of determining the NMA, test time, number of sessions and the behavior observed during the assessment. In addition to quantitative research, we designed a guide guidelines for conducting the VRA. 123 children were evaluated, of which 57 were included in the survey, the main reasons for exclusion were changed tympanograms, multiple disabilities, delayed motor and auditory neuropathy spectrum disorder. Participated in the control group (CG) 33 children without hearing impairment, mean age 12 months, and 24 with hearing loss in the experimental group (GE), average age of 18 months. In total 718 were obtained NMA considering the 57 children and 10 evaluated stimuli. For the GC average of VRA-warble was 17.05 dBHL and for VRA-Ling of 13.60 dB HL; GE in the averages were respectively 95.51 and 85.88 dBHL dBNA, ie, statistically the values obtained with the sounds of Ling were lower than those obtained with the warble stimulus. The average time to achieve at least one or all of the NMA NMA with Ling and warble, did not differ compared intra groups, as well as the number of sessions. However, it was noted in comparison between groups, the number of sessions, the number of NMA obtained and the and the test time in achieving VRA-warble were higher in the EG. Other behaviors were observed during the course of the VRA: attention, orientation reflex, imitation of auditory stimuli, point to the phone, look appraiser / mother. Considering the results obtained: the test protocol used was effective for obtaining the NMA in both groups; Ling sounds can be used in the audiological evaluation of children to complement the findings with specific frequency stimuli. However, since Ling sounds have a wide range of frequencies, other studies correlating to NMA Ling sounds in different audiometric configurations are needed.

Estudo da alteração temporária dos limiares auditivos pós-laboral em trabalhadores metalúrgicos / Study of afterwork temporary threshold shift in metalworkers

Contexto: Na avaliação audiométrica ocupacional o repouso auditivo prévio evita a Alteração Temporária dos Limiares Auditivos (ATLA), um fenômeno de fadiga auditiva. A ocorrência da ATLA é muitas vezes negligenciada na prática cotidiana e, além disso, há poucos estudos demonstrando a sua ocorrência. Objetivo: Pesquisar a ocorrência da ATLA numa amostra de trabalhadores metalúrgicos expostos à ruído ocupacional. Método: Estudo de coorte histórico com 43 metalúrgicos avaliados através de dois exames audiométricos: o primeiro em repouso de 12 horas e outro após a jornada de trabalho. Os resultados foram avaliados comparando-se os exames em repouso com os pós-jornada nas frequências isoladas e na média de 0.5, 1 e 2 KHz. Foi considerado exame alterado quando piora ?10 dB nas frequências isoladas ou na média; alterações <10 dB foram consideradas não significantes. Resultados: Dos 43 indivíduos, 19 deles (44,2%) apresentaram pelo menos uma frequência com alteração significativa em comparação entre os exames (IC95% 0,27?0,56). A média (0.5, 1 e 2 KHz) dos 43 trabalhadores antes da exposição foi 8,5 dB e, na avaliação após, 9,3 dB, com diferença média de 0,8 dB (p=0,011). Conclusão: Nosso estudo confirma a ocorrência da ATLA e reforça a necessidade do repouso acústico em avaliações audiométricas ocupacionais.

Context: The occupational audiometric evaluation shall be preceded by a time without exposure to noise, in the way to prevent temporary threshold shift (TTS). This period before test is hard to obtain routinely and there are few studies demonstrating the TTS. Objective: To demonstrate the TTS in metalworkers exposed to occupational noise. Method: This historic cohort study included 43 metalworkers subjected to two audiometric evaluations: one just before the workday with 12 hours without exposure to noise and the other after the end of the workday. The results were analyzed comparing both exams in the isolated frequencies and in average of 0.5, 1 and 2 KHz. Results were considered changed in a variation ?10 dB in isolated frequencies or in the average; variation of less than 10 dB were considered non-significant. Results: From the 43 evaluated subjects, 19 (44.2%) showed at least one frequency with significant variation in the exams comparisons (CI95% 0.27?0.56). The average (0.5, 1 and 2 KHz) of all 43 workers before the noise exposition was 8.5 dB and after was 9.3 dB, with average of 0.8 dB (p=0.011). Conclusion: Our study confirms the occurrence of TTS and reinforces that the audiogram shall be preceded by a time without exposure to workplace noise.

Sound localization and word discrimination in reverberant environment in children with developmental dyslexia / Localización sonora y discriminación de palabras en ambientes reverberantes en niños con dislexia del desarrollo

Objective Compare if localization of sounds and words discrimination in reverberant environment is different between children with dyslexia and controls. Method We studied 30 children with dyslexia and 30 controls. Sound and word localization and discrimination was studied in five angles from left to right auditory fields (-90o, -45o, 0o, +45o, +90o), under reverberant and no-reverberant conditions; correct answers were compared. Results Spatial location of words in no-reverberant test was deficient in children with dyslexia at 0º and +90o. Spatial location for reverberant test was altered in children with dyslexia at all angles, except –-90o. Word discrimination in no-reverberant test in children with dyslexia had a poor performance at left angles. In reverberant test, children with dyslexia exhibited deficiencies at -45o, -90o, and +45o angles. Conclusion Children with dyslexia could had problems when have to locate sound, and discriminate words in extreme locations of the horizontal plane in classrooms with reverberation. .

Objetivo Comparar localización de sonidos y localización-discriminación de palabras bajo reverberación y sin reverberación en niños disléxicos y controles. Método Estudiamos 30 niños disléxicos y 30 controles, pareados por edad. La localización sonora y discriminación a palabras fue estudiada en cinco ángulos horizontales en los campos izquierdo y derecho (-90o, -45o, 0o, +45o, +90o), bajo reverberación y sin reverberación; las respuestas correctas fueron comparadas Resultados: La localización sonora sin reverberación fue deficiente en niños disléxicos a 0º y +90º. La localización bajo reverberación falló en niños disléxicos en todos los ángulos, excepto –-90o. Durante la discriminación a palabras, sin reverberación, los niños disléxicos fallaron en ángulos izquierdos. En la prueba reverberante, los niños disléxicos fallaron a -–45o, -90o y +45o. Conclusion Los niños con dislexia pueden tener problemas cuando tienen que localizar sonidos y discriminar palabras en las localizaciones extremas del plano horizontal en salones de clases típicos con reverberación. .

Audiological outcomes of cochlear implantation in Waardenburg Syndrome

The most relevant clinical symptom in Waardenburg syndrome is profound bilateral sensorioneural hearing loss. AIM: To characterize and describe hearing outcomes after cochlear implantation in patients with Waardenburg syndrome to improve preoperative expectations. METHOD: This was an observational and retrospective study of a series of cases. Children who were diagnosed with Waardenburg syndrome and who received a multichannel cochlear implant between March 1999 and July 2012 were included in the study. Intraoperative neural response telemetry, hearing evaluation, speech perception, and speech production data before and after surgery were assessed. RESULTS: During this period, 806 patients received a cochlear implant and 10 of these (1.2%) were diagnosed with Waardenburg syndrome. Eight of the children received a Nucleus 24® implant and 1 child and 1 adult received a DigiSonic SP implant. The mean age at implantation was 44 months among the children. The average duration of use of a cochlear implant at the time of the study was 43 months. Intraoperative neural responses were present in all cases. Patients who could use the speech processor effectively had a pure tone average of 31 dB in free-field conditions. In addition, the MUSS and MAIS questionnaires revealed improvements in speech perception and production. Four patients did not have a good outcome, which might have been associated with ineffective use of the speech processor. CONCLUSION: Despite the heterogeneity of the group, patients with Waardenburg syndrome who received cochlear implants were found to have hearing thresholds that allowed access to speech sounds. However, patients who received early intervention and rehabilitation showed better evolution of auditory perception...

Validación de criterio de la Escala Abreviada del Desarrollo (EAD-1) en el dominio audición-lenguaje / Validating abbreviated developmental scale (ADS-1) criterion in the language-hearing domain

Objetivo Establecer la validez de criterio de la escala EAD-1 en el dominio audición-lenguaje en niños de 4 a 5 años del municipio de Popayán, durante el mes de diciembre de 2011 y enero de 2012. Métodos Se realizó un estudio de validación de pruebas diagnósticas en 96 niños a quienes se les valoró el lenguaje y la audición mediante la escala EAD-1, aplicada dentro del programa de crecimiento y desarrollo y con la valoración fonoaudiológica como prueba oro (Test de Reynell para valorar el leguaje, y la audiometría tonal y otoemisiones acústicas para valorar la audición). Se determinó la validez de criterio de la escala y la concordancia entre las dos valoraciones mediante el valor Kappa. Los resultados fueron analizados con el paquete estadístico SPSS - 19. Resultados La escala EAD-1 presentó una sensibilidad del 54 %, una especificidad del 42 %, un valor predictivo positivo del 87 %, un valor predictivo negativo del 11 % y un Índice de Kappa=-0,0. Conclusiones La escala EAD-1, presenta poca capacidad para clasificar correctamente al enfermo como verdadero enfermo y al sano como verdadero sano, no coincidiendo este valor con la prevalencia encontrada (87,5 %); además, la pobre concordancia entre los dos métodos, no permiten en el momento clasificarla como un instrumento válido para ser utilizado como prueba tamiz de detección temprana de las alteraciones del lenguaje y la audición en niños de 4 a 5 años.(AU)

Objective Establishingthe validityof abbreviated developmentalscale (ADS-1)criterion,regardingthe language and hearing domainfor 4- to 5-year-old children in the city of Popayan(2012). Methods This work involved a validation study of diagnostic tests for 96 children whose language and hearing wereassessed by ADS-1 within a growth and development program andthrough speech therapy assessment as gold standard (Reynell norm-referencedtest for measuring expressive and receptive language skills and tone audiometryand otoacoustic emissions for assessing hearing). The validity of the scale’s criterion was determined as was the correlation between both testsusing the Kappa value. SPSS-19 was used for analyzing theresults. Results TheADS-1 scale had 54 % sensitivity, 42 % specificity, 87 %positive predictive value, 11 % negative predictive value and K=-0.0 concordance. Conclusions The ADS-1scalehas little predictive ability for correctly classifying apatient as being really ill and/or thehealthy as being really sound. This value didnot coincide with the prevalence found (87.5%).Pooragreement between both methods didnot allow it to be classifiedas a valid instrument for use as a screening test for the earlydetection of language and hearing disorders in children aged 4 to 5 years old.(AU)