Segmentation of binaural room impulse responses for speech intelligibility prediction.

The two most important aspects in binaural speech perception-better-ear-listening and spatial-release-from-masking-can be predicted well with current binaural modeling frameworks operating on head-related impulse responses, i.e., anechoic binaural signals. To incorporate effects of reverberation, a model extension was proposed, splitting binaural room impulse responses into an early, useful, and late, detrimental part, before being fed into the modeling framework. More recently, an interaction between the applied splitting time, room properties, and the resulting prediction accuracy was observed. This interaction was investigated here by measuring speech reception thresholds (SRTs) in quiet with 18 normal-hearing subjects for four simulated rooms with different reverberation times and a constant room geometry. The mean error with one of the most promising binaural prediction models could be reduced by about 1 dB by adapting the applied splitting time to room acoustic parameters. This improvement in prediction accuracy can make up a difference of 17% in absolute intelligibility within the applied SRT measurement paradigm.

Impulse Noise Injury Model.

OBJECTIVES: The new Auditory 4.0 model has been developed for the assessment of auditory outcomes, expressed as temporary threshold shift (TTS) and permanent threshold shift (PTS), from exposures to impulse noise for unprotected ears, including the prediction of TTS recovery. METHODS: Auditory 4.0 is an empirical model, constructed from test data collected from chinchillas exposed to impulse noise in the laboratory. Injury outcomes are defined as TTS and PTS, and Auditory 4.0 provides the full range of TTS and PTS dose-response curves with the risk factor constructed from A-weighted sound exposure level. Human data from large weapons noise exposure was also used to guide the development of the recovery model. RESULTS: Guided by data, a 28-dBA shift was applied to the dose-response curves to account for the scaling from chinchillas to humans. Historical data from rifle noise tests were used to validate the dose-response curves. New chinchilla tests were performed to collect recovery data to construct the TTS recovery model. CONCLUSIONS: Auditory 4.0 is the only model known to date that provides the full TTS and PTS dose-response curves, including a TTS recovery model. The model shows good agreement with historical data.

Classifying human audiometric phenotypes of age-related hearing loss from animal models.

Age-related hearing loss (presbyacusis) has a complex etiology. Results from animal models detailing the effects of specific cochlear injuries on audiometric profiles may be used to understand the mechanisms underlying hearing loss in older humans and predict cochlear pathologies associated with certain audiometric configurations ("audiometric phenotypes"). Patterns of hearing loss associated with cochlear pathology in animal models were used to define schematic boundaries of human audiograms. Pathologies included evidence for metabolic, sensory, and a mixed metabolic + sensory phenotype; an older normal phenotype without threshold elevation was also defined. Audiograms from a large sample of older adults were then searched by a human expert for "exemplars" (best examples) of these phenotypes, without knowledge of the human subject demographic information. Mean thresholds and slopes of higher frequency thresholds of the audiograms assigned to the four phenotypes were consistent with the predefined schematic boundaries and differed significantly from each other. Significant differences in age, gender, and noise exposure history provided external validity for the four phenotypes. Three supervised machine learning classifiers were then used to assess reliability of the exemplar training set to estimate the probability that newly obtained audiograms exhibited one of the four phenotypes. These procedures classified the exemplars with a high degree of accuracy; classifications of the remaining cases were consistent with the exemplars with respect to average thresholds and demographic information. These results suggest that animal models of age-related hearing loss can be used to predict human cochlear pathology by classifying audiograms into phenotypic classifications that reflect probable etiologies for hearing loss in older humans.

Miringoplastias primarias. Resultados a los 2 años de seguimiento / Primary myringoplasties. Results after a 2 year follow-up period

Introducción y objetivos: La miringoplastia tiene como finalidad el cierre de la perforación timpánica y mejorar la audición, con resultados variables en la literatura. Nuestro objetivo fue saber cuál es la realidad de esta cirugía en nuestro centro y compararla con la publicada. Métodos: Análisis retrospectivo de 217 miringoplastias primarias efectuadas en el Servicio de Otorrinolaringología del Hospital Universitario Ramón y Cajal entre los años 1998 y 2003, con descripción de las características de perforación, técnica quirúrgica y resultados postoperatorios (cierre de la perforación y mejoría de la audición). Resultados: En su mayoría eran adultos y la etiología principal fue la secuela otorreica (91 %). Predominaron perforaciones menores a subtotal en tamaño (64 %) que no afectaban al anillo timpánico (79 %). La técnica de colocación del injerto respecto al resto timpánico fue lateral (45 %), mixta (29 %) y medial (26 %); se utilizó el abordaje retroauricular (66 %) y endoaural (34 %). La fascia de músculo temporal fue el injerto más utilizado (87 %). El cierre de la perforación se consiguió entre un 78 y un 91 % de los casos a lo largo de los 24 meses de seguimiento, con un valor final del 78 % a los 2 años de seguimiento. La mejora de la audición, reflejada como un umbral diferencial audiométrico menor de 20dB, se observó en aproximadamente el 56 % de los casos. Conclusiones: La miringoplastia en nuestro centro alcanza cifras de éxito anatómico (78 %) y funcional (56 %) comparables con las de la literatura. Consideramos fundamental el seguimiento a medio plazo de los pacientes por el fenómeno de reperforación, que puede ocurrir hasta pasados 2 años o más (AU)

Introduction and goals: The goals of myringoplasty are closure of the perforation in the tympanic membrane and improvement in hearing levels, with varying results in the published literature. Our aim was to determine the results of this procedure at our centre and compare them with the literature. Methods: Retrospective analysis of 217 primary myringoplasties carried out in the Otorhinolaryngology Department of the Ramón y Cajal University Hospital between 1998 and 2003, describing the characteristics of the perforations, surgical technique and post-operative results (perforation closure and hearing improvement). Results: The majority were adults with perforations secondary to recurrent middle ear infections (91 %). Most were less than sub-total (64 %) and did not involve the tympanic annulus (79 %). Grafts were inserted using lateral (45 %), mixed (29 %) and medial (26 %) techniques, using retroauricular (66 %) and endaural (34 %) approaches. Temporal muscle fascia was the graft most frequently used (87 %). Perforation closure was achieved in between 78 % and 91 % of cases throughout the 24-month follow-up period, with an overall closure value of 78 % after 2years of follow-up. Hearing improvement, established as an air bone gap difference of less than 20dB, was seen in proximately 56 % of cases. Conclusions: At our centre, myringoplasty achieves anatomical (78 %) and functional (56 %) success comparable to the results described in the literature. We consider medium-term follow-up to be of the utmost importance because of reperforation phenomena, which may occur as much as 2 years or more after surgery (AU)

Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras.

OBJECTIVES: An investigation of the hearing status of musicians of professional symphony orchestras. Main questions are: (1) Should musicians be treated as a special group with regard to hearing, noise, and noise related hearing problems (2) Do patterns of hearing damage differ for different instrument types (3) Do OAE have an added value in the diagnosis of noise induced hearing loss (NIHL) in musicians. METHODS: 241 professional musicians, aged between 23-64 participated. A brief medical history and the subjective judgment of their hearing and hearing problems were assessed. Musicians were subjected to an extensive audiological test battery, which contained testing of audiometric thresholds, loudness perception, diplacusis, tinnitus, speech perception in noise, and otoacoustic emissions. RESULTS: Most musicians could be categorized as normal hearing, but their audiograms show notches at 6 kHz, a frequency that is associated with NIHL. Musicians often complained about tinnitus and hyperacusis, while diplacusis was generally not reported as a problem. Tinnitus was most often localized utmost left and this could not be related to the instrument. It was usually perceived in high frequency areas, associated with NIHL. In general, musicians scored very well on the speech-in-noise test. The results of the loudness perception test were within normal limits. Otoacoustic emissions were more intense with better pure-tone thresholds, but due to large individual differences it can still not be used as an objective test for early detection of NIHL. CONCLUSIONS: Musicians show more noise induced hearing loss than could be expected on the basis of age and gender. Other indicators, such as complaints and prevalence of tinnitus, complaints about hyperacusis and prevalence of diplacusis suggest that musicians' ears are at risk. Continuing education about the risks of intensive sound exposure to musicians, with the emphasis on the possible development of tinnitus and hyperacusis and the need for good hearing protection is warranted.

La detección precoz auditiva de los neonatos / Newborn hearing screening

Internacionalmente está totalmente asumida lanecesidad de la detección precoz auditiva de formauniversal en los neonatos, existiendo protocolos ytecnologías para llevarla a cabo. Se han suscitadocontroversias sobre la sensibilidad, la especificidad ylas técnicas de realización de las mismas.Las metas ideales a alcanzar son: detección precozantes del mes, establecimiento del diagnóstico a los3 meses e inicio de rehabilitación protésica y logopédicaa los 6 meses. Una rehabilitación precoz supone laposibilidad de utilizar plenamente los períodos críticosde aprendizaje y conseguir la maduración de la víaauditiva de forma correcta, obteniéndose una calidadde lenguaje próxima al normooyente.El congreso bianual Newborn Hearing Screening2008 (NHS, 2008) ha supuesto la posibilidad de contrastarnuestros criterios en un foro en el que se hanpresentado más de 60 programas de detección precozauditiva de 30 países distintos.Se incluyen en las conclusiones algunos de los puntosrecogidos en el resumen final de este importantecongreso después del seguimiento de las distintasconferencias sobre la neuropatía y el screening auditivouniversal

It is all over recognized the need of the universal newborn hearing screening, even there are several protocols to perform it. There are some differences about the specificity, sensibility and technical ways to make the tests.The ideal is: detection before one month, diagnosis inthree months and to begin the prothesis and logopedicrehabilitation at six months. An early rehabilitationgives the possibility to use properly the critical periodand to develop the maturation of the nervous hearingsystem, obtaining a quality of language near the normalone.The NHS (Newborn Hearing Screening) 2008 biannualcongress has been a good opportunity to contrast ourcriteria. 60 newborn screening programes have beenpresented from 30 different countries.We present a summary of several aspects mentioned inthe final conclusions of this important congress afterattending thel presentations about neurophathy and universal newborn hearing screening programmes (AU)

Requerimiento auditivo en licencias de conducción de vehículos del Grupo 2. Actualización conforme a la legislación vigente en España / Auditory requirement for Group 2 vehicle driving licences. An update in accordance with valid legislation in Spain

Introducción: La hipoacusia permitida para obtener licencias de conducción del Grupo 2 es del 35%, pero su medida no está estandarizada. Métodos: En 35 conductores hipoacúsicos con licencias del Grupo 2 se evaluó esta pérdida de forma habitual, equiparando umbral a porcentaje, y con arreglo a la legislación vigente, que considera hipoacusia descensos superiores a 25 dB en cada frecuencia. Resultados: La pérdida binaural media fue del 41,3±6,3% en el primer método, y del 30,7±10,2% en el segundo. Ambos modelos se correlacionaron bien por la recta de regresión lineal de ecuación y=1,4785x-30,382, con R2=0,8467. Conclusiones: En los permisos del Grupo 2, el grado de hipoacusia observado entre conductores debe ser estandarizado en su forma de cuantificación ya que, según el modelo, el porcentaje de hipoacusia varía ampliamente. Existe un reglamento sobre cuantificación de minusvalías en nuestro país, válido para marcar la medida de sordera también en la conducción de vehículos

Introduction: Hearing loss level admitted for acquisition of Group 2 driving licences is actually 35%, but this measurement is not standarized. Methods: In 35 drivers with Group 2 licence bearing of hearing loss, it was measured in the usual way -considering threshold as an average-, and also in accordance with valid legislation, which considers deafness when hearing thresholds are under 25 dB in each tone. Results: Binaural hearing loss average was 41.3±6.3% for the first model, and 30.7±10.2% for the second. There was a good correlation between the two models by mean of lineal regression (y=1.4785x-30.382; R2=0.8467). Conclusions: In Group 2 licences, hearing loss average must be standarized in its quantifyng technique, because there is a wide difference in the results, depending on the model used to measure. In our country there are rules and regulations about quantifying for disable people, valid for establishing deafness measurement patterns in vehicle driving too

Efeito da melhora da audição sobre o zumbido em pacientes com hipoacusia condutiva submetidos à timpanoplastia e estapedotomia / Effect of hearing improvement on tinnitus in patients with conductive hearing loss submitted to timpanoplasty and stapedotomy

Com o objetivo de avaliar a correlação entre a melhora da audição e do zumbido em pacientes com hipoacusia condutiva e sua estabilidade a médio prazo, analisamos 33 pacientes submetidos à timpanoplastia ou estapedotomia por meio da audiometria tonal e da nota de incômodo pela escala numérica de 0 a 10, repetindo os procedimentos após 1 e 6 meses de cirurgia. Houve melhora significante do incômodo com a hipoacusia e com o zumbido após 1 e 6 meses, assim como uma correlação positiva entre a variação do incômodo de ambos os sintomas após 1 e 6 meses. Concluímos que os pacientes com zumbido e hipoacusia condutiva submetidos à timpanoplastia ou estapedotomia incomodam-se mais com a hipoacusia do que o zumbido, mas ambos os sintomas apresentam melhora significante no pós-operatório, que se mantém estável entre 1 e 6 meses / In clinical practice, hearing improvement procedures often promote tinnitus improvement as well. The aims of this study were to evaluate: 1) the correlation between hearing improvement and tinnitus evolution in patients with conductive hearing loss submitted to tympanoplasty or stapedotomy; 2) the stability of such results after 1 and 6 months of surgery. Patients with tinnitus and hearing loss with indication of stapedotomy and tympanoplasty have major bannoyance with hearing loss than with tinnitus and show significant and stable improvement after 5 months of surgical follow-up. Tinnitus improvement is correlated with annoyance with hearing loss but not do the audiometric thresholds...

NRT-based versus behavioral-based MAP: a comparison of parameters and speech perception in young children.

The present study was designed to evaluate the effect of neural response telemetry (NRT)-based cochlear implant (CI) programming versus behavioral-based programming on electrical stimulation parameters (MAP) threshold (T) and comfortable (C) levels and speech perception abilities in young children, during the first year of implant use. Ten congenitally deaf children at the age of 12-39 months (mean age: 25.2 months) implanted with the Nucleus 24R(CS) CI participated in the study. The group was randomly divided into two: (1) NRT-based MAP group (n = 5) consisted of children who were programmed using intra-operative NRT measurements; (2) behavioral-based MAP group (n = 5) consisted of children who were programmed using the behavioral responses of the patients. MAP parameters as well as sound-field aided thresholds and speech perception abilities were compared between the two groups at consecutive programming sessions: 1, 3, 6, and 12 months post initial stimulation. Results indicated no significant differences among NRT-based MAPs and behavioral-based MAPs. Although MAP profiles at initial stimulation differed in the apical region, these differences decreased with time. In addition, a gradual increase of T and C levels of NRT-based MAPs as well as those of behavioral-based MAPs was evident until the 1-month time point, thereafter stabilization occurred. Sound-field aided thresholds improved with time for both groups; however, they were found to be significantly better for the NRT-based MAP group. Despite these differences, speech perception abilities were comparable among groups at 12 months post initial stimulation. NRT-based programming was found to be significantly shorter than behavioral-based programming. In conclusion, for this small group of children, our findings support the use of NRT for programming of young children during the initial period after implantation.

Hearing at low and infrasonic frequencies.

The human perception of sound at frequencies below 200 Hz is reviewed. Knowledge about our perception of this frequency range is important, since much of the sound we are exposed to in our everyday environment contains significant energy in this range. Sound at 20-200 Hz is called low-frequency sound, while for sound below 20 Hz the term infrasound is used. The hearing becomes gradually less sensitive for decreasing frequency, but despite the general understanding that infrasound is inaudible, humans can perceive infrasound, if the level is sufficiently high. The ear is the primary organ for sensing infrasound, but at levels somewhat above the hearing threshold it is possible to feel vibrations in various parts of the body. The threshold of hearing is standardized for frequencies down to 20 Hz, but there is a reasonably good agreement between investigations below this frequency. It is not only the sensitivity but also the perceived character of a sound that changes with decreasing frequency. Pure tones become gradually less continuous, the tonal sensation ceases around 20 Hz, and below 10 Hz it is possible to perceive the single cycles of the sound. A sensation of pressure at the eardrums also occurs. The dynamic range of the auditory system decreases with decreasing frequency. This compression can be seen in the equal-loudness-level contours, and it implies that a slight increase in level can change the perceived loudness from barely audible to loud. Combined with the natural spread in thresholds, it may have the effect that a sound, which is inaudible to some people, may be loud to others. Some investigations give evidence of persons with an extraordinary sensitivity in the low and infrasonic frequency range, but further research is needed in order to confirm and explain this phenomenon.

Temporary hearing threshold shifts and restitution after energy-equivalent exposures to industrial noise and classical music.

In order to investigate whether the energy-equivalence principle is at least acceptable for exposures with a duration in the range of hours and in order to disclose the actual physiological responses to exposures which varied with respect to the time structure and the semantic quality of sounds, a series of tests was carried out where physiological costs associated with varying exposures were measured audiometrically. In a cross-over test design, 10 Subjects (Ss) participated in test series with 3 energetically equal sound exposures on different days. The exposures corresponded with a tolerable rating level of 85 dB / 8 h. In a first test series (TS I), the Ss were exposed to a prototype of industrial noise with a sound pressure level of 94 dB(A) / 1 h. In a second test series (TS II), the same type of noise was applied, but the exposure time of a reduced level of 91 dB(A) was increased to 2 hours. In a third test series (TS III), classical music was provided also for 2 h at a mean level of 91 dB(A). The physiological responses to the 3 exposures were recorded audiometrically via the temporary threshold shift TTS2, the restitution time t(0 dB), and the IRTTS-value. IRTTS is the integrated restitution temporary threshold shift which is calculated by the sum of all threshold shifts. It represents the total physiological costs the hearing must "pay" for the sound exposure. Physiological responses of the hearing to the industrial noise exposures in TS I and TS II, all in all, were identical in the 3 parameters. Maximum threshold shifts of approximately 25 dB occurred which did not dissipate completely until 2.5 h after the end of the exposure and IRTTS-values of about 800 dBmin were calculated. Therefore, at least for exposure times in the range of hours, the equilibration of intensity and duration of sound exposures according to the energy-equivalence principle seems to have no influence on the hearing. Classical music was associated with the least severe TTS of less than 10 dB which disappeared much more quickly. IRTTS added up to just about 100 dBmin and, in comparison with 800 dBmin as specific responses to industrial noise, amounted to only about 12%. The substantially lower physiological costs of classical music apparently indicate a decisive influence of the type of sound exposures. Making inferences from the results of the study, the conventional approach of rating sound exposures exclusively by the principle of energy equivalence can lead to gravely misleading assessments of their actual physiological costs.

Alterações dos limiares auditivos causados pelo colabamento de meato acústico externo / Misdiagnosis of Hearing Loss Due to Ear Canal Collapse

O colabamento do meato acústico externo pode resultar em uma piora dos limiares auditivos, principalmente nas freqüências mais agudas, em decorrência de um fechamento total ou parcial do meato acústico externo, devido à pressão dos fones exercida sobre o pavilhão auricular durante a avaliação audiológica. Para evitar erros deste tipo, algum método deve ser utilizado para que meatos acústicos externos estreitos e/ou pavilhões auriculares flácidos permaneçam livres permitindo que a onda sonora seja capaz de atingir a membrana timpânica durante a obtenção dos limiares tonais. Material e métodos: Neste trabalho estão demonstrados os resultados com 47 pacientes que apresentaram melhora de seus limiares auditivos de até 50 dBNA quando um tubo de polietileno foi inserido no meato acústico externo para evitar o colabamento.

Collapse of the external auditory meatus during audiometry can lead to spuriously increased hearing thresholds being obtained, particularly at high frequencies, by pressure exerted on the pinna during audiometryc testing. The pressure of the earphone against the pinna may result in the partial closure or complete collapse of the external auditory meatus during audiometry. To avoid such errors, na effective method has to be used to eliminate outer ear closure to allow sound to reach" the tympanic membrane during tonal audiometry. Material and methods: In a sample of 47 patients, we demonstraded best. results after using a small piece of polyethylene tubbing inserted in the canal to avoid the collapse of the ear canal.

Audiometría de alta frecuencia: umbrales en relación con la edad / High frequency audiometric testing: thresholds related to age

Una aplicación cada vez más importante de la audiometría de alta frecuencia es la monitorización de los tratamientos considerados potencialmente ototóxicos.Sin embargo, establecer unos umbrales auditivos de alta frecuencia sigue siendo una tarea difícil, principalmente debido a la diversidad de los sistemas empleados y de los métodos de calibración.El objetivo de este estudio ha sido establecer unos umbrales auditivos de alta frecuencia en función de la edad, que puedan servir como parámetros de referencia. Estudiamos a 162 pacientes control que fueron sometidos a una audiometría tonal liminar de alta frecuencia, calculando los umbrales para las frecuencias comprendidas entre los 10 y 20 KHz.Los resultados se presentan en relación a grupos de edad, y sugieren, como otros autores, que los umbrales auditivos aumentan con la edad y con la frecuencia. Destacamos la contaminación medioambiental y la presbiacusia dentro del grupo de los principales factores etiológicos que justificarían este agravamiento progresivo de la capacidad auditiva con el tiempo. (AU)

Brainstem auditory evoked responses elicited by tone-burst stimuli in clinically normal dogs.

Brainstem auditory evoked responses (BAERs) to click and tone-burst stimuli (0.5, 1, 2, 4, and 8 kHz) were recorded from 32 ears in 16 adult Beagles. BAERs were used to establish a normative database and describe response thresholds and latencies (wave I-IV) for the different stimuli. The frequencies of sound used were 8, 4, 2, 1, and 0.5 kHz. Sound stimuli were delivered by a closed headphone and masking stimuli were not applied. The BAER waveforms obtained were similar to those reported previously, except for a frequency-following response evoked by 1-kHz tone-bursts. The threshold was lowest when clicks and 4-kHz tone-bursts were used. Significant differences were observed between the mean values of the peak latencies for clicks and 4- and 8-kHz tone-bursts. The tone-burst stimulation used in our experiment was shown to be an appropriate method for detecting the BAERs. Thus, for investigating the frequency-specificity of the auditory sense, BAER data obtained using tone-burst sound in dogs may be meaningful.

Correlación entre umbrales por audiometría convencional y por emisiones otoacústicas de distorsión en pre-escolares / Correlation between conventional tonal audiometry thresholds and otoacoustic distortion emissions in children

Se estudió desde el punto de vista audiológico, un grupo de 49 pre-escolares sanos seleccionados previamente por medio de examen general de ORL y audiometría, mediante la técnica de emisiones otoacústicas por distorción (EOD). Se compararon los valores de los umbrales auditivos con estímulos a las frecuencias 1000, 2000 y 4000 Hz de la audiometría y de 1000-1187, 2000-2406 y 4000-4812 Hz de las EOD por el coeficiente de correlación de Pearson. Se observaron coeficientes de correlación significativos entre ambas pruebas. Estos resultados muestran que las EOD pueden ser una buena herramienta clínica confiable para determinar audición normal o anormal en sujetos que no cooperan

Distortion product emission features and the prediction of pure tone thresholds.

Distortion product emission (DPE) growth functions, demographic data, and pure tone thresholds (PTTs) were recorded in 229 normal-hearing and hearing-impaired ears. Half of the data set (115 ears) was used by a discriminant analysis routine to classify DPE and demographic features into either a normal PTT group or an impaired PTT group (PTT greater than 30 dB SPL [sound pressure level]) at six frequencies in the audiometric range. The six discriminant functions developed from this classification process were then used to predict PTT group membership in the remaining 114-ear data set. Frequency-specific prediction accuracy was approximately 85% overall. Of the 45 DPE and demographic variables evaluated, the DPE amplitude associated with an f2 (a primary tone of frequency) of moderate level (50 dB SPL) and a frequency corresponding to PTT was generally most predictive. DPE features associated with frequencies immediately adjacent to the PTT frequency also appear to be useful. DPE level was found to be weakly correlated with subject age; perhaps for this reason, age was frequently included in discriminant functions. This study describes the DPE measures that can most reliably categorize PTTs as normal or impaired in large populations with varied cochlear hearing status.

La rubeola congénita como probable agente de hipoacusia sensorioneuronal en Chile / Congenital rubella as a probability agent of sensoryneural hypoacusia in Chile

En Chile la infección por rubeola es adquirida tempranamente: cerca del 90 por ciento de los niños menores de 5 años presentaban pruebas inmunológicas positivas (Clin Obst Gynecol 25:585,82). Los objetivos fueron medir con audiometría por potenciales evocados auditivos de tronco cerebral (PEAT) la prevalencia de hipoacusia sensorioneural (HSN) en niños que consultaban la clínica ORL de nuestro hospital Universitario por sospecha de daño auditivo y comparar la prevalencia de HSN en niños sospechosos de rubeola congénita con el grupo no rubeólico. 199 niños fueron estudiados en 34 meses. Su audición fue medida en cada oído usando PEAT. Se consideró probable portador de rubeola congénita (RC) por examen clínico y/o pruebas inmunológicas positivas a 16 pacientes. Se encontró una discapacidad auditiva severa (umbral del mejor oído 61 dBnHL o mayor) en el grupo rubeólico a un 81 por ciento (13/16). En el grupo no rubeólico un 41 por ciento (75/183) presentaban la misma discapacidad y 39 por ciento (72/183) tenían un oído normal. Se concluye que la discapacidad auditiva severa en esta población pediátrica es sorprendentemente alta (41 por ciento). La sospecha de RC en un niño aumenta su probabilidad de daño auditivo severo y la vacunación de mujeres en edad fértil negativas para rubeola debe considerarse para prevenir daño auditivo fetal. La RC sería responsable de un 15 por ciento de las discapacidades auditivas graves en esta población