Uma reflexão sobre as conexões entrea fonoaudiologia e Saúde Única / A reflection on the connections betweenspeech therapy and One Health

A Saúde Única é uma crescente abordagem sistêmica para aumentar indissociavelmente os níveis de saúde das pessoas, dos animais e do ambiente no planeta. Por sua característica interdisciplinar e multidisciplinar, a Saúde Única tem arregimentado cada vez mais novos agentes na área de saúde, ampliando novas fronteiras de prática profissional. Objetivo: tendo em vista de que a abordagem sistêmica da Saúde Única (One Health) é holística, objetivou-se descrever e refletir sobre o papel da fonoaudiologia nesse contexto. Métodos: fez-se uma revisão de escopo sobre as ligações da fonoaudiologia com as desordens de saúde que são o foco em Saúde Única. Realizou-se uma procura de artigos nas plataformas PubMed e SciELO, com a combinação booleana dos indexadores "fonoaudiologia" e "Saúde Única", em idioma português; e as palavras "speech-language therapy" e "One Health" em idioma inglês. O operador booleano foi "E" e "AND". Adicionalmente, procurou-se teses e dissertações com esses mesmos operadores e combinações no Catálogo de Teses e Dissertações da CAPES. Analisou-se os dados por uma abordagem qualitativa, por isso os métodos estatísticos não foram aplicados. A partir dessa abordagem, complementou-se a argumentação com uma reflexão crítica sobre a inclusão da fonoaudiologia na estratégia de Saúde Única. Resultados: apenas na plataforma SciELO encontrou-se cinco obras com os descritores e a combinação "Saúde Única AND fonoaudiologia"; esse resultado é fortemente sugestivo de que o profissional em fonoaudiologia não tem sido incluído como um agente na abordagem Saúde Única. Contrariando esse cenário, argumenta--se que a fonoaudiologia pode preencher um nicho de trabalho e atuação acadêmica na abordagem de Saúde Única, cujo foco são desordens de saúde que podem resultar em distúrbios da comunicação nas pessoas. Considerações finais: há um nicho para a fonoaudiologia na abordagem da Saúde Única para a prevenção, o tratamento e a investigação científica das desordens da comunicação humana.

One Health is a growing systemic approach aimed at increasing the health levels of people, animals and the environment on the planet. Due to its inter- and multidisciplinary characteristics, One Health has been recruiting an increasing number of new agents in the health area, expanding new frontiers of professional practice. Objective: considering that the systemic approach of One Health is holistic, the objective is to describe and reflect on the role of speech therapy in this context. Methods: a scoping review was conducted to explore the connections between speech therapy and the health disorders that are the focus of One Health. A search for articles was carried out on the PubMed and SciELO platforms, using the Boolean combination of the terms "fonoaudiologia" (speech therapy) and "Saúde Única" (One Health), in Portuguese; and the words "speech-language therapy" and "One Health" in English using the Boolean operator "E" and "AND". Additionally, we searched for theses and dissertations with these same operators and combinations, in the CAPES Catalog of Theses and Dissertations. The data was analyzed using a qualitative approach, therefore statistical methods were not applied. Based on this approach, the argument was complemented with a critical reflection on the inclusion of speech therapy in the One Health strategy. Results: five works were found on the SciELO platform using the descriptors and combination "Saúde Única AND fonoaudiologia". This result suggests that the speech therapy professional has not been included as an agent in the One Health approach. Contrary to this scenario, it is argued that speech therapy can play a significant professional and academic role in One Health, which focuses on health disorders that may result in communication disorders. Final considerations: there is a niche for speech therapy in the One Health approach to the prevention, treatment and scientific investigation of human communication disorders.

Relationship Between Chloroquine or Hydroxychloroquine Use and Hearing Disorders: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Chloroquine and its analog hydroxychloroquine are derivatives of 4-aminoquinoline and are regularly used in the treatment of malaria and autoimmune diseases. Among the side effects of these drugs, alterations associated with the auditory system are frequently mentioned. Thus, the aim of this systematic review is to systematically review publications on hearing disorders and chloroquine or hydroxychloroquine use. MATERIALS AND METHODS: Inclusion criteria were observational or interventional studies on audiological assessment in participants who were using chloroquine or hydroxychloroquine. The methodological quality was independently assessed by two reviewers using the Meta-Analysis of Statistics: assessment and review Instrument. The certainty of the evidence was assessed using the GRADE tool. RESULTS: A total of 1,372 non-duplicate papers were screened, out of which 17 were included in the final qualitative synthesis, and 5 studies in the meta-analysis. The odds ratio for the two subgroups evaluated did not show significance with no heterogeneity between the effects observed between the different diseases (I2=0%) and obtaining the global estimate of 0.76 (95% confidence interval [CI]=0.41-1.39; p>0.05). Despite the inclusion of papers with different disease samples, the heterogeneity observed in the analysis was low (I2= 0%) and prediction interval (95% PI=0.32-1.80; p>0.05) remained close to that estimated by the CI (95% CI=0.41-1.39; p>0.05). The certainty of the evidence assessed by the GRADE tool was considered very low due to the risk of bias, indirect evidence, and imprecision. CONCLUSIONS: The findings of this study suggest that the use of chloroquine/hydroxychloroquine is not associated with hearing disorders.

Does a patient with acquired arbovirus infection have a hearing impairment? A scoping review of hearing changes in an adult with Dengue, Chikungunya, and Zika.

OBJECTIVES: To identify and understand the evidence regarding hearing changes related to acquired Dengue, Chikungunya, and Zika virus infection in adult individuals. METHODS: A scoping review was performed according to the recommendations of The Joanna Briggs Institute and guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in the Embase, PubMed/Medline, ScienceDirect, Scopus, and Web of Science databases without restriction on language and year of publication. Case studies, observational studies, and clinical trials reporting hearing loss in adult subjects (>18-60 years of age) of both sexes with DENV, CHIKV, or ZIKV diagnosed by positive molecular/serological examination by RT-PCR or IgM/IgG by ELISA method were included. RESULTS: Thirteen studies met the inclusion criteria and were selected for review. The occurrence of auditory symptoms caused by arboviroses and the presence of permanent or transient sensorineural hearing loss was variable in adults. CONCLUSIONS: Dengue, Chikungunya, and Zika infections in adults are associated with a variety of auditory symptoms. The frequency of permanent or transient sensorineural hearing loss is low but not negligible.

Does a patient with acquired arbovirus infection have a hearing impairment? A scoping review of hearing changes in an adult with Dengue, Chikungunya, and Zika

Abstract Objectives To identify and understand the evidence regarding hearing changes related to acquired Dengue, Chikungunya, and Zika virus infection in adult individuals. Methods A scoping review was performed according to the recommendations of The Joanna Briggs Institute and guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in the Embase, PubMed/Medline, ScienceDirect, Scopus, and Web of Science databases without restriction on language and year of publication. Case studies, observational studies, and clinical trials reporting hearing loss in adult subjects (>18-60 years of age) of both sexes with DENV, CHIKV, or ZIKV diagnosed by positive molecular/serological examination by RT-PCR or IgM/IgG by ELISA method were included. Results Thirteen studies met the inclusion criteria and were selected for review. The occurrence of auditory symptoms caused by arboviroses and the presence of permanent or transient sensorineural hearing loss was variable in adults. Conclusions Dengue, Chikungunya, and Zika infections in adults are associated with a variety of auditory symptoms. The frequency of permanent or transient sensorineural hearing loss is low but not negligible.

Comparative Study Between Single Layer and Double Layer Graft Technique in Tympanoplasty for Subtotal Tympanic Membrane Perforation.

Introduction Tympanoplasty is the main treatment of mucosal type of chronic suppurative otitis media. Objective The aim of the present study was to compare clinical outcomes in terms of healing and audiological outcomes of two groups. The authors used single layer graft (perichondrium with cartilage island) graft in one group and double layer grafts (perichondrium cartilage island composite plus temporalis fascia) were used in the second group. Methods Forty patients complained of chronic suppurative otitis media safe type with subtotal perforation subdivided into two groups. The first group author used single-layer perichondrium with cartilage island graft (composite graft) while in the second group authors used double graft in the form of perichondrium/cartilage island (composite graft) plus temporalis fascia. Results There was no significant difference in the mean Air bone gap (ABG) between pre- and post-operative audiometry in subjects who had single layer tympanoplasty. There was a significant difference in the mean ABG between pre- and postoperative audiometry in subjects who had double layer tympanoplasty. There was a significant difference in in the mean ABG differences between subjects who had single layer tympanoplasty and double layer tympanoplasty. Also, there was a significant difference in the healing of the tympanic membrane between subjects who had single layer tympanoplasty and double layer tympanoplasty. Conclusion Tympanoplasty by double graft (temporalis fascia and tragal cartilage/perichondrium) achieved a considerable improvement in healing of the tympanic membrane ™ with lower risk for residual perforation or graft rejection.

Associação entre autopercepção auditiva e comprometimento cognitivo em idosos brasileiros: estudo populacional / Association between self-perceived hearing status and cognitive impairment in the older Brazilian population: a population-based study

Resumo Saúde cognitiva é um fator importante para qualidade de vida e a autonomia dos idosos, sendo influenciada pela capacidade auditiva. O objetivo deste artigo é analisar a associação entre autopercepção auditiva e comprometimento cognitivo em idosos brasileiros. Trata-se de um estudo transversal de base populacional com 4.977 idosos que participaram do ELSI Brasil 2015. Comprometimento cognitivo (desfecho, categorizado como sim e não) e a variável de interesse (autopercepção auditiva, categorizada como boa, regular e ruim), ambos obtidos de forma autorreferida. Para a cognição foram considerados os domínios orientação temporal, memória (curto e longo prazo) e linguagem (recente e tardia). Foi utilizada a regressão de Poisson com estimativa de variância robusta para aferir a associação nas análises bruta e ajustada. Variáveis sociodemográficas, de estilo de vida e de histórico clínico foram utilizadas para ajuste das análises. Dos participantes, 31,8% relataram audição regular ou ruim e 42% apresentaram comprometimento cognitivo. Na análise ajustada, idosos com audição ruim apresentaram maior força de associação com comprometimento cognitivo, em comparação com seus pares com audição boa. Em idosos brasileiros, quanto pior a autopercepção auditiva, maior a associação com o comprometimento cognitivo.

Abstract Cognitive health plays an important role in the quality of life and autonomy of older adults. and it is influenced by hearing ability. This article aims to analyze the association between self-perceived hearing status and cognitive impairment in Brazilian older adults. This cross-sectional population-based study was conducted with 4,977 older adults who participated in ELSI Brazil 2015. The cognitive impairment status (outcome. categorized as "yes" and "no") and variable of interest (self-perceived hearing status. categorized as "good" "fair" and "poor") were obtained using a self-report method. The following domains were considered for cognition: temporal orientation. memory (short and long term). and language (recent and late). Poisson regression with robust variance estimation was used to assess the self-perceived hearing status-cognitive impairment association in the crude and adjusted analyses. Sociodemographic. lifestyle. and medical history variables were used to adjust the analyses. We found that 31.8% of the participants reported fair or poor hearing and 42% had cognitive impairment. In the adjusted analysis. older adults with poor hearing were revealed to have a stronger association with cognitive impairment than their peers with good hearing. Therefore. in older Brazilian adults. lower self-perceived hearing status is associated higher levels of cognitive impairment.

Behavioral tests used to assess central auditory processing in children - an integrative literature review / A utilização de testes comportamentais na avaliação do processamento auditivo central em crianças - revisão integrativa da literatura

ABSTRACT Purpose: to analyze the Brazilian bibliographic production, in the last decade, regarding the most used behavioral tests to assess central auditory processing in children. Methods: an integrative literature review, whose research question was, "Which behavioral tests are most used to assess children's central auditory processing?". The following search strategy "(auditory processing) AND (behavioral tests) AND (children)", was used to consult the Oasisbr, VHL, and SciELO databases. Free-access studies, published in full text in national and international journals, in Brazilian Portuguese or English, with replicable methods, and whose descriptors and topics answered the research question, were selected. Reviews, opinion articles, administration reports, websites, policies with indicators, information systems, and repeated or duplicate publications, were excluded. Two researchers conducted the analysis, and the studies were classified as either feasible or unfeasible. Data were collected between September and November 2021 and organized in tables and spreadsheets developed in Microsoft Excel. Literature Review: initially, 64 studies were located, but after applying the eligibility criteria, 28 publications remained, which were read in full text. Conclusion: the Frequency Pattern Test, Dichotic Digits Test, Gaps in Noise Test, Speech-in-Noise Test, and Pediatric Speech Intelligibility were the most used behavioral tests to assess children's auditory processing.

RESUMO Objetivo: analisar a produção bibliográfica nacional da última década acerca dos testes comportamentais mais utilizados na avaliação do processamento auditivo central em crianças. Métodos: trata-se de uma revisão integrativa da literatura cuja questão norteadora foi: "Quais testes comportamentais são mais utilizados na avaliação do processamento auditivo central em crianças?". A estratégia de busca foi: "(processamento auditivo) AND (testes comportamentais) AND (crianças)" e as bases de dados Oasisbr, BVS e SciELO foram consultadas. Foram selecionados estudos de acesso gratuito, publicados integralmente em revistas nacionais e internacionais, em português brasileiro ou inglês, com metodologias replicáveis e com descritores e temática pertinentes à questão norteadora. Foram excluídas revisões, publicações de opinião, relatórios de gestão, sites, políticas com indicadores, sistemas de informações e publicações repetidas ou duplicadas. A análise foi realizada por ambas as pesquisadoras e os estudos foram classificados como viáveis e inviáveis. Para a organização dos dados, foram elaboradas tabelas e planilhas no Microsoft Excel. A coleta de dados ocorreu entre setembro e novembro de 2021. Revisão da Literatura: inicialmente, foram localizados 64 estudos; mas, após a aplicação dos critérios de elegibilidade, restaram 28 estudos, que foram lidos na íntegra. Conclusão: os testes comportamentais mais utilizados na avaliação do processamento auditivo em crianças foram: o Teste de Padrão de Frequência, o Teste Dicótico de Dígitos, o "Gaps in Noise", o Teste de Fala com Ruído e o Teste de Logoaudiometria Pediátrica.

Comparative Study Between Single Layer and Double Layer Graft Technique in Tympanoplasty for Subtotal Tympanic Membrane Perforation

Abstract Introduction Tympanoplasty is the main treatment of mucosal type of chronic suppurative otitis media. Objective The aim of the present study was to compare clinical outcomes in terms of healing and audiological outcomes of two groups. The authors used single layer graft (perichondrium with cartilage island) graft in one group and double layer grafts (perichondrium cartilage island composite plus temporalis fascia) were used in the second group. Methods Forty patients complained of chronic suppurative otitis media safe type with subtotal perforation subdivided into two groups. The first group author used single-layer perichondrium with cartilage island graft (composite graft) while in the second group authors used double graft in the form of perichondrium/cartilage island (composite graft) plus temporalis fascia. Results There was no significant difference in the mean Air bone gap (ABG) between pre- and post-operative audiometry in subjects who had single layer tympanoplasty. There was a significant difference in the mean ABG between pre- and postoperative audiometry in subjects who had double layer tympanoplasty. There was a significant difference in in the mean ABG differences between subjects who had single layer tympanoplasty and double layer tympanoplasty. Also, there was a significant difference in the healing of the tympanic membrane between subjects who had single layer tympanoplasty and double layer tympanoplasty. Conclusion Tympanoplasty by double graft (temporalis fascia and tragal cartilage/perichondrium) achieved a considerable improvement in healing of the tympanic membrane ™ with lower risk for residual perforation or graft rejection.

Expectativa de vida com perda auditiva: estimativas para o Brasil / Life expectancy with hearing loss: estimates for Brazil

RESUMO Objetivo analisar a prevalência da perda auditiva autorreferida em relação à idade, sexo e regiões do Brasil e estimar a expectativa de vida com perda auditiva no Brasil, ao nascer e aos 60 anos, em ambos os sexos. Métodos foi utilizado o Método de Sullivan, combinando a tábua de vida e as prevalências de perdas auditivas no período, assim como a adoção de dados da Pesquisa Nacional de Saúde de 2013 e Tábuas de Vida Completas, por sexo, publicadas pelo Instituto Brasileiro de Geografia e Estatística. Resultados no Brasil, em 2013, a prevalência da perda auditiva aumentou gradativamente a partir dos 60 anos de idade, em ambos os sexos, sendo o masculino o mais afetado pela deficiência auditiva. A expectativa de vida ao nascer era de 71 anos e 2 meses para os homens e de 78 anos e 6 meses para as mulheres. Destes anos de vida, 3,4% (para homens) e 2,8% (para mulheres) eram com perda auditiva. Já aos 60 anos, essa diferença permanece, com expectativa de mais 19,9 anos para os homens e 21,7 anos para as mulheres. Nessa faixa etária, os homens apresentavam taxa de 2,2 anos (11,3%) com perdas auditivas, enquanto, para as mulheres, a taxa era 2,1 anos (9,7%). Conclusão no Brasil, com base nos dados de 2013, observou-se um aumento gradativo da prevalência de perda auditiva a partir dos 60 anos de idade para ambos os sexos. As mulheres apresentam maior expectativa de vida, maior expectativa de vida livre de perdas auditivas e vivem menor parcela de suas vidas com perdas auditivas, quando comparadas aos homens, independentemente da idade. A avaliação da expectativa de vida com perdas auditivas ao nascer e aos 60 anos pode auxiliar na compreensão das necessidades da população, o que permite o melhor planejamento de políticas públicas relacionadas à saúde auditiva dos indivíduos.

ABSTRACT Purpose to analyze the prevalence of self-reported hearing loss in relation to age, gender and regions of Brazil and to estimate life expectancy with hearing loss in Brazil, at birth and at age 60, for both sexes. Methods the Sullivan method was used, combining the life table and the prevalence of hearing loss in the period, as well as the adoption of data from the 2013 National Health Survey and Complete Life Tables, by sex, published by the Brazilian Institute of Geography and Statistics. Results in Brazil, in 2013, the prevalence of hearing loss gradually increased from the age of 60, in both genders, with males being more affected by hearing loss. Life expectancy at birth was 71.2 years for men and 78.5 years for women. Of these years of life, 3.4% (for men) and 2.8% (for women) were with hearing loss. At age 60, this difference remains, with an expectation of another 19.9 years for men and 21.7 years for women. In this age group, men had a rate of 2.2 years (11.3%) with hearing loss, while for women the rate was 2.1 years (9.7%). Conclusion in Brazil, based on data from 2013, there was a gradual increase in the prevalence of hearing loss from the age of 60 for both genders. Women had higher life expectancy, greater life expectancy free of hearing loss and live a smaller portion of their lives with hearing loss than men, regardless of age. The assessment of life expectancy with hearing loss at birth and at age 60 can help to understand the needs of the population, which allows for better planning of public policies related to the hearing health of individuals.

Intensidade e desconforto do zumbido pós-covid-19: um estudo comparativo / Intensity and discomfort of post-COVID-19 tinnitus: a comparative study

RESUMO Objetivo caracterizar o grau de intensidade e desconforto do zumbido de indivíduos, pós-COVID-19. Métodos pesquisa observacional, exploratória e de corte transversal com 242 participantes, divididos em dois grupos iguais, pareados de acordo com gênero e faixa etária: grupo-controle (GC), composto por indivíduos com zumbido em período pré-pandêmico, e grupo de estudo (GE), composto por participantes que referiram zumbido pós-COVID-19, de diferentes regiões do país. Foram comparados os escores gerais e de domínios específicos do Tinnitus Handicap Inventory (THI) e da Escala Visual Analógica (EVA), por meio de análise estatística descritiva, testes de normalidade, comparação de grupos e de correlação entre as variáveis. Resultados em cada grupo, 93 participantes eram do gênero feminino e 28, do masculino, sendo a média das idades de 35 anos. Os graus desprezível e leve do THI e leve e moderado da EVA foram maiores para o GE, enquanto o domínio catastrófico do THI e a EVA apontaram piores escores para o GC. Houve diferença significativa entre todos os domínios das escalas inter e intragrupos. Conclusão manifestações mais brandas de incômodo, intensidade e desconforto do zumbido pós-COVID-19 foram encontradas, em comparação ao sintoma decorrente de outras causas. Assim, o impacto do zumbido para a população estudada foi menos autorreferido, apontando para melhores possibilidades terapêuticas e prognósticas.

ABSTRACT Purpose to characterize the degree of intensity and discomfort of tinnitus in post-COVID-19 individuals. Methods observational, exploratory and cross-sectional research with 242 participants, divided into two equal groups matched according to sex and age group. The control group, composed of individuals with tinnitus in the pre-pandemic period, and the study group, composed of participants who reported post-COVID-19 tinnitus in different regions of the country. General and domain-specific scores from the Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) were compared through descriptive statistical analysis, normality tests, comparison of groups and correlation between variables. Results in each group, 93 participants were female and 28 male, with a mean age of 35 years. The "negligible" and "mild" degrees of the THI and the "mild" and "moderate" of the VAS were higher for the SG, while the catastrophic domain of the THI and the VAS indicate worse scores for the CG. There was a significant difference between all domains of the inter- and intra-group scales. Conclusion milder manifestations of post-COVID-19 tinnitus disturbance, intensity and discomfort were found, compared to symptoms arising from other causes. Thus, the self-reported impact of the studied population was lower, pointing to better therapeutic and prognostic possibilities.

Migraine associated with tinnitus and hearing loss in adults: a systematic review.

OBJECTIVE: To describe evidence of migraine-associated tinnitus and hearing loss. DESIGN: This study was registered in PROSPERO and followed the PRISMA guidelines. The inclusion criteria were observational studies with subjects aged ≥18 years, in which the association between migraine and tinnitus and/or hearing loss was evaluated. Reviews, case reports, commentaries, letters to the editor, and studies that included individuals with some diseases were excluded. STUDY SAMPLE: The search yielded 698 articles from electronic databases. Six studies were eligible for this review with 26,166 participants. RESULTS: Most studies have shown an association between migraine and tinnitus, and between migraine and hearing loss. Studies have concluded that migraine presented high odds ratio, and hazard ratio for tinnitus. Another study found a strong association between these conditions (p < 0.001), and two investigations detected the presence of migraine in 10.1 and 22.5% of tinnitus patients. Migraine presented high odds ratio and hazard ratio for hearing loss. Additionally, the studies included were of good quality, adhering to most of the requirements on the JBI Critical Appraisal Checklist. However, a limitation of this review is the small number of studies included. CONCLUSIONS: Associations between migraine, tinnitus, and hearing loss were observed in the included studies.

Benefícios do treinamento auditivo para idosos usuários de aparelhos de amplificação sonora individual (AASI): Revisão integrativa da literatura / Benefits of hearing training for elderly users of individual sound amplification devices (ISAD): Integrative literature review / Beneficios del entrenamiento auditivo para personas mayores usuarios de dispositivos de amplificación de sonido individuales (DASI): Revisión integradora de la literatura

Introdução: Os Aparelhos de Amplificação Sonora Individual (AASI) são considerados como uma ajuda externa e não solucionam todos os obstáculos de comunicação. Muitos idosos não apresentam bom aproveitamento da amplificação sonora, pois as próteses auditivas não fornecem as habilidades comunicativas ou equivalem à função natural do sistema auditivo. O Treinamento Auditivo tem como princípio desenvolver a neuroplasticidade, promovendo mudanças nas habilidades auditivas e desempenho auditivo mediante estimulação, permitindo que o idoso aprenda a vivenciar os sons de maneira significante. Objetivo: Verificar os benefícios do treinamento auditivo em idosos usuários de AASI. Metodologia: Trata-se de uma revisão integrativa. Foram pesquisados artigos nas bases de dados CAPES, SciELO e LILACS, e selecionados aqueles que atendiam aos critérios de inclusão. A questão norteadora que compôs o estudo foi a seguinte: "Quais os benefícios que o treinamento auditivo proporciona aos idosos usuários de próteses auditivas?" Resultados: A partir das combinações dos Descritores em Saúde (DeCS), obteve-se uma amostra de 318 artigos. Após o processo de análise, restaram 6 artigos para responder à questão proposta. Conclusão: O Treinamento Auditivo ocasionou melhora das habilidades de figura-fundo, integração binaural, ordenação e resolução temporal, em idosos usuários de AASI. A associação entre o uso das próteses auditivas e o treinamento auditivo, além de proporcionar audibilidade das informações acústicas, potencializa as habilidades envolvidas no processamento auditivo, independentemente da idade.

Introduction: Individual Sound Amplification Devices (ISAD) are considered an external help and do not solve all communication obstacles. Many elderly people do not present good use of the sound amplification, as hearing aids do not provide communication skills and are not equivalent to the natural function of the auditory system. The principle of Auditory Training is to develop neuroplasticity, promoting changes in auditory skills and auditory performance through stimulation, allowing the elderly to learn to experience sounds in a significant way. Objective: To verify the benefits of auditory training in elderly hearing aid users. Methodology: This is an integrative review. Articles were searched in the CAPES, SciELO and LILACS databases, and those that met the inclusion criteria were selected. The guiding question that composed the study was the following: "What are the benefits that auditory training provides to elderly users of hearing aids?" Results: From the combinations of Health Descriptors, a set of 318 articles was obtained. After the analysis process, 6 articles remained to answer the proposed question. Conclusion: Hearing Training improved figure-ground skills, binaural integration, ordering and temporal resolution in elderly hearing aid users. The association between the use of hearing aids and auditory training, in addition to providing audibility of acoustic information, enhances the skills involved in auditory processing, regardless of age.

Introducción: Los dispositivos de amplificación de sonido individuales se consideran una ayuda externa y no resuelven todos los obstáculos de comunicación. Muchas personas mayores no hacen un buen uso de la amplificación del sonido, ya que los audífonos no brindan habilidades de comunicación o son equivalentes a la función natural del sistema auditivo. El principio del Entrenamiento Auditivo es desarrollar la neuroplasticidad, promoviendo cambios en las habilidades auditivas y el desempeño auditivo a través de la estimulación, permitiendo que las personas mayores aprendan a experimentar los sonidos de manera significativa. Objetivo: Verificar los beneficios del entrenamiento auditivo en usuarios de audífonos de edad avanzada. Metodología: Esta es una revisión integradora. Se realizaron búsquedas de artículos en las bases de datos CAPES, SciELO y LILACS y se seleccionaron aquellos que cumplieron con los criterios de inclusión. La pregunta orientadora que compuso el estudio fue la siguiente: "¿Cuáles son los beneficios que brinda el entrenamiento auditivo a los usuarios mayores de audífonos?" Resultados: De las combinaciones de Descriptores de Salud (DeCS) se obtuvo una muestra de 318 artículos. Tras el proceso de análisis, quedaron 6 artículos para dar respuesta a la pregunta propuesta. Conclusión: El entrenamiento auditivo mejoró las habilidades de figura-fondo, integración binaural, ordenamiento y resolución temporal en usuarios de audífonos de edad avanzada. La asociación entre el uso de audífonos y el entrenamiento auditivo, además de proporcionar audibilidad de la información acústica, mejora las habilidades involucradas en el procesamiento auditivo, independientemente de la edad.

Hearing and communicative skills in the first years of life in children with congenital Zika syndrome / Habilidades auditivas e de comunicação nos primeiros anos de vida em crianças com síndrome congênita do Zika

Abstract Introduction Microcephaly is recognized as one of the main consequences of congenital Zika syndrome, but other serious problems such as global hypertonia, irritability, excessive crying, swallowing disorders, seizures, visual impairment and sensorineural hearing loss have been identified as associated with the syndrome. Objective Describe the developmental characteristics of hearing and language skills in the first year of life of children with normal hearing thresholds' and congenital Zika syndrome. Methods This is a cross-sectional study that evaluated hearing and language skills in the first year of life of 88 children with normal peripheral hearing and confirmed congenital Zika syndrome. All children were submitted to a behavioral auditory test and a validated questionnaire addressed to parents or caregivers, which was used as an instrument for assessing hearing and communicative skills. Results The delay in communicative skills was present in 87.5% of the children, while 44.3% of them demonstrated a delay in hearing acuity. Only the alteration of cervical motor control presented as a statistically significant association with delays in both skills (p-value = 0.006 and <.001 for hearing and communicative skills, respectively), while the presence of microcephaly and the degree of its severity were only associated with delayed development of communicative skills. Conclusion Despite a normal peripheral auditory system, children with congenital Zika syndrome may demonstrate delayed language development by having neurological damage at the center of auditory processing, requiring more specific studies to clarify language acquisition in this population.

Resumo Introdução A microcefalia é reconhecida como uma das principais consequências da síndrome congênita do Zika, mas outros problemas graves, como hipertonia global, irritabilidade, choro excessivo, distúrbios da deglutição, convulsões, deficiência visual e perda auditiva neurossensorial, foram identificados como associados à síndrome. Objetivo Descrever as características do desenvolvimento das habilidades auditivas e de linguagem no primeiro ano de vida de crianças com limiares auditivos normais e síndrome congênita do Zika. Método Estudo transversal que avaliou habilidades auditivas e de linguagem no primeiro ano de vida de 88 crianças com audição periférica normal e síndrome congênita do Zika confirmada. Todas as crianças foram submetidas a um teste auditivo comportamental e um questionário validado foi endereçado aos pais ou cuidadores e usado como instrumento para avaliar as habilidades auditivas e de comunicação. Resultados O atraso nas habilidades de comunicação estava presente em 87,5% das crianças, enquanto 44,3% delas apresentaram atraso nas habilidades auditivas. Somente a alteração do controle motor cervical apresentou associação estatisticamente significante com atrasos nas duas habilidades (valor de p = 0,006 e < 0,001 para habilidades auditivas e de comunicação, respectivamente), enquanto a presença de microcefalia e o grau de sua gravidade foram associados apenas ao atraso no desenvolvimento das habilidades de comunicação. Conclusão Apesar de um sistema auditivo periférico normal, crianças com síndrome congênita do Zika podem apresentar atraso no desenvolvimento da linguagem por apresentarem danos neurológicos no centro do processamento auditivo, exige estudos mais específicos para esclarecer a aquisição da linguagem nessa população.

Auditory evoked potentials in children and adolescents with multiple sclerosis and neuromyelitis optica spectrum disorders.

BACKGROUND: In children, an acute demyelinating disease may evolve as a multiphasic disease with multiple relapses, such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The Brainstem Auditory Evoked Potentials (BAEP) and Long-Latency Auditory Evoked Potentials (LLAEP) contribute to the identification of either retrocochlear changes or other central auditory nervous system (CANS) changes. OBJECTIVES: To characterize BAEP and LLAEP in children and adolescents with MS and NMOSD and verify the diagnostic values of these potentials in each of the demyelinating diseases. METHODS: The 40 participants were divided into two study groups (SG1 - MS, SG2 - NMOSD) and two comparison groups (CG1 and CG2), matched for age (9 years-17 years and 11 months) and sex. Electrophysiological hearing assessment was performed with BAEP and LLAEP. RESULTS: When SG1 and SG2 were compared with CG1 and CG2 regarding BAEP and LLAEP, both SG1 and SG2 presented a higher occurrence of changes. Also, individuals with MS had higher occurrences of BAEP changes, whereas individuals with NMOSD had a higher occurrence of LLAEP changes. CONCLUSIONS: BAEP and LLAEP in children and adolescents with MS or NMOSD showed higher latencies and lower amplitudes of some components when these individuals were compared with their peers. These procedures were highly accurate to identify demyelinating diseases. BAEP results were more abnormal in individuals with MS, while LLAEP was so with NMOSD. These findings indicate that the auditory evoked potentials are important instruments for the differential diagnosis of MS and NMOSD, and valuable to monitor disease evolution.

Hearing and communicative skills in the first years of life in children with congenital Zika syndrome.

INTRODUCTION: Microcephaly is recognized as one of the main consequences of congenital Zika syndrome, but other serious problems such as global hypertonia, irritability, excessive crying, swallowing disorders, seizures, visual impairment and sensorineural hearing loss have been identified as associated with the syndrome. OBJECTIVE: Describe the developmental characteristics of hearing and language skills in the first year of life of children with normal hearing thresholds' and congenital Zika syndrome. METHODS: This is a cross-sectional study that evaluated hearing and language skills in the first year of life of 88 children with normal peripheral hearing and confirmed congenital Zika syndrome. All children were submitted to a behavioral auditory test and a validated questionnaire addressed to parents or caregivers, which was used as an instrument for assessing hearing and communicative skills. RESULTS: The delay in communicative skills was present in 87.5% of the children, while 44.3% of them demonstrated a delay in hearing acuity. Only the alteration of cervical motor control presented as a statistically significant association with delays in both skills (p-value=0.006 and <0.001 for hearing and communicative skills, respectively), while the presence of microcephaly and the degree of its severity were only associated with delayed development of communicative skills. CONCLUSION: Despite a normal peripheral auditory system, children with congenital Zika syndrome may demonstrate delayed language development by having neurological damage at the center of auditory processing, requiring more specific studies to clarify language acquisition in this population.

Behavioral assessment tests for central hearing skills in individuals with sensorineural hearing loss: an integrative review / Testes para a avaliação comportamental das habilidades auditivas centrais em indivíduos com perdas auditivas neurossensorial: uma revisão integrativa

ABSTRACT Purpose: to identify the most used tests and the changed hearing skills in the central auditory processing of individuals with sensorineural hearing loss. Methods: an integrative literature review conducted between March and August 2021 in PubMed/MEDLINE, LILACS, SciELO, IBECS, and Index Psi Scientific Journals. The review included studies addressing central hearing skills with central auditory processing behavioral tests in subjects with mild to moderate sensorineural hearing loss. Two independent reviewers made the study selection, data extraction, and qualitative synthesis. The selection aimed at verifying whether the studies answered the research question. Literature Review: 39 studies were found for full-text reading; after applying the eligibility criteria, 13 studies were included in the review. Participants diagnosed with sensorineural hearing loss predominantly had hearing changes in verbal tests, in comparison with normal standards for individuals without hearing loss. Thus, the most changed skills are the ones that depend on speech sound discrimination. Conclusion: the Staggered Spondaic Word Test predominated among the most used behavioral tests, while the most researched central auditory skills were binaural integration and binaural separation.

RESUMO Objetivo: identificar os testes mais utilizados e as habilidades auditivas alteradas no processamento auditivo central, em indivíduos com perda auditiva neurossensorial. Métodos: revisão de literatura integrativa, realizada de março a agosto de 2021 nas bases de dados: PubMed/Medline, Lilacs, Scielo, IBECS e Index Psicologia Periódicos técnico-científicos. Foram incluídos estudos que realizaram a pesquisa das habilidades auditivas centrais, através do teste comportamental do processamento auditivo central, em sujeitos portadores de perda auditiva neurossensorial, de grau leve a moderado. A seleção, extração e síntese qualitativa foram realizadas por dois revisores independentes. A seleção teve como objetivo verificar se os estudos contemplavam a pergunta do estudo. Revisão da Literatura: foram encontrados 39 estudos para leitura do texto na íntegra e, ao aplicar os critérios de elegibilidade, foram incluídos 13 estudos. Observou-se que os participantes diagnosticados com perda auditiva neurossensorial apresentam predomínio de alteração auditiva em testes verbais quando comparados aos padrões de normalidade estabelecidos para indivíduos sem perda. Sendo assim, as habilidades mais alteradas são as que dependem da discriminação dos sons da fala. Conclusão: entre os testes comportamentais mais utilizados, predominou o teste SSW. Quanto as habilidades auditivas centrais mais pesquisadas foram integração binaural e separação binaural.

Association between cytogenetic alteration and the audiometric profile of individuals with Turner syndrome / Relação entre alteração citogenética e o perfil audiométrico de indivíduos com síndrome de Turner

Abstract Introduction: Turner syndrome is a frequent genetic disorder that affects female individuals and covers a large phenotypic variability. Scientific literature suggests an association between hearing loss and Turner syndrome, but it remains a controversial topic. Objective: To associate the cytogenetic alteration with the audiometric profile of individuals with Turner syndrome. Methods: Cross-sectional study, with a hospital-based, convenience sample. Patients diagnosed with Turner syndrome were included and those with difficulty understanding the audiometry and/or other associated syndromes were excluded. The participants were studied with pure tone audiometry. Results: Of the 65 patients included, 36.9% had X chromosome monosomy and 63.0% had other alterations. Regarding the audiometry, 64.6% had normal thresholds and 35.3% had hearing impairment. Of these, 30.4% had hybrid hearing loss, 26.0% alteration at 6 and/or 8 kHz, 17.3% had conductive hearing loss, 13.0% sensorineural loss and 13.0% had mixed hearing loss. We observed that the mild degree was the most frequent one. There was no statistically significant association between the cytogenetic type of Turner syndrome and the presence or absence of hearing loss, or with the type and degree of hearing loss. Conclusion: The cytogenetic alteration in Turner syndrome was not associated with the audiometric profile, which showed variability regarding the type and degree of hearing loss.

Resumo Introdução: A síndrome de Turner é uma alteração frequente e genética que acomete indivíduos do sexo feminino e abrange grande variabilidade fenotípica. A literatura científica sugere uma relação entre perda auditiva e síndrome de Turner, porém ainda é um tema controverso. Objetivo: Relacionar a alteração citogenética com o perfil audiométrico de indivíduos com síndrome de Turner. Método: Estudo transversal, com amostra de conveniência, de base hospitalar. Foram incluídas pacientes com diagnóstico de síndrome de Turner e excluídas as com dificuldade para compreender a audiometria e/ou outras síndromes associadas. As participantes foram submetidas à audiometria tonal. Resultados: Das 65 pacientes incluídas, 36,9% apresentaram monossomia do cromossomo X e 63,0%, outras alterações. Com relação à audiometria, 64,6% apresentaram limiares dentro da normalidade e 35,3% alteração auditiva. Dessas, 30,4% apresentaram perda auditiva híbrida, 26,0% alteração em 6 e/ou 8 KHz; 17,3% perda auditiva condutiva, 13,0% perda neurossensorial e 13,0% perda auditiva mista. Observamos que o grau leve foi o mais frequente. Não foi observada associação estatiscamente significativa entre o tipo citogenético da síndrome de Turner e a presença ou não perda auditiva, ou com o tipo e grau de perda auditiva. Conclusão: A alteração citogenética na síndrome de Turner não teve associação com o perfil audiométrico, o qual apresentou variabilidade quanto ao tipo e grau da perda auditiva.

Photobiomodulation Therapy in Hearing Related Aspects: an Integrative Bibliometric Study.

INTRODUCTION: In the last decades have been increasing cases of inner ear disorders and among them is included hearing loss, tinnitus, and vertigo, on that way the demand for new treatments is growing, with low-level laser therapy (LLLT) being a highly targeted treatment due to its non-invasive nature. OBJECTIVES: The present study aims to investigate the studies of low level laser (LLL) and audiology in recent years. MATERIALS AND METHODS: The quantitative bibliometric study was performed by searching scientific articles in the Web of Science - Clarivate Analytics database. The association of the words "low level laser therapy" and "hearing" was used to construct the sample. RESULTS: The most recurrent objectives analyzed the action of LLLT regarding its effectiveness, with predominantly positive results in the effectiveness of the treatment of hearing problems such as hearing loss, tinnitus and vertigo. CONCLUSIONS: LLL is a great tool for professionals who take care of human hearing, helping in the recovery of patients with hearing problems in a noninvasive or drug way, thus improving the functions in which the TBLI is applied.

Dichotic sentence identification test in Portuguese: a study in young adults / Teste de reconhecimento de sentenças dicóticas em português: estudo em adultos jovens

Abstract Introduction Among the currently-applied auditory processing tests, dichotic listening tests have been widely used, since they allow investigating the hemispheric and inter-hemispheric function and their respective skills to process the received auditory information. Objective To obtain normality reference measures with the new dichotic sentence identification test in right-handed adults with normal hearing. Methods Quantitative, observational, cross-sectional study. 72 subjects were assessed, aged 19-44 years, right-handed, with normal hearing, without hearing complaints. The dichotic sentence identification test consists of different lists of sentences, which were combined two by two and presented at the same time, using earphones in both ears, at 50 dB Sensation Level. The test was applied in four stages: training of the 3 stages, free attention, right and left directed attention, thus evaluating different auditory skills. Results In the free attention task, the average percentage of correct answers in the right ear was 93.59% and in the left ear 86.06%, with a statistically significant difference between the ears, with an advantage for the right ear. In the directed attention task, the average percentage of correct answers was 99.37% in the right ear and 98.8% in the left ear, with no statistical difference between the ears. Conclusion It is suggested, as a normality reference for the stage of free attention, 90%-100% for correct answers for the right ear and for the left ear, from 80% to 100%. When there is asymmetry between the ears, differences of up to 20% are expected, with an advantage for the right ear For the directed attention stage, the expected normality reference values ​​are 100% for the right ear and for the left ear, with no asymmetry between the ears; however, if it occurs, a difference of 10% is expected between the ears, with an advantage for the right ear.

Resumo Introdução Entre os testes de processamento auditivo aplicados atualmente, os testes de escuta dicótica têm sido amplamente usados, uma vez que permitem investigar a função hemisférica e inter-hemisférica e suas respectivas habilidades, para processar a informação auditiva recebida. Objetivo Obter medidas de referência de normalidade com o novo teste dicótico de reconhecimento de sentenças em indivíduos adultos, destros, com audição normal. Método Estudo quantitativo, observacional, de corte transversal. Foram avaliados 72 indivíduos, entre 19 e 44 anos, destros, com audição normal, sem queixa auditiva. O teste dicótico de reconhecimento de sentenças é constituído por diferentes listas de sentenças, que foram combinadas duas a duas e apresentadas ao mesmo tempo, por meio de fones auriculares em ambas as orelhas, a 50 dB nível de sensação. O teste foi aplicado em quatro etapas: treino das 3 etapas, atenção livre, atenção direcionada direita e esquerda, avaliou assim diferentes habilidades auditivas. Resultados Na tarefa de atenção livre, as porcentagens médias de acertos na orelha direita foram de 93,59% e na orelha esquerda de 86,06%, com diferença estatisticamente significante entre as orelhas, com vantagem para a orelha direita. Na tarefa de atenção direcionada, as porcentagens médias de acertos foram de 99,37% na orelha direita e de 98,8% na orelha esquerda, sem diferença estatística entre as orelhas. Conclusão Sugere-se como referência de normalidade na etapa de atenção livre, para a orelha direita, 90% e 100% de acertos e para a orelha esquerda, de 80% a 100%. Quando houver assimetria entre as orelhas, são esperadas diferenças de até 20%, com vantagem para a orelha direita. Para a etapa de atenção direcionada os valores de referência de normalidade esperados são de 100% para a orelha direita e para a orelha esquerda, sem assimetria entre as orelhas, mas se ocorrer é esperada diferença entre as orelhas de 10%, com vantagem para a orelha direita.

Dichotic sentence identification test in Portuguese: a study in young adults.

INTRODUCTION: Among the currently-applied auditory processing tests, dichotic listening tests have been widely used, since they allow investigating the hemispheric and inter-hemispheric function and their respective skills to process the received auditory information. OBJECTIVE: To obtain normality reference measures with the new dichotic sentence identification test in right-handed adults with normal hearing. METHODS: Quantitative, observational, cross-sectional study. 72 subjects were assessed, aged 19-44 years, right-handed, with normal hearing, without hearing complaints. The dichotic sentence identification test consists of different lists of sentences, which were combined two by two and presented at the same time, using earphones in both ears, at 50dB Sensation Level. The test was applied in four stages: training of the 3 stages, free attention, right and left directed attention, thus evaluating different auditory skills. RESULTS: In the free attention task, the average percentage of correct answers in the right ear was 93.59% and in the left ear 86.06%, with a statistically significant difference between the ears, with an advantage for the right ear. In the directed attention task, the average percentage of correct answers was 99.37% in the right ear and 98.8% in the left ear, with no statistical difference between the ears. CONCLUSION: It is suggested, as a normality reference for the stage of free attention, 90%-100% for correct answers for the right ear and for the left ear, from 80% to 100%. When there is asymmetry between the ears, differences of up to 20% are expected, with an advantage for the right ear For the directed attention stage, the expected normality reference values ​​are 100% for the right ear and for the left ear, with no asymmetry between the ears; however, if it occurs, a difference of 10% is expected between the ears, with an advantage for the right ear.