Converted and upgraded maps programmed in the newer speech processor for the first generation of multichannel cochlear implant.

OBJECTIVE: To identify the technological contributions of the newer version of speech processor to the first generation of multichannel cochlear implant and the satisfaction of users of the new technology. Among the new features available, we focused on the effect of the frequency allocation table, the T-SPL and C-SPL, and the preprocessing gain adjustments (adaptive dynamic range optimization). STUDY DESIGN: Prospective exploratory study. SETTING: Cochlear implant center at hospital. PATIENTS: Cochlear implant users of the Spectra processor with speech recognition in closed set. Seventeen patients were selected between the ages of 15 and 82 and deployed for more than 8 years. INTERVENTIONS: The technology update of the speech processor for the Nucleus 22. MAIN OUTCOME MEASURES: To determine Freedom's contribution, thresholds and speech perception tests were performed with the last map used with the Spectra and the maps created for Freedom. To identify the effect of the frequency allocation table, both upgraded and converted maps were programmed. One map was programmed with 25 dB T-SPL and 65 dB C-SPL and the other map with adaptive dynamic range optimization. To assess satisfaction, SADL and APHAB were used. RESULTS: All speech perception tests and all sound field thresholds were statistically better with the new speech processor; 64.7% of patients preferred maintaining the same frequency table that was suggested for the older processor. The sound field threshold was statistically significant at 500, 1,000, 1,500, and 2,000 Hz with 25 dB T-SPL/65 dB C-SPL. Regarding patient's satisfaction, there was a statistically significant improvement, only in the subscale of speech in noise abilities and phone use. CONCLUSION: The new technology improved the performance of patients with the first generation of multichannel cochlear implant.

Quais as frequências audiométricas acometidas são responsáveis pela queixa auditiva nas disacusias por ototoxicidade após o tratamento oncológico? / What are the audiometric frequencies affected are the responsible for the hearing complaint in the hearing loss for ototoxicity after the oncological treatment?

INTRODUÇÃO: A perda auditiva neurossensorial bilateral simétrica resultante do tratamento oncológico é subestimada, pois os pacientes têm a detecção auditiva preservada, relatando queixa em determinadas situações, ou a não compreensão de parte da mensagem. OBJETIVO: Investigar quais as frequências audiométricas acometidas são responsáveis pela presença de queixa auditiva. MÉTODO: Estudo prospectivo avaliando 200 pacientes com câncer na infância fora de tratamento oncológico há no mínimo 8 anos, com idade média ao diagnóstico de 6,21 anos (4,71). Foi aplicada anamnese para investigar a presença de queixa auditiva e realizada audiometria tonal limiar. Para verificar a associação entre queixa e perda auditiva, foi empregado o teste exato de Fisher, com um erro a=5%. Os pacientes foram divididos em: audição normal, perda auditiva em 8kHz, perda em 6-8kHz, perda em 4-8kHz, perda em 2-8kHz e perda em <1-8kHz. RESULTADOS: Encontramos 125 pacientes com audição normal, 10 apresentaram queixa auditiva. Entre os pacientes com perda auditiva, 16 apresentaram perda somente em 8kHz, e 1 com queixa; 22 com perda em 6-8kHz, sendo 3 com queixa; 16 com perda em 4-8kHz, destes 10 com queixa; 15 com perda 2-8kHz, sendo 14 com queixa e 6 com perda em <1-8kHz todos com queixa. Houve relação estatisticamente significante entre perda e queixa auditiva (p<0.001), quando a frequência de 4kHz foi envolvida. CONCLUSÃO: Quanto maior o número de frequências acometidas maior a ocorrência de queixa auditiva, sobretudo quando as frequências da fala estão envolvidas, sendo que o acometimento de 4kHz já determina o aparecimento das queixas.

INTRODUCTION: The neurosensory bilateral simetric hearing loss resulting of the oncological treatment is underestimated, because the patients has the hearing detection preserved, reporting complaints in determined situation, or the not comprehension of part of the message. OBJECTIVE: Investigate which are the audiometric frequencies affected are the responsible by the presence of hearing complaints. METHOD: Prospective study evaluating 200 patients with cancer in the childhood out of the oncological treatment in at least 8 years, with average age to the diagnosis of 6,21 years (4,71). Was applied anamnesis to investigate the presence of hearing complaints and performed a tonal threshold audiometry. To check the association between the complaint and the hearing loss, was applied the Exact test of Fisher, with one error a=5%, the patients were split into: normal hearing, hearing loss in 8kHz, loss in 6-8 kHz, loss in 4-8 kHz, loss in 2-8 kHz and loss in < 1-8 kHz. RESULTS: We found 125 patients with hearing loss, 10 presented hearing complaints. Between the patients with hearing loss, 16 presented loss only at 8kHz, and 1 with complaint; 22 with loss in 6-8 kHz, being 3 with complaint; 16 with loss in 4-8 kHz, from them 10 with complaint; 15 with loss 2-8 kHz, being 14 with complaint and 6 with loss in < 1-8 kHz all with complaints. There were a significant relationship between the loss and hearing complaint (p<0,001), when the frequency of 4 kHz was involved. CONCLUSION: The bigger the number of affected frequencies the bigger the occurrence of hearing complaint, most of all when the speech frequencies are involved, and the involvement of 4 kHz already determines the appearing of the complaints.