Influence of obstructive sleep apnea on auditory event-related potentials.

PURPOSE: To evaluate the influence of obstructive sleep apnea (OSA) on the P300 response of auditory event-related potentials (ERPs) and to correlate the electrophysiological findings with OSA severity. METHODS: Patients with no OSA and mild, moderate, and severe OSA according to polysomnography (PSG) with normal hearing and no comorbidities were studied. Individuals with a body mass index (BMI) ≥ 40 kg/m2, hypertension, diabetes, dyslipidemia, the use of chronic medications, and a risk of hearing loss were excluded. All patients underwent full PSG and auditory ERP measurement using the oddball paradigm with tone burst and speech stimuli. For P300 analysis (latencies and amplitudes), normal multiple linear regression models were adjusted with the groups (No OSA, Mild OSA, Moderate OSA, Severe OSA), age, BMI, and Epworth score as explanatory variables. RESULTS: We studied 54 individuals (47 males) aged 35 ± 8 years with a BMI of 28.4 ± 4.3 kg/m2. Patients were divided according to the apnea-hypopnea index (AHI) derived from PSG into no OSA (n = 14), mild (n = 16), moderate (n = 12), and severe OSA (n = 12) groups. Patients with severe OSA presented prolonged P300 latencies with tone burst stimuli compared to patients with no OSA and those with mild and moderate OSA. CONCLUSION: Severe OSA is associated with impairment of the P300 response of auditory ERPs, suggesting a decrease in the processing speed of acoustic information that may be mediated by the level of somnolence.

Development of auditory perception in preschool children.

OBJECTIVE: The aim of this study was to determine whether the auditory skills presented by five-year-old children can predict their performance in auditory processing (AP) tests at seven years old. DESIGN: Thirty-five children were evaluated for AP at two different times. At evaluation 1, the children were between 5 years 2 months and 6 years 1 month of age, and at evaluation 2, they were between 7 years 1 month and 7 years 8 months of age. The interval between the evaluations ranged from 18 to 23 months. After evaluation 2, the 7-year-olds were classified according to their performance on central AP tests. The children were divided into three groups: GI included nine children with at least two AP tests that scored two standard deviations below the mean and the presence of a speech complaint; GII included 18 children with at least two AP tests that scored two standard deviations below the mean and no speech complaints; and GIII included eight children with no more than one test scored two standard deviations below the mean and no speech disorders complaint. The analysis was performed considering each test individually and as a battery of applied tests. From the results obtained, a discriminant analysis was performed to assess the differences in test performance between the groups when the children were 5 years old. RESULTS: The discriminant analysis showed that with the results obtained during evaluation 1, it was possible to predict which group 74.3% of the children would be classified into after evaluation 2. The percentage of correct classifications for each group was 77.8% for GI, 66.7% for GII and 87.5% for GIII. That is, 87.5% of the children who were classified as GIII after evaluation 2 had already demonstrated good auditory performance in the tests applied at 5 years of age. CONCLUSIONS: Children who exhibited lower scores on AP tests at 7 years of age had demonstrated poor auditory perception at 5 years of age. This finding is relevant because it offers the possibility of stimulating or training these auditory skills in preschoolers to foster their development.

Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea / Avaliação da via auditiva periférica e do tronco encefálico na apneia obstrutiva do sono

Abstract Introduction Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature. Objective To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea. Methods The sample consisted of 38 adult males, mean age of 35.8 (±7.2), divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n = 10), mild obstructive sleep apnea (n = 11) moderate obstructive sleep apnea (n = 8) and severe obstructive sleep apnea (n = 9). All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2-factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%. Results There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p = 0.03). There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p = 0.01). Conclusion The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem Auditory Evoked Response.

Resumo Introdução A Apneia Obstrutiva do Sono provoca modificações na arquitetura normal do sono, fragmentando-o de forma crônica com hipóxias intermitentes levando, a longo prazo, a sérias consequências na saúde. Acredita-se que a ocorrência de eventos respiratórios durante o sono como apneia e hipopneia pode prejudicar a transmissão de impulsos nervosos ao longo da via auditiva que são altamente dependentes do fornecimento do oxigênio. Contudo, essa associação não se encontra bem estabelecida na literatura. Objetivo Comparar os achados da avaliação da via auditiva periférica e no tronco encefálico entre indivíduos portadores e não portadores de apneia obstrutiva do sono. Método A casuística foi composta por 38 adultos do sexo masculino, média de idade de 35,8 (±7,2); divididos em quatro grupos experimentais pareados por idade e índice da massa corpórea. Os grupos foram classificados com base na polissonografia em: controle (n = 10), apneia obstrutiva do sono leve (n = 11), apneia obstrutiva do sono moderada (n = 8) e apneia obstrutiva do sono grave (n = 9). Todos os sujeitos do estudo negaram história pregressa de risco para perda auditiva e foram submetidos à audiometria, timpanometria, pesquisa dos reflexos acústicos e Potenciais Evocados Auditivos de Tronco Encefálico. As análises estatísticas foram realizadas por meio de ANOVA 3-fatores, ANOVA 2-fatores, teste de Qui-quadrado e teste exato de Fisher. O nível de significância adotado para todos os testes foi de 5%. Resultados Não houve diferença entre os grupos para os limiares auditivos, timpanometria e parâmetros avaliados do Peate. Observou-se associação entre a presença da apneia obstrutiva do sono e alteração da latência absoluta da onda V (p = 0,03). Observou-se associação entre apneia obstrutiva do sono de grau moderado e alteração da latência da onda V (p = 0,01). Conclusão A presença de apneia obstrutiva do sono está associada à presença de alteração na condução nervosa do estímulo acústico na via auditiva em tronco encefálico. O aumento do grau de severidade da apneia obstrutiva do sono não promove piora das respostas avaliadas pela audiometria, timpanometria e Potenciais Evocados Auditivos de Tronco Encefálico.

Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea.

INTRODUCTION: Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature. OBJECTIVE: To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea. METHODS: The sample consisted of 38 adult males, mean age of 35.8 (±7.2), divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n=10), mild obstructive sleep apnea (n=11) moderate obstructive sleep apnea (n=8) and severe obstructive sleep apnea (n=9). All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2-factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%. RESULTS: There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p=0.03). There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p=0.01). CONCLUSION: The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem Auditory Evoked Response.

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.

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.

The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children.

OBJECTIVE: To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder . METHODS: Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results. RESULTS: When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder. CONCLUSIONS: The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.

The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children

OBJECTIVE: To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder . METHODS: Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results. RESULTS: When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder. CONCLUSIONS: The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.

Efferent inhibition of otoacoustic emissions in preterm neonates / Inibição eferente das emissões otoacústicas em neonatos prematuros

ABSTRACT INTRODUCTION: Abnormalities in auditory function of newborns may occur not only because of preterm birth, but also from the use of medications and from diseases related to prematurity. OBJECTIVE: To analyze the inhibitory effect from stimulation of the olivocochlear efferent system on transient evoked otoacoustic emissions in preterm neonates, comparing these data with those from full-term neonates. METHODS: This was a prospective, cross-sectional, contemporary cohort study with 125 neonates, pooled into two groups: full-term (72 full-term neonates, 36 females and 36 males, born at 37-41 weeks of gestational age); and preterm (53 neonates, 28 males and 25 females, born at ≤36 weeks of gestational age, evaluated at the corrected gestational age of 37-41 weeks). Otoacoustic emissions were recorded using linear and nonlinear click-evoked stimuli, with and without contralateral stimulation. RESULTS: The inhibitory effect of the efferent pathway in otoacoustic emissions was different (p = 0.012) between groups, and a mean reduction of 1.48 dB SPL in full-term births and of 1.02 dB SPL in preterm births was observed for the non-linear click-evoked stimulus. CONCLUSION: The results suggest a reduced inhibitory effect of the olivocochlear efferent system on otoacoustic emissions in preterm neonates.

RESUMO Introdução: Alterações na função auditiva de recém-nascidos prematuros podem ocorrer não só devido ao nascimento antecipado, mas também pelo uso de medicamentos e por doenças relacionadas à prematuridade. Objetivo: Analisar o efeito inibitório da estimulação do sistema eferente olivo coclear sobre a amplitude das emissões otoacústicas evocadas transientes em recém-nascidos prematuros, comparando esses dados aos de recém-nascidos a termo. Método: Estudo prospectivo, de coorte contemporânea com corte transversal, com 125 recémnascidos, distribuídos em dois grupos: a termo (72 recém-nascidos a termo, 36 feminino e 36 masculino, nascidos entre 37-41 semanas de idade gestacional), e pretermo (53 recém-nascidos, 28 masculino e 25 feminino, nascidos com idade gestacional ≤ 36 semanas avaliados entre 37-41 semanas de idade gestacional corrigida). As emissões otoacústicas foram registradas a partir de estímulos clique lineares e não lineares, com e sem estimulação contralateral. Resultados: O efeito inibitório da via eferente nas otoemissões foi diferente (p = 0,012) entre os grupos, sendo observada uma redução média de 1,48 dB SPL nos nascimentos a termo e 1,02 dBSPL no grupo pretermo para o estímulo clique não-linear. Conclusão: Os resultados sugerem efeito inibitório do sistema eferente olivococlear reduzido sobre as emissões otoacústicas em recém-nascidos prematuros.

Efferent inhibition of otoacoustic emissions in preterm neonates.

INTRODUCTION: Abnormalities in auditory function of newborns may occur not only because of preterm birth, but also from the use of medications and from diseases related to prematurity. OBJECTIVE: To analyze the inhibitory effect from stimulation of the olivocochlear efferent system on transient evoked otoacoustic emissions in preterm neonates, comparing these data with those from full-term neonates. METHODS: This was a prospective, cross-sectional, contemporary cohort study with 125 neonates, pooled into two groups: full-term (72 full-term neonates, 36 females and 36 males, born at 37-41 weeks of gestational age); and preterm (53 neonates, 28 males and 25 females, born at ≤36 weeks of gestational age, evaluated at the corrected gestational age of 37-41 weeks). Otoacoustic emissions were recorded using linear and nonlinear click-evoked stimuli, with and without contralateral stimulation. RESULTS: The inhibitory effect of the efferent pathway in otoacoustic emissions was different (p=0.012) between groups, and a mean reduction of 1.48dB SPL in full-term births and of 1.02dB SPL in preterm births was observed for the non-linear click-evoked stimulus. CONCLUSION: The results suggest a reduced inhibitory effect of the olivocochlear efferent system on otoacoustic emissions in preterm neonates.

Middle ear muscle reflex measurement in neonates: comparison between 1000Hz and 226Hz probe tones.

INTRODUCTION: Middle ear muscle reflex (MEMR) evaluation assists in diagnosing hearing problems because normal responses depend on preconditions of a healthy auditory system. Studies in neonates recording the acoustic reflex with 226Hz probes have described high rates of absence. Other studies using a high frequency probe have found higher rates of presence in normal neonates. However, few studies have compared results between low and high frequency probes in the same newborns. OBJECTIVE: To comparatively assess the ipsilateral acoustic reflex recorded by 226Hz and 1000Hz probes in newborns. METHOD: A total of 77 newborns, with the presence of transient otoacoustic emissions, underwent tympanometry, wideband acoustic immittance, and ipsilateral reflex investigations with 226Hz and 1000Hz tone probes. RESULTS: The acoustic reflex was activated at a much lower intensity with all activating stimuli using the 1000Hz probe compared with the values of the 226Hz probe. There was a higher incidence of ipsilateral acoustic reflexes recorded by the 1000Hz tone probe compared to the 226Hz tone probe. There was no correlation between the acoustic reflex thresholds and otoacoustic emissions. CONCLUSION: In newborns, the acoustic reflex measurements obtained with the 1000Hz probe showed advantages over the 226Hz probe.

Teleaudiometry as a screening method in school children.

OBJECTIVE: To compare the efficacy and feasibility of teleaudiometry with that of sweep audiometry in elementary school children, using pure-tone audiometry as the gold standard. METHODS: A total of 243 students with a mean age of 8.3 years participated in the study. Of these, 118 were boys, and 125 were girls. The following procedures were performed: teleaudiometry screening with software that evaluates hearing at frequencies of 1,000, 2000 and 4000 Hz at 25 dBHL; sweep audiometry screening in an acoustic booth (20 dBHL at the same frequencies); pure-tone audiometry thresholds in an acoustic booth (frequencies of 500, 1000, 2000 and 4000 Hz); and acoustic immittance measurements. RESULTS: The diagnostic capacities of the teleaudiometry/sweep audiometry screening methods were as follows: sensitivity  ϝ  58%/65%; specificity  ϝ  86%/99%; positive predictive value  ϝ  51%/91%; negative predictive value  ϝ  89%/92%; and accuracy  ϝ  81%/92%. Teleaudiometry and sweep audiometry showed moderate agreement. Furthermore, the use of these methods in series with immittance testing improved the specificity, whereas parallel testing improved the sensitivity. CONCLUSION: Teleaudiometry was found to be reliable and feasible for screening hearing in school children. Moreover, teleaudiometry is the preferred method for remote areas where specialized personnel and specific equipment are not available, and its use may reduce the costs of hearing screening programs.

Teleaudiometry as a screening method in school children

OBJECTIVE: To compare the efficacy and feasibility of teleaudiometry with that of sweep audiometry in elementary school children, using pure-tone audiometry as the gold standard. METHODS: A total of 243 students with a mean age of 8.3 years participated in the study. Of these, 118 were boys, and 125 were girls. The following procedures were performed: teleaudiometry screening with software that evaluates hearing at frequencies of 1,000, 2000 and 4000 Hz at 25 dBHL; sweep audiometry screening in an acoustic booth (20 dBHL at the same frequencies); pure-tone audiometry thresholds in an acoustic booth (frequencies of 500, 1000, 2000 and 4000 Hz); and acoustic immittance measurements. RESULTS: The diagnostic capacities of the teleaudiometry/sweep audiometry screening methods were as follows: sensitivity  ϝ  58%/65%; specificity  ϝ  86%/99%; positive predictive value  ϝ  51%/91%; negative predictive value  ϝ  89%/92%; and accuracy  ϝ  81%/92%. Teleaudiometry and sweep audiometry showed moderate agreement. Furthermore, the use of these methods in series with immittance testing improved the specificity, whereas parallel testing improved the sensitivity. CONCLUSION: Teleaudiometry was found to be reliable and feasible for screening hearing in school children. Moreover, teleaudiometry is the preferred method for remote areas where specialized personnel and specific equipment are not available, and its use may reduce the costs of hearing screening programs. .

Medidas de reflectância acústica na otosclerose: estudo de caso / Acoustic reflectance measurements in otosclerosis: case study

O objetivo deste trabalho foi analisar as medidas de reflectância em uma paciente com otosclerose. A paciente, do gênero feminino, 51 anos, apresentava queixa de hipoacusia bilateral e a hipótese diagnóstica de otosclerose. Foram realizados os seguintes testes de avaliação audiológica: imitanciometria, audiometria tonal, vocal e medidas de reflectância acústica, em ambas as orelhas. Por meio da análise dos resultados da reflectância acústica de banda larga, foi possível observar aumento na reflectância, característico de otosclerose, entre as frequências de 500 e 1500 Hz, e diferenciar a orelha esquerda e a orelha direita. As medidas de reflectância permitiram a obtenção de resultados detalhados por frequência que, em conjunto, possibilitaram a diferenciação entre as duas orelhas. O uso da reflectância de banda larga é sugerido para complementar o diagnóstico da otosclerose.

This research aimed to analyze the reflectance measurements in a patient with otosclerosis. The patient, female, 51 years old; she complained of bilateral hearing loss and had a diagnosis hypothesis of otosclerosis. The following audiological tests were performed in both ears: tympanometry, pure-tone audiometry, and speech audiometry tests and acoustic reflectance measurements. Through acoustic wideband reflectance analysis, it was possible to observe an increase in reflectance, such as is seen in otosclerotic ears, between the frequencies of 500 Hz and 1500 Hz and to differentiate the left and right ear. Acoustic reflectance measurements have the potential to yield results that allow the differentiation between the two ears; thus, the use of the wideband acoustic reflectance is suggested as a part of the otosclerosis diagnostic procedure.

Simetria das medidas timpanométricas e as respostas das emissões otoacústicas transientes em neonatos / Symmetry of tympanometric measurements and transient evoked otoacoustic emissions in neonates

OBJETIVO: verificar a ocorrência de simetria maior ou igual à 70%, entre as orelhas, comparando os resultados da timpanometria nas frequências de 226 e 1000Hz com as respostas das emissões otoacústicas em neonatos. MÉTODOS: foram avaliados 39 neonatos, em média com 60 horas de vida, sendo 20 do sexo feminino e 19 do sexo masculino. Cada recém-nascido foi submetido à avaliação timpanométrica com as sondas de 226 e 1000 Hz, e avaliação das emissões otoacústicas transientes em ambas as orelhas. Os resultados foram submetidos a testes estatísticos. RESULTADOS: na análise da amostra pode-se observar ocorrência de simetria <70% nas respostas das emissões otoacústicas em 74,4% do total de neonatos. Por outro lado, na timpanometria, houve uma maior ocorrência de simetria ≥ 70%, tanto para sonda de 226 quanto para 1000Hz (76,9% e 84,6%, respectivamente). No que diz respeito ao gênero e orelha, as diferenças encontradas em cada teste não foram significantes, embora tenha sido observada maior amplitude de respostas de emissões otoacústicas na orelha direita. CONCLUSÃO: os resultados sugerem haver simetria no sistema auditivo em sua porção mais periférica, e início de assimetrias a partir da cóclea. .

PURPOSE: to determine the occurrence of symmetry ≥ 70% between the ears, comparing the results of 226- and 1000-Hz tympanograms with otoacoustic emissions in neonates. METHODS: thirty-nine neonates (20 female and 19 male) were evaluated at an average age of 60 hours. Each newborn underwent 226- and 1000-Hz probe tone tympanometry and evaluation of the transient-evoked otoacoustic emissions in both ears. The results were subjected to statistical tests. RESULTS: occurrence of symmetry < 70% was observed in otoacoustic emissions for 74.4% of the neonates. Tympanometry produced a greater occurrence of symmetry ≥ 70% for both the 226- and 1000-Hz probe tones (76.9% and 84.6%, respectively). With regard to gender and ear, the differences in each test were not significant, although greater otoacoustic emission amplitude was observed for the right ear. CONCLUSION: the results suggest symmetry in the auditory system in its most peripheral portion, and asymmetries begin to occur from the cochlea. .

Wideband reflectance in newborns with present transient-evoked otoacoustic emissions.

PURPOSE: To characterize the normal values of acoustic energy reflectance obtained with pure-tone stimulation in neonates prior to hospital discharge. METHODS: Seventy-seven infants (37 girls and 40 boys) were evaluated by measuring acoustic reflectance using pure-tone stimuli, transient-evoked otoacoustic emissions, and tympanometric probe frequencies of 226 Hz and 1 kHz. RESULTS: At low frequencies (258-750 Hz), greater energy reflectance was observed, while at medium frequencies (1-3 kHz), greater energy absorption was observed. There was no difference between ears or between genders. CONCLUSION: Normal energy reflectance values were obtained for the studied population. The data indicate a reflectance curve with a distinct configuration for the studied age.

Temporal auditory processing and phonological awareness in reading and writing disorders: preliminary data.

PURPOSE: To verify if there is an association between temporal auditory tests and phonological awareness in individuals with reading and writing disorders. METHODS: Sixteen children were subjects of this study, aged between 7 and 12 years old, who had reading and writing disorders confirmed after specific assessment. All participants underwent phonological awareness assessment using CONFIAS test. In order to assess the auditory temporal processing, duration and frequency pattern tests were used. RESULTS: The descriptive analysis indicated low performance in syllabic and phonemic activities of phonological awareness as well as in temporal auditory tests. Fisher's test indicated association between disorders in auditory temporal processing and phonological awareness (p>0.001). It suggests that disorders in temporal processing contribute to low performance in phonological awareness tasks. CONCLUSIONS: There was association between performance in temporal auditory tests and in the phonological awareness. Data found provide reflections about including temporal auditory assessment among procedures used in the analysis of individuals with reading and writing disorders.

Processamento temporal e consciência fonológica nas alterações de leitura e escrita: dados preliminares / Temporal auditory processing and phonological awareness in reading and writing disorders: preliminary data

OBJETIVO: Verificar se há associação entre o desempenho nos testes auditivos temporais e na consciência fonológica em indivíduos com alterações de leitura e escrita. MÉTODOS: Foram sujeitos deste estudo 16 crianças, entre 7 e 12 anos, com alterações de leitura e escrita confirmada após avaliação específica. Todos os participantes foram submetidos à avaliação da consciência fonológica, utilizando-se o teste de consciência fonológica - Instrumento de Avaliação Sequencial. Para avaliar o processamento auditivo temporal foram utilizados os testes de padrão de duração e frequência, realizados em cabina audiométrica. RESULTADOS: A análise descritiva indicou desempenho alterado nas habilidades silábicas e fonêmicas da consciência fonológica, bem como nos testes temporais. O teste de Fisher indicou associação entre a presença de alteração no processamento temporal e nas tarefas de consciência fonológica (p<0,001), sugerindo que a alteração no processamento temporal contribua para pior desempenho nestas habilidades. CONCLUSÕES: Houve associação entre o desempenho em testes auditivos temporais e consciência fonológica. Os dados encontrados trazem reflexões no sentido de incluir a avaliação dos padrões temporais dentre os procedimentos utilizados na avaliação dos indivíduos com alterações de leitura e escrita.

PURPOSE: To verify if there is an association between temporal auditory tests and phonological awareness in individuals with reading and writing disorders. METHODS: Sixteen children were subjects of this study, aged between 7 and 12 years old, who had reading and writing disorders confirmed after specific assessment. All participants underwent phonological awareness assessment using CONFIAS test. In order to assess the auditory temporal processing, duration and frequency pattern tests were used. RESULTS: The descriptive analysis indicated low performance in syllabic and phonemic activities of phonological awareness as well as in temporal auditory tests. Fisher's test indicated association between disorders in auditory temporal processing and phonological awareness (p>0.001). It suggests that disorders in temporal processing contribute to low performance in phonological awareness tasks. CONCLUSIONS: There was association between performance in temporal auditory tests and in the phonological awareness. Data found provide reflections about including temporal auditory assessment among procedures used in the analysis of individuals with reading and writing disorders.

Reflectância de banda larga em recém-nascidos com presença de emissões otoacústicas evocadas por transiente / Wideband reflectance in newborns with present transient-evoked otoacoustic emissions

OBJETIVO: Caracterizar os valores normais de reflectância da energia acústica obtidos com estímulo de tom puro na população neonatal antes da alta hospitalar. MÉTODOS: Setenta e sete recém-nascidos (37 meninas e 40 meninos) foram avaliados por meio das medidas de reflectância acústica, utilizando estímulos de tom puro, emissões otoacústicas por transientes e timpanometria com sondas de frequências de 226 Hz e 1 kHz. RESULTADOS: Nas baixas frequências (258 a 750 Hz) foi observado um valor elevado de reflectância da energia, enquanto nas médias frequências (1 a 3 kHz) obteve-se uma maior absorção da energia. Não existiu diferença entre orelhas e entre gêneros. CONCLUSÃO: Foram caracterizados os valores normais de reflectância da energia para a população estudada. Tais dados revelaram uma curva de reflectância com configuração peculiar para a idade.

PURPOSE: To characterize the normal values of acoustic energy reflectance obtained with pure-tone stimulation in neonates prior to hospital discharge. METHODS: Seventy-seven infants (37 girls and 40 boys) were evaluated by measuring acoustic reflectance using pure-tone stimuli, transient-evoked otoacoustic emissions, and tympanometric probe frequencies of 226 Hz and 1 kHz. RESULTS: At low frequencies (258-750 Hz), greater energy reflectance was observed, while at medium frequencies (1-3 kHz), greater energy absorption was observed. There was no difference between ears or between genders. CONCLUSION: Normal energy reflectance values were obtained for the studied population. The data indicate a reflectance curve with a distinct configuration for the studied age.

Middle ear resonance in infants: Age effects

Introduction: The resonant frequency is the probe frequency in which susceptance is 0 due to the neutralization of the forces of mass and stiffness components that control the middle ear. This frequency can be evaluated by multifrequency tympanometry, and the normality value for adults ranges 800-1,200 Hz. Studies about resonant frequency in children are scarce. Aim: Identify the variation of the resonant frequency in infants between the first days after birth and the third month of life. Method: Prospective study. Thirty newborns were evaluated at 2 different times: at the neonatal phase up to 12 days of life, and between 72 and 84 days of life. In the first evaluation, we carried out otoacoustic emissions and identified the resonant frequency, and identified the resonant frequency again in the second evaluation. Results: In the first evaluation, we determined a mean resonance value of 250 Hz for both ears, while that in the second evaluation was 385 Hz. In both assessments, we found no significant differences between the ears. There was a significant difference between the first and second evaluation. Conclusion: The middle ear resonant frequency in infants is lower in the first days of life due to the influence of the mass component. The present study demonstrated that the resonance frequency increased in the first months of life...