Evaluating the Quality of Rigid Optic Videolaryngoscopy Image Taken Through Dental Protection Cap and Its Feasibility as Additional Barrier Method Against COVID-19.

Videolaryngoscopy screening is essential to help assessing human larynx. The use of 70° optical fiber in association with image recording by analog or digital cameras is one of the methods adopted to perform this examination. Endoscopic exams can contaminate the equipment with several microorganisms. The pandemic caused by the new coronavirus reinforces the importance of developing efficient barrier methods to be adopted in videolaryngoscopy procedures. Although dental intraoral camera covers are a barrier method authorized by Brazilian health organs, it has not yet been used in videolaryngoscopy examinations. The aim of the current longitudinal, individualized, single-blind, prospective, self-controlled, and accurate study is to evaluate the quality of images generated through, and confidence level of, diagnosis based on videolaryngoscopy performed with intraoral dental camera equipped with disposable protection cap and connected to 70° rigid laryngoscope in vocally healthy individuals. Videolaryngoscopy examinations based on 70° rigid optics were performed in 13 euphonic and asymptomatic volunteers at an otorhinolaryngology specialist clinic; only 1 patient was excluded from the study. Images were taken with, and without, disposable intraoral dental camera protection cap; high-grade disinfection protocol was applied between examinations. Recorded videos were randomly distributed in a single-blind manner in order to be evaluated by four otorhinolaryngologists, who answered a questionnaire comprising three questions. Statistical analysis was used to compare groups - which were defined by the use, or not, of protection cap - based on Wilcoxon nonparametric test. Statistical significance was set at 5% with 95% confidence interval. There was no statistically significant difference in image quality between examinations performed with, and without, protection cap (P= 0.646) or in the diagnosis confidence level of examinations performed with, or without, the barrier method. The use of disposable protection cap on intraoral dental camera did not significantly change the quality of images taken through videolaryngoscopy performed with 70° rigid optics in vocally healthy patients.

Diagnostic accuracy of CO-RADS in patients with suspected Coronavirus Disease-2019: A single center experience.

INTRODUCTION: COVID-19 Reporting and Data System (CO-RADS) is a tool for standardizing the reports of patients with suspected or confirmed Sars-CoV-2 infection. We performed a study of the performance of the CO-RADS in a triage scenario of patients in Brazil. METHODS: Data from 426 Computed Tomography (CT) scans from March 2020 through December 2020 were assessed in an ambidirectional, both retrospective and prospective, for the assessment in one of the six categories of the CO-RADS. We assessed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) Youden's index, Positive and Negative Clinical Utility Index (UC + and UC- respectively) and diagnostic odds ratio (DOR). We also plotted Receiver Operating Characteristics (ROC) curve with Area Under the Curve (AUC) for CO-RADS of >4 (4 + 5). RESULTS: For CO-RADS classification > 4 (4 + 5) considered positive, the AUC obtained was of 0.89 (95% CI of 0.02), sensitivity of 78% (95% CI of 0.3), specificity of 91% (95% CI of 0.3), PPV of 0.92 (95% CI of 0.02), NPV of 0.41 (95% CI of 0.03), PLR of 0.85 (95% CI of 0.2), and NLR of 0.23 (95% CI of 0.02). CONCLUSION: CO-RADS demonstrated overall good diagnostic performance in stratifying patients with suspected Sars-CoV-2 infection, even those without confirmed laboratorial diagnosis, therefore being useful in a triage scenario with lack of resources.

Videolaryngoscopy Quality with Protective Cover of Intraoral Odontologic Camera Evaluation in Vocal Fold Coverage Lesions.

INTRODUCTION: The examination of the larynx with indirect visualization is one of a series of steps in otorhinolaryngological evaluation. In the past this exam was performed more commonly with mirrors and headlights, but for at least the last four decades physicians have resorted to assessing the laryngopharynx with both rigid and fiberoptic instruments. The rigid 70° laryngoscope is the most used in our practice, its main drawback being the time-consuming resterilization process needed between scope usages in different patients. Recently we have been using a disposable protective cover over the rigid scope to obviate instrument contamination and thus the office time delays. OBJECTIVE: To investigate the maintenance of image quality in videolaryngoscopy (VDL), with and without a protective cover of intraoral odontologic camera (PCIOC), in patients with benign lesions of the vocal fold. METHODS: Quantitative and accurate cross-sectional study of VDL images with and without PCIOC. The images were captured by videolaringoscope of digital camera chip-on-the-tip type in an otorhinolaryngological care center. We studied patients presenting with vocal fold nodules, intracordal cysts, polyps, and Reinke's edema. All judges evaluating the images were otorhinolaryngologists. The exams with and without PCIOC were presented in a randomized form. The data of professionals' answers were analyzed by means of descriptive statistics and application of variables association tests. RESULTS: Thirty professionals participated in the study. There was no statistically significant difference between the probability of success in exams performed with or without PCIOC, nor between the perception of image quality and the number of correct answers in the diagnosis. In the polyp lesion without PCIOC there was a statistically significant difference between the confidence level of the diagnosis (and the number of correct answers (P = 0.037). CONCLUSION: There is no difference between VDL diagnoses of vocal fold coverage lesions with and without PCIOC, maintaining image quality in both VDL exams.

Pure-Tone Hearing Thresholds and Brainstem Auditory Evoked Potentials in Sporadic Ataxia

Abstract Introduction Spinocerebellar ataxia (SCA) is part of a genetic and clinical heteroge- neous group of neurodegenerative diseases characterized by progressive cerebellar ataxia. Objective To describe the results of audiological and electrophysiological hearing evaluations in patients with sporadic ataxia (SA). Methods A retrospective cross-sectional study was carried out with 11 patients submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, tonal and vocal audiometry, acoustic immittance and brainstem auditory evoked potential (BAEP) tests. Results The patients presented with a prevalence of gait imbalance, of dysarthria, and of dysphagia; in the audiometric and BAEPs, four patients presented with alterations; in the acoustic immittance test, five patients presented with alterations, predominantly bilateral. Conclusion The most evident alterations in the audiological evaluation were the prevalence of the descending audiometric configuration between the frequencies of 2 and 4 kHz and the absence of the acoustic reflex between the frequencies of 3 and 4 kHz bilaterally. In the electrophysiological evaluation, the patients presented changes with a prevalence of increased I, III and V wave latencies and the interval in the interpeak I-III, I-V and III-V. In the present study, it was observed that auditory complaints did not have a significant prevalence in this type of ataxia, which does not occur in some types of autosomal recessive and dominant ataxia.

Pure-Tone Hearing Thresholds and Brainstem Auditory Evoked Potentials in Sporadic Ataxia.

Introduction Spinocerebellar ataxia (SCA) is part of a genetic and clinical heterogeneous group of neurodegenerative diseases characterized by progressive cerebellar ataxia. Objective To describe the results of audiological and electrophysiological hearing evaluations in patients with sporadic ataxia (SA). Methods A retrospective cross-sectional study was carried out with 11 patients submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, tonal and vocal audiometry, acoustic immittance and brainstem auditory evoked potential (BAEP) tests. Results The patients presented with a prevalence of gait imbalance, of dysarthria, and of dysphagia; in the audiometric and BAEPs, four patients presented with alterations; in the acoustic immittance test, five patients presented with alterations, predominantly bilateral. Conclusion The most evident alterations in the audiological evaluation were the prevalence of the descending audiometric configuration between the frequencies of 2 and 4 kHz and the absence of the acoustic reflex between the frequencies of 3 and 4 kHz bilaterally. In the electrophysiological evaluation, the patients presented changes with a prevalence of increased I, III and V wave latencies and the interval in the interpeak I-III, I-V and III-V. In the present study, it was observed that auditory complaints did not have a significant prevalence in this type of ataxia, which does not occur in some types of autosomal recessive and dominant ataxia.

The Importance of Otoneurological Evaluation in Brazilian Workers Exposed to Pesticides: A Preliminary Study

Introduction: Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective: To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods: Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males, mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results: Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions: Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders (AU)

The Importance of Otoneurological Evaluation in Brazilian Workers Exposed to Pesticides: A Preliminary Study.

Introduction Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males, mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions: Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders.

Comparing Individuals through the Speech Recognition Test Applied to Regional Live Voice and Recorded Speeches from Paraná State in Five Brazilian Counties

Abstract Introduction Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective Analyzing results of the SRI test applied to live voiceand recorded speeches from Paraná State, in different Brazilian counties. Method The sample comprised 125 individuals, 25 fromeach county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.

Comparing Individuals through the Speech Recognition Test Applied to Regional Live Voice and Recorded Speeches from Paraná State in Five Brazilian Counties.

Introduction Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective Analyzing results of the SRI test applied to live voice and recorded speeches from Paraná State, in different Brazilian counties. Method The sample comprised 125 individuals, 25 from each county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.

Pitch-Matching Accuracy and Temporal Auditory Processing

Abstract Introduction Pitch-matching refers to the ability to vocally reproduce an acoustic model in a corresponding tone to the presented sound. This ability, which is dependent on pitch perception ability, can vary among individuals, and some are not able to sing in the correct tune or discriminate differences between tones. Objective To correlate pitch-matching accuracy and auditory processing in individuals without musical training. Methods A Pitch-Matching Test (vocal reproduction of synthesized and human voice sounds) and two commercially available tests of auditory temporal processing (the Pitch Pattern Sequence Test and the Random Gap DetectionTest) were administered to all participants. A total of 62 college students of both genders, aged between 18 and 35 years old, were divided into 2 groups, according to their performances in the Pitch- Matching Test (the accurate match group and the inaccurate match group). Results In the Pitch-Matching Test, both groups achieved better results when reproducing vocalized sounds. The accurate match group achieved a significantly higher pitch pattern sequence test performance. In the Random Gap Detection Test analysis, there were no differences between the two groups. The Pearson's chi-squared test showed a direct correlation between the Pitch-Matching Test and the Pitch Pattern Sequence Test. Conclusion The findings of this study suggest the existence of a significant relationship between temporal auditory processing and pitch-matching, through which accurate pitch-matching individuals perform better in the Pitch Pattern Sequence Test. Inaccurate pitch-matching individuals may be skilled at discriminating pitch, despite their poor performance in the Pitch-Matching Test.

Otoneurological findings prevalent in hereditary ataxias.

Objective To describe and compare the vestibular findings most evident among the hereditary ataxias, as well as correlate their clinical features with the nervous structures affected in this disease. Methods Seventy-five patients were evaluated and underwent a case history, otorhinolaryngological and vestibular assessments. Results Clinically, the patients commonly had symptoms of gait disturbances (67.1%), dizziness (47.3%), dysarthria (46%) and dysphagia (36.8%). In vestibular testing, alterations were predominantly evident in caloric testing (79%), testing for saccadic dysmetria (51%) and rotational chair testing (47%). The presence of alterations occurred in 87% of these patients. A majority of the alterations were from central vestibular dysfunction (69.3%). Conclusion This underscores the importance of the contribution of topodiagnostic labyrinthine evaluations for neurodegenerative diseases as, in most cases, the initial symptoms are otoneurological; and these evaluations should also be included in the selection of procedures to be performed in clinical and therapeutic monitoring.

The importance of central auditory evaluation in Friedreich's ataxia.

Objective To assess central auditory function in Friedreich's ataxia. Methods A cross-sectional, retrospective study was carried out. Thirty patients underwent the anamnesis, otorhinolaryngology examination, pure tone audiometry, acoustic immittance measures and brainstem auditory evoked potential (BAEP) assessments. Results The observed alterations were: 43.3% in the pure tone audiometry, bilateral in 36.7%; 56.6% in the BAEP test, bilateral in 50%; and 46.6% in the acoustic immittance test. There was a significant difference (p < 0.05) in the comparison between the tests performed. Conclusion In the audiological screening, there was a prevalence of the descending audiometric configuration at the frequency of 4kHz, and absence of the acoustic reflex at the same frequency. In the BAEP test, there was a prevalence of an increase of the latencies in waves I, III and V, and in the intervals of interpeaks I-III, I-V and III-V. In 13.3% of the patients, wave V was absent, and all waves were absent in 3.3% of patients.

Pitch-Matching Accuracy and Temporal Auditory Processing.

Introduction Pitch-matching refers to the ability to vocally reproduce an acoustic model in a corresponding tone to the presented sound. This ability, which is dependent on pitch perception ability, can vary among individuals, and some are not able to sing in the correct tune or discriminate differences between tones. Objective To correlate pitch-matching accuracy and auditory processing in individuals without musical training. Methods A Pitch-Matching Test (vocal reproduction of synthesized and human voice sounds) and two commercially available tests of auditory temporal processing (the Pitch Pattern Sequence Test and the Random Gap Detection Test) were administered to all participants. A total of 62 college students of both genders, aged between 18 and 35 years old, were divided into 2 groups, according to their performances in the Pitch-Matching Test (the accurate match group and the inaccurate match group). Results In the Pitch-Matching Test, both groups achieved better results when reproducing vocalized sounds. The accurate match group achieved a significantly higher pitch pattern sequence test performance. In the Random Gap Detection Test analysis, there were no differences between the two groups. The Pearson's chi-squared test showed a direct correlation between the Pitch-Matching Test and the Pitch Pattern Sequence Test. Conclusion The findings of this study suggest the existence of a significant relationship between temporal auditory processing and pitch-matching, through which accurate pitch-matching individuals perform better in the Pitch Pattern Sequence Test. Inaccurate pitch-matching individuals may be skilled at discriminating pitch, despite their poor performance in the Pitch-Matching Test.

Effect of virtual reality in Parkinson's disease: a prospective observational study.

OBJECTIVE: To assess the effectiveness of balance exercises by means of virtual reality games in Parkinson's disease. METHODS: Sixteen patients were submitted to anamnesis, otorhinolaryngological and vestibular examinations, as well as the Dizziness Handicap Inventory, Berg Balance Scale, SF-36 questionnaire, and the SRT, applied before and after rehabilitation with virtual reality games. RESULTS: Final scoring for the Dizziness Handicap Inventory and Berg Balance Scale was better after rehabilitation. The SRT showed a significant result after rehabilitation. The SF-36 showed a significant change in the functional capacity for the Tightrope Walk and Ski Slalom virtual reality games (p < 0.05), as well as in the mental health aspect of the Ski Slalom game (p < 0.05). The Dizziness Handicap Inventory and Berg Balance Scale showed significant changes in the Ski Slalom game (p < 0.05). There was evidence of clinical improvement in patients in the final assessment after virtual rehabilitation. CONCLUSION: The Tightrope Walk and Ski Slalom virtual games were shown to be the most effective for this population.

The importance of central auditory evaluation in Friedreich's ataxia / A importância da avaliação auditiva central na ataxia de Friedreich

ABSTRACT Objective To assess central auditory function in Friedreich's ataxia. Methods A cross-sectional, retrospective study was carried out. Thirty patients underwent the anamnesis, otorhinolaryngology examination, pure tone audiometry, acoustic immittance measures and brainstem auditory evoked potential (BAEP) assessments. Results The observed alterations were: 43.3% in the pure tone audiometry, bilateral in 36.7%; 56.6% in the BAEP test, bilateral in 50%; and 46.6% in the acoustic immittance test. There was a significant difference (p < 0.05) in the comparison between the tests performed. Conclusion In the audiological screening, there was a prevalence of the descending audiometric configuration at the frequency of 4kHz, and absence of the acoustic reflex at the same frequency. In the BAEP test, there was a prevalence of an increase of the latencies in waves I, III and V, and in the intervals of interpeaks I-III, I-V and III-V. In 13.3% of the patients, wave V was absent, and all waves were absent in 3.3% of patients.

RESUMO Objetivo Avaliar a função auditiva central na ataxia de Friedreich (AFRD). Métodos Foi realizado um estudo retrospectivo de corte transversal. 30 pacientes realizaram anamnese, avaliações otorrinolaringológica, audiológica, imitanciométrica e do potencial evocado auditivo de tronco encefálico (PEATE). Resultados As alterações observadas foram: 43,3% no exame audiométrico sendo 36,7% dos casos, bilateralmente; 56,6% na avaliação do PEATE com 50% dos casos, bilateralmente e 46,6% no exame imitanciométrico. Houve diferença significativa (p < 0,05) na comparação entre os exames realizados. Conclusão No exame audiológico, ocorreu uma preponderância maior da configuração audiométrica descendente a partir da freqüência de 4kHz e ausência do reflexo acústico na mesma frequência. No exame do PEATE, houve prevalência do aumento das latências nas ondas I, III e V, e nos intervalos dos interpicos I-III, I-V e III-V. Em 13,3% dos casos, a onda V estava ausente, e em 3,3% dos casos, todas as ondas estavam ausentes.

Otoneurological findings prevalent in hereditary ataxias / Alterações otoneurológicas prevalentes nas ataxias hereditárias

ABSTRACT Objective To describe and compare the vestibular findings most evident among the hereditary ataxias, as well as correlate their clinical features with the nervous structures affected in this disease. Methods Seventy-five patients were evaluated and underwent a case history, otorhinolaryngological and vestibular assessments. Results Clinically, the patients commonly had symptoms of gait disturbances (67.1%), dizziness (47.3%), dysarthria (46%) and dysphagia (36.8%). In vestibular testing, alterations were predominantly evident in caloric testing (79%), testing for saccadic dysmetria (51%) and rotational chair testing (47%). The presence of alterations occurred in 87% of these patients. A majority of the alterations were from central vestibular dysfunction (69.3%). Conclusion This underscores the importance of the contribution of topodiagnostic labyrinthine evaluations for neurodegenerative diseases as, in most cases, the initial symptoms are otoneurological; and these evaluations should also be included in the selection of procedures to be performed in clinical and therapeutic monitoring.

RESUMO Objetivo Descrever e comparar os achados vestibulares mais evidentes entre a ataxia hereditária, bem como correlacionar seus aspectos clínicos com o estudo das estruturas nervosas afetadas nesta doença. Métodos 75 pacientes foram avaliados e submetidos aos seguintes procedimentos: anamnese, avaliação otorrinolaringológica e vestibular. Resultados Clinicamente, os pacientes apresentaram sintomas de distúrbios da marcha (67,1%), tonturas (47,3%), disartria (46%) e disfagia (36,8%). No teste vestibular, as alterações foram predominantemente evidentes no teste calórico (79%), dismetria sacádicas (51%) e no teste rotatório (47%). A presença de alterações ocorreu em 87% dos pacientes. A maioria das alterações observadas foram da disfunção vestibular central (69,3%). Conclusão O estudo ressalta a importância da contribuição da avaliação labiríntica no topodiagnóstico para doenças neurodegenerativas, uma vez que, na maioria dos casos, os sintomas iniciais são otoneurológicos, e essas avaliações também devem ser incluídas na seleção de procedimentos a serem realizados no monitoramento clínico e terapêutico.

Effect of virtual reality in Parkinson's disease: a prospective observational study / Efeito da realidade virtual na doença de Parkinson: estudo observacional prospectivo

ABSTRACT Objective: To assess the effectiveness of balance exercises by means of virtual reality games in Parkinson's disease. Methods: Sixteen patients were submitted to anamnesis, otorhinolaryngological and vestibular examinations, as well as the Dizziness Handicap Inventory, Berg Balance Scale, SF-36 questionnaire, and the SRT, applied before and after rehabilitation with virtual reality games. Results: Final scoring for the Dizziness Handicap Inventory and Berg Balance Scale was better after rehabilitation. The SRT showed a significant result after rehabilitation. The SF-36 showed a significant change in the functional capacity for the Tightrope Walk and Ski Slalom virtual reality games (p < 0.05), as well as in the mental health aspect of the Ski Slalom game (p < 0.05). The Dizziness Handicap Inventory and Berg Balance Scale showed significant changes in the Ski Slalom game (p < 0.05). There was evidence of clinical improvement in patients in the final assessment after virtual rehabilitation. Conclusion: The Tightrope Walk and Ski Slalom virtual games were shown to be the most effective for this population.

RESUMO Objetivo: Verificar a eficácia dos exercícios de equilíbrio com realidade virtual (RVi) na doença de Parkinson. Métodos: Dezesseis pacientes foram submetidos a uma anamnese, exames otorrinolaringológico e vestibular, ao Dizziness Handicap Inventory (DHI), Escala de Equilíbrio de Berg (EEB), questionário SF-36 e o Teste de Sentar e Levantar (TSL) que foram aplicados antes e após a reabilitação com RVi. Resultados: Os resultados dos escores finais do DHI e EEB foram melhores após a reabilitação. O TSL apresentou resultado significativo após a reabilitação. O SF-36 demonstrou alteração significativa da capacidade funcional para os jogos Tightrope Walk e Ski Slalom (p < 0,05) e da saúde mental para o jogo Ski Slalom (p < 0,05). O DHI e EEB apresentaram alterações significativas no jogo Ski Slalom (p < 0,05). Houve melhora clínica evidente dos pacientes após reabilitação virtual. Conclusão: Os jogos virtuais Tightrope Walk e o Ski Slalom foram os mais eficazes.

Otoneurological Abnormalities in Patients with Friedreich's Ataxia

Abstract Introduction Friedreich's ataxia is a neurodegenerative disease and progressive by nature. It has autosomal recessive inheritance and early onset inmost cases. Nystagmus and hearing loss (in some cases) make up some of the common symptoms seen in this disorder. Objective The objective of this study is to examine vestibular disorders in patientswith Friedreich ataxia. Methods We conducted a retrospective cross-sectional study. We evaluated 30 patients with ages ranging from six to 72 years (mean age of 38.6 ( 14.7). The patients underwent the following procedures: anamnesis, ENT, and vestibular evaluations. Results Clinically, the patients commonly had symptoms of incoordination of movement (66.7%), gait disturbances (56.7%), and dizziness (50%). In vestibular testing, alterations were predominantly evident under caloric testing (73.4%), gaze nystagmus testing (50.1%), rotational chair testing (36.7%), and optokinetic nystagmus testing (33.4%). The presence of alterations occurred under examination in 90% of subjects, with the majority occurring in those with central vestibular dysfunction (70% of the examinations). Conclusion The most evident neurotological symptoms were incoordination of movement, gait disturbances, and dizziness. Alterations in vestibular examinations occurred in 90% of patients, mostly in the caloric test, with a predominance of deficient central vestibular system dysfunction.