Description of tinnitus and its relation to discomfort level in a group of elderly hearing aid wearers.

INTRODUCTION: Evaluating quality of life for tinnitus patients has been an interest of several specialties that have seen the negative impact that the disorder has on people. OBJECTIVE: To assess and qualify tinnitus in a group of elderly hearing aid wearers. MATERIALS AND METHODS: A descriptive cross-sectional study involving 53 elderly patients with tinnitus without remission after wearing hearing aids. All subjects were submitted to: a medical evaluation, an audiological evaluation, acuphenometry, an investigation of tinnitus annoyance level and quality of life. RESULTS: There were 20 men and 33 women. The mean age was 72.5 years. The sample was mostly characterized by having sensorineural hearing loss (84%), moderate to moderately severe (86%) and downward sloping (82%). With respect to the description of the tinnitus sound, the most common were a hissing sound (93%) of average pitch (84%). Regarding the subjects' perception of tinnitus, it was found that subjects had varying levels of annoyance: mild (25%), moderate (33%), severe (22%), most severe (20%). Men are more bothered by tinnitus than women. Most of the sample reported being satisfied or very satisfied with their quality of life. CONCLUSION: It was possible to evaluate and qualify tinnitus in the sample. Although tinnitus is a frequent audiological symptom that interferes in the life of the elderly, in the sample it did not weigh heavily in terms of quality of life.

Avazum app usability testing. / Teste de usabilidade do aplicativo Avazum.

PURPOSE: To verify the effectiveness, efficiency, and satisfaction in the usability test of the tinnitus assessment application. METHODS: This is a descriptive usability test study that assessed the satisfaction, effectiveness, and efficiency of the application. The test was carried out virtually via Google Forms. First, the participants received instructions on how to access and use Avazum, through texts and illustrative images. Afterward, the users used the application, observing its functions and usability. Next, the participants answered the usability questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences, version 21.0, to perform descriptive analysis such as frequency, percentages of data in the System Usability Questionnaire (SUS), and analysis in the Net Promoter Score (NPS). RESULTS: Thus, the overall mean SUS score was consistent with satisfactory usability, which implies that the application does not present serious usability problems. Also, the overall NPS percentage indicated very good user satisfaction, with a good percentage of promoting users. As far as effectiveness is concerned, it was found that Avazum reached its goals, besides being efficient, as it uses clear language and is comfortably used. CONCLUSION: Avazum obtained very good satisfaction from users, in addition to achieving its goals. It proved to be effective, has clear language, and is comfortably used, adducing efficiency in the multidisciplinary evaluation of tinnitus.

OBJETIVO: Verificar a efetividade, eficiência e satisfação no teste de usabilidade para o aplicativo de avaliação do zumbido. MÉTODO: Trata-se de um estudo descritivo de teste de usabilidade, no qual será avaliado satisfação, eficácia e eficiência do aplicativo. O teste foi realizado virtualmente por meio de um formulário do Google Forms. Primeiramente, os participantes receberam as instruções de acesso e uso do avazum através de textos e imagens ilustrativas. Logo após, os usuários fizeram o uso do aplicativo, observando suas funções e usabilidade. Em seguida, os participantes responderam o questionário de usabilidade. A análise estatística foi realizada no software Statistics Package for the Social Sciences (SPSS) versão 21.0 para realizar a análise descritiva como frequência, percentagens dos dados do System Usability Questionnaire (SUS), além de análise do score do Net Promoter Score (NPS). RESULTADOS: Sendo assim, a média geral do score do SUS foi condizente com score de usabilidade satisfatório, o que implica dizer que o aplicativo não apresenta graves problemas de usabilidade, além da porcentagem geral NPS indicar uma satisfação muito boa dos usuários, com bom percentual de usuários promotores. No que diz respeito sobre a efetividade, foi possível observar que o Avazum atinge os objetivos propostos, além de ser eficiente, pois apresenta uma linguagem clara e confortabilidade durante o uso. CONCLUSÃO: O Avazum obteve satisfação muito boa dos usuários, além de atingir os objetivos propostos, tornando-o efetivo, apresentou uma linguagem clara e confortabilidade durante o uso, aduzindo eficiência na avaliação multidisciplinar do zumbido.

Translation, Cultural Adaptation and Validation to Brazilian Portuguese of the Tinnitus Functional Index Questionnaire.

Introduction Tinnitus affects a large portion of the world's population. There are several questionnaires being used for the evaluation of the severity of tinnitus and its impact in quality of life; however, they do not measure treatment-related changes. So, a new self-reported questionnaire was developed, the Tinnitus Functional Index (TFI), which has been translated into several languages. Objective To perform the translation, cultural adaptation and validation of the TFI questionnaire for Brazilian Portuguese. Method This is a multicenter project divided into two stages: translation and cultural adaptation; and validation and reliability. For the validation, the Brazilian Portuguese version of the TFI was correlated with the Tinnitus Handicap Inventory (THI) domains for tinnitus and quality of life and was evaluated by the Spearman ρ test. The reliability and internal consistency were evaluated by the Cronbach α test. Result The Brazilian version of the TFI was obtained through an initial translation process, synthesis of translations, backtranslation and evaluation by a committee of experts. This version was then applied in 88 patients complaining of tinnitus from speech therapy and otorhinolaryngology outpatient clinics of the three school clinics. The Brazilian version presented high reliability, as evidenced by the Cronbach α value (α = 0.870), and strong correlation (rho = 0.760 and p = 0.000). Conclusion The high reliability found in the results demonstrates that the Brazilian Portuguese version of the TFI is a valid and reliable instrument to evaluate the severity and impact of tinnitus on quality of life and changes related to its treatment.

Auditory attention in individuals with tinnitus.

INTRODUCTION: Tinnitus is characterized by the presence of a sound in the absence of external sound stimulus. In individuals with normal audiometry, it may be associated with auditory attention difficulty, especially in those who report high tinnitus annoyance. OBJECTIVE: To investigate auditory attention ability in individuals with tinnitus complaint. METHODS: Cross-sectional analytical observational study. We evaluated 30 volunteers with normal hearing (up to 25dBHL): 15 with tinnitus (test group) and 15 with no complaints (control group), aged between 18-40 years. The volunteers answered the tinnitus handicap inventory questionnaire and a visual analogue scale. Subsequently, a basic audiological evaluation (meatoscopy, tonal and vocal audiometry, and imittanciometry) and psychoacoustic measures of tinnitus (loudness and pitch) were performed. To evaluate auditory attention, the following tests were performed: auditory cognitive evoked potential (P300), central auditory processing tests (dichotic digits test and speech-in-noise test) and sustained auditory attention ability test. RESULTS: In the tinnitus handicap inventory, individuals with tinnitus had a mean score of 37.78 (±27.05), characterized as moderate degree. In the dichotic digits test (binaural separation), a difference was observed between the groups in both ears. Moreover, there was a difference in the speech-in-noise test in both ears (RE: p=0.044; LE: p=0.019), in P300 (p=0.049) and in total sustained auditory attention ability test (p=0.032). Also, there is a negative correlation between sustained auditory attention ability test, decrease in attentiveness and binaural integration (RE: p=0.044; LE: p=0.048). CONCLUSIONS: Individuals with tinnitus had a poorer performance compared to the control group regarding auditory attention ability. Therefore, it is inferred that tinnitus is associated with poor performance in selective and sustained auditory attention in the assessed volunteers. These aspects should be considered for the management of patients with tinnitus.

Transcranial direct current stimulation improves tinnitus perception and modulates cortical electrical activity in patients with tinnitus: A randomized clinical trial.

OBJECTIVES: This study aims to determine whether transcranial direct current stimulation (tDCS): a) is effective in the treatment of tinnitus by decreasing its annoyance and severity; b) modulates the cortical electrical activity of such individuals. METHODS: A double-blind, placebo-controlled clinical trial was conducted with 24 patients with tinnitus, randomized into two groups: Group 1 (n = 12) received anodal tDCS over the left temporoparietal area (LTA) and cathodal tDCS over the right dorsolateral prefrontal cortex (DLPFC) and Group 2 (n = 12) received placebo intervention. Tinnitus perception using a visual analog scale (VAS) and the Tinnitus Handicap Inventory (THI) questionnaire, in addition to electroencephalogram (EEG) was measured with eyes opened and closed at baseline and after the intervention. For the treatment, patients were subjected to five consecutive sessions of tDCS with the anodal electrode over the LTA and cathodal electrode over the right DLPFC (7 × 5 cm, 2 mA for 20 min). tDCS was turned off after 30 s in the sham group. RESULTS: Active tDCS significantly improved tinnitus annoyance and severity. It was associated with decreased beta and theta EEG frequency bands with eyes opened and decreased alpha frequency with eyes closed. sLORETA identified changes in frequency bands in the frontal, temporoparietal, and limbic regions. Finally, there were negative correlations between baseline EEG frequency bands and tDCS-induced change in tinnitus annoyance and severity. CONCLUSIONS: These results demonstrate that tDCS modulates the EEG activity and alleviates tinnitus perception. This effect may be related to baseline EEG activity.

Scientific research about tinnitus in Brazil: An observational compilation / Pesquisas científicas sobre zumbido no Brasil: Um compilado observacional

ABSTRACT Purpose: to identify the profile of tinnitus research in Brazil and the main procedures adopted by professionals in the field in the national territory. Methods: an observational, descriptive, and cross-sectional study, in which an active search was made on digital platforms to identify researchers in Brazil who have tinnitus as a study focus. After identifying the tinnitus study groups, an online Form was sent to the researchers comprising 21 questions, so as to know the works in development. The collected responses were extracted and tabulated intoMicrosoft Excel Professional Plus2019 through the absolute and relative frequency measurements of the final sample. Results: 117 researchers were identified, of these, 21 participated in the study, being (90.5%) females, specifically from public universities (81%) in the Southeast region of Brazil (47.7%). These professionals develop clinical research (76.1%), focusing on therapies and/or treatments (38.1%), and use sound therapy (52.38%) as the main technological resource of their studies. Conclusion: the research profile is clinical, with a main focus on therapies and/or treatments for tinnitus. As for the procedures, there is a predominant application of the Visual Analogue Scale- VAS and the Tinnitus Handicap Inventory- THI as evaluation protocols and sound therapy as the main technological resource of their studies.

RESUMO Objetivo: identificar o perfil das pesquisas sobre zumbido realizadas no Brasil e os principais procedimentos adotados pelos profissionais da área em território nacional. Métodos: estudo de caráter observacional, descritivo e transversal, em que foi feita uma busca ativa em plataformas digitais para identificar pesquisadores no Brasil que têm o zumbido como foco de estudo. Após a identificação dos grupos de estudo sobre zumbido, foi enviado aos pesquisadores um formulário online composto por 21 questões, com o intuito de conhecer os trabalhos em desenvolvimento. As respostas coletadas foram extraídas e tabuladas no Microsoft Excel professional plus 2019 por meio das medidas de frequência absoluta e relativa da amostra final. Resultados: foram identificados 117 pesquisadores, destes, 21 participaram do estudo, sendo (90,5%) do sexo feminino, especificamente de universidades públicas (81%) da região Sudeste do Brasil (47,7%). Esses profissionais desenvolvem pesquisas clínicas (76,1%), com foco em terapias e/ou tratamentos (38,1%) e utilizam a terapia sonora (52,38%) como recurso tecnológico principal de seus estudos. Conclusão: o perfil das pesquisas é do tipo clínico, com foco principal em terapias e/ou tratamentos para o zumbido. Quanto aos procedimentos, há o predomínio de aplicação da Escala Visual Analógica- EVA e do Tinnitus Handicap Inventory-THI como protocolos de avaliação e a terapia sonora como recurso tecnológico principal de seus estudos.

Tinnitus evaluation: relationship between pitch matching and loudness, visual analog scale and tinnitus handicap inventory.

INTRODUCTION: Tinnitus is a subjective auditory symptom usually associated with a sound, even in the absence of external sound sources. Its diagnosis is complex, and some of the forms of measurement alone or in combination, include self-assessment questionnaires, such as the tinnitus handicap inventory, the visual analog scale and/or pitch and loudness matching. OBJECTIVE: To analyze the correlation among three tinnitus measurement methods: tinnitus handicap inventory, visual analog scale and pitch and loudness matching. METHODS: The study consisted of 148 patients complaining of chronic tinnitus. An otorhinolaryngological evaluation, anamnesis directed to tinnitus, audiometry (pure tone and speech), imitanciometry, tinnitus handicap inventory, visual analog scale, and pitch and loudness matching were performed. The study was registered in the Ethics Committee of the Institution with no. 0129/12. RESULTS: Regarding the frequency of tinnitus handicap inventory responses, a higher occurrence of the mild degree was observed. An average of 6 points was observed on the visual analog scale. The mean loudness matching in the right ear was 20dBNS, and in the left ear was 17dBNS. As for the type of stimulus, the most found was continuous pure tone. The frequency of the pitch sensation was 6000Hz in the largest number of cases. Regarding the measures of tinnitus handicap inventory and the visual analogical scale, a significant correlation was observed, and as one value increases the other also increases. Pitch and loudness matching and the visual analogical scale results are also significant. CONCLUSION: There was a significant correlation between the values measured by the tinnitus handicap inventory, visual analogical scale (annoyance) and loudness matching in the evaluation of tinnitus. The selection of any one of the three evaluative methods for tinnitus investigation provides different dimensions of the tinnitus and complements the others.

Central auditory processing and aphasia: A scoping review / Processamento auditivo central e afasia: uma revisão de escopo

ABSTRACT Purpose: to report scientific evidence on the impact of aphasia on central auditory processing and map the contribution of auditory training to aphasic individuals. Methods: a scoping review approaching national and international databases (SciELO, LILACS, PubMed, Scopus, and Cochrane Library) and the gray literature (Google Scholar and Open Grey). The inclusion criteria covered articles that addressed the interface between central auditory processing and aphasia, excluding duplicates, literature reviews, and scientific abstracts. Literature Review: the review comprised 13 articles that met the eligibility criteria for this study. Seven of the selected articles assessed central auditory processing, four used electrophysiological examinations (such as auditory brainstem response and long-latency auditory evoked potentials) to assess the auditory pathway, and only one analyzed the intervention in aphasic individuals with auditory training. Conclusion: scientific evidence points to an important change in aphasic people's central auditory processing, with impaired figure-ground, auditory closure, temporal resolution and ordering, and binaural integration. Moreover, it is relevant to assess auditory processing, given the contribution of auditory training in speech-language-hearing therapy for a better prognosis in the rehabilitation of aphasia.

RESUMO Objetivo: reportar as evidências científicas do impacto da afasia no Processamento Auditivo Central e mapear a contribuição do Treinamento Auditivo para a população afásica. Métodos: trata-se de uma revisão de escopo realizada nas bases de dados nacionais e internacionais: Scielo, Lilacs, Pubmed, Scopus, Cochrane Library e com uma busca adicional à literatura cinzenta no Google Scholar e Open Grey. Os critérios de inclusão abrangeram artigos que abordassem a interface do processamento auditivo central e afasia, excluindo-se as duplicações, artigos de revisão da literatura e resumos científicos. Revisão de Literatura: selecionaram-se 13 artigos que cumpriram os critérios de elegibilidade deste estudo. Dos artigos selecionados, sete apresentaram a avaliação do Processamento Auditivo Central, quatro apresentaram os exames eletrofisiológicos - como os exames de Potencial Evocado Auditivo de Tronco Encefálico (PEATE) e Potencial Evocado Auditivo de Longa Latência (PEALL) - para avaliação da via auditiva e apenas um estudo analisou a intervenção dos indivíduos afásicos por meio do treinamento auditivo. Conclusão: as evidências científicas apontam importante alteração no Processamento Auditivo Central dos afásicos, apresentando prejuízos nas habilidades auditivas de figura-fundo, fechamento auditivo, resolução e ordenação temporal e integração binaural. Ainda, demonstra-se como relevante a avaliação do processamento, devido à contribuição do Treinamento Auditivo nas terapias fonoaudiológicas para um melhor prognóstico na reabilitação das afasias.

Characterization of linguistic development of children affected by congenital Zika virus syndrome as compared to typically developing peers / Caracterização do desenvolvimento infantil e linguístico de crianças acometidas da Síndrome Congênita do Zika Vírus comparadas com crianças de desenvolvimento típico

ABSTRACT Purpose: to describe the development, focusing on language, of children affected by congenital Zika syndrome and compare it with that of typically developing children. Methods: a quantitative, observational, cross-sectional, case-control study. Data from the group of children with congenital Zika virus syndrome (case) were matched for sex and age with data from the group of typically developing children without comorbidities (control). The research included 20 parents/guardians of the children in the case group and 20 parents/guardians of the children in the control group, using interview as an adapted instrument. The data underwent descriptive and inferential statistical analysis, through association tests and comparison of means, with the significance level set at 5%. Results: there was a statistical difference in motor, auditory, and language development between the groups, according to the parents' perception. Conclusion: Based on the caregivers' reports, most of the case group communicated non-verbally through babbling, shouting, and eye contact, whereas the minority communicated through dialogue, understood simple orders, and performed imitative behaviors, symbolic play, and shared attention. On the other hand, the control group communicated through complex sentences constructed into narratives.

RESUMO Objetivo: descrever o desenvolvimento infantil, com enfoque na linguagem, de crianças acometidas da síndrome congênita do Zika e compará-lo com o de crianças com desenvolvimento típico. Métodos: trata-se de um estudo observacional, transversal, do tipo caso-controle, e de natureza quantitativa. Os dados do grupo de crianças com Síndrome Congênita do Zika vírus (caso) foram pareados por sexo e idade com os dados do grupo de crianças sem comorbidades e desenvolvimento típico (controle). Participaram da pesquisa, 20 responsáveis pelas crianças do grupo caso e 20 pelas crianças do grupo controle e o instrumento utilizado foi uma entrevista adaptada. Os dados foram examinados por meio de uma análise estatística descritiva e inferencial por meio de testes de associação e de comparação de médias, com nível de significância de 5%. Resultados: foi observada diferença estatística entre os grupos estudados, referente ao desenvolvimento infantil, no âmbito motor, auditivo e de linguagem, com base na percepção dos pais. Conclusão: diante das informações dos cuidadores, a comunicação da maioria do grupo caso ocorre de forma não verbal por meio de gorjeios, gritos e contato visual; e a minoria comunica-se por diálogo, compreende ordens simples, realiza condutas imitativas, brincar simbólico e tem atenção compartilhada. Diferentemente, o grupo controle comunica-se por meio de frases complexas presentes em narrativas.

Teste de usabilidade do aplicativo Avazum / Avazum app usability testing

RESUMO Objetivo Verificar a efetividade, eficiência e satisfação no teste de usabilidade para o aplicativo de avaliação do zumbido. Método Trata-se de um estudo descritivo de teste de usabilidade, no qual será avaliado satisfação, eficácia e eficiência do aplicativo. O teste foi realizado virtualmente por meio de um formulário do Google Forms. Primeiramente, os participantes receberam as instruções de acesso e uso do avazum através de textos e imagens ilustrativas. Logo após, os usuários fizeram o uso do aplicativo, observando suas funções e usabilidade. Em seguida, os participantes responderam o questionário de usabilidade. A análise estatística foi realizada no software Statistics Package for the Social Sciences (SPSS) versão 21.0 para realizar a análise descritiva como frequência, percentagens dos dados do System Usability Questionnaire (SUS), além de análise do score do Net Promoter Score (NPS). Resultados Sendo assim, a média geral do score do SUS foi condizente com score de usabilidade satisfatório, o que implica dizer que o aplicativo não apresenta graves problemas de usabilidade, além da porcentagem geral NPS indicar uma satisfação muito boa dos usuários, com bom percentual de usuários promotores. No que diz respeito sobre a efetividade, foi possível observar que o Avazum atinge os objetivos propostos, além de ser eficiente, pois apresenta uma linguagem clara e confortabilidade durante o uso. Conclusão O Avazum obteve satisfação muito boa dos usuários, além de atingir os objetivos propostos, tornando-o efetivo, apresentou uma linguagem clara e confortabilidade durante o uso, aduzindo eficiência na avaliação multidisciplinar do zumbido.

ABSTRACT Purpose To verify the effectiveness, efficiency, and satisfaction in the usability test of the tinnitus assessment application. Methods This is a descriptive usability test study that assessed the satisfaction, effectiveness, and efficiency of the application. The test was carried out virtually via Google Forms. First, the participants received instructions on how to access and use Avazum, through texts and illustrative images. Afterward, the users used the application, observing its functions and usability. Next, the participants answered the usability questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences, version 21.0, to perform descriptive analysis such as frequency, percentages of data in the System Usability Questionnaire (SUS), and analysis in the Net Promoter Score (NPS). Results Thus, the overall mean SUS score was consistent with satisfactory usability, which implies that the application does not present serious usability problems. Also, the overall NPS percentage indicated very good user satisfaction, with a good percentage of promoting users. As far as effectiveness is concerned, it was found that Avazum reached its goals, besides being efficient, as it uses clear language and is comfortably used. Conclusion Avazum obtained very good satisfaction from users, in addition to achieving its goals. It proved to be effective, has clear language, and is comfortably used, adducing efficiency in the multidisciplinary evaluation of tinnitus.

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.

Variation in the Hearing Threshold in Women during the Menstrual Cycle.

Introduction The hormonal changes that occur during the menstrual cycle and their relationship with hearing problems have been studied. However, they have not been well explained. Objective The objective of our study is to investigate the variation in hearing thresholds in women during the menstrual cycle. Method We conducted a cohort and longitudinal study. It was composed of 30 volunteers, aged 18-39 years old, of which 20 were women during the phases of the menstrual cycle and 10 were men (control group) who underwent audiometry and impedance exams, to correlate the possible audiological changes in each phase of the menstrual cycle. Results There were significant changes in hearing thresholds observed during the menstrual cycle phases in the group of women who used hormonal contraceptives and the group who did not use such contraceptives. Improved hearing thresholds were observed in the late follicular phase in the group who did not use hormonal contraceptives and the hearing thresholds at high frequencies were better. Throughout the menstrual cycle phases, the mean variation was 3.6 db HL between weeks in the group who used hormonal contraceptives and 4.09 db HL in the group who did not use them. Conclusions The present study found that there may be a relationship between hearing changes and hormonal fluctuations during the menstrual cycle based on changes in the hearing thresholds of women. In addition, this study suggests that estrogen has an otoprotective effect on hearing, since the best hearing thresholds were found when estrogen was at its maximum peak.

Characterization of patients with tinnitus seen by the Hearing Health service / Caracterização dos pacientes com zumbido atendidos por serviço de Saúde Auditiva

ABSTRACT Purpose: to establish the profile of individuals with tinnitus treated at a Hearing Health service and to associate the symptom with gender, audiological profile, and presence of vertigo. Methods: a descriptive, retrospective study with an analysis of 6,000 medical records of individuals treated at a hearing health service was carried out. The data collected from the medical records were: sociodemographic data, characteristics of hearing impairment, characteristics of tinnitus and vertigo, speech therapy interview, and otorhinolaryngological, audiological, otoneurological assessments, characteristics of life style and risk factors. An descriptive analysis was performed using the Chi-square test of association, adopting a statistical significance level of 5% (p<0.05) for the inferential analysis. Results: there was a statistically significant association between the presence of tinnitus and gender, normal hearing, and vertigo, and a significant association was also found between tinnitus and unilateral and bilateral conductive hearing loss, and unilateral and bilateral sensorineural hearing loss. Conclusion: there was a significant association, in the population evaluated, for the presence of tinnitus and female gender, normal hearing, unilateral and bilateral conductive hearing loss, unilateral and bilateral sensorineural hearing loss, and the presence of vertigo.

RESUMO Objetivo: estabelecer o perfil dos indivíduos com zumbido, atendidos em um serviço de Saúde Auditiva e associar o sintoma com gênero, perfil audiológico e presença de vertigem. Métodos: estudo descritivo, retrospectivo. Foi realizada a análise de 6.000 prontuários de indivíduos atendidos em um serviço de saúde auditiva, os dados coletados do prontuário foram: dados sociodemográficos, características da deficiência auditiva, caraterísticas do zumbido e da vertigem, entrevista fonoaudiológica, avaliações otorrinolaringológicas, audiológicas, otoneurológicas, estilo de vida e dos fatores de risco. A análise descritiva, foi realizada por meio do teste de associação Qui-quadrado, sendo adotado o nível de significância estatística de 5% (p<0,05) para a análise inferencial. Resultados: houve associação estatisticamente significante entre presença de zumbido e gênero, audição normal e vertigem e foi constatada também associação significante entre zumbido e perda auditiva condutiva unilateral e bilateral, perda auditiva sensorioneural unilateral e bilateral. Conclusão: houve associação significante, na população avaliada, para presença de zumbido e gênero feminino, audição normal, perda auditiva condutiva unilateral e bilateral, perda auditiva sensorioneural unilateral e bilateral e presença de vertigem.

Translation, Cultural Adaptation and Validation to Brazilian Portuguese of the Tinnitus Functional Index Questionnaire

Abstract Introduction Tinnitus affects a large portion of the world's population. There are several questionnaires being used for the evaluation of the severity of tinnitus and its impact in quality of life; however, they do not measure treatment-related changes. So, a new self-reported questionnaire was developed, the Tinnitus Functional Index (TFI), which has been translated into several languages. Objective To perform the translation, cultural adaptation and validation of the TFI questionnaire for Brazilian Portuguese. Method This is a multicenter project divided into two stages: translation and cultural adaptation; and validation and reliability. For the validation, the Brazilian Portuguese version of the TFI was correlated with the Tinnitus Handicap Inventory (THI) domains for tinnitus and quality of life and was evaluated by the Spearman ρ test. The reliability and internal consistency were evaluated by the Cronbach α test. Result The Brazilian version of the TFI was obtained through an initial translation process, synthesis of translations, backtranslation and evaluation by a committee of experts. This version was then applied in 88 patients complaining of tinnitus from speech therapy and otorhinolaryngology outpatient clinics of the three school clinics. The Brazilian version presented high reliability, as evidenced by the Cronbach α value (α = 0.870), and strong correlation (rho = 0.760 and p = 0.000). Conclusion The high reliability found in the results demonstrates that the Brazilian Portuguese version of the TFI is a valid and reliable instrument to evaluate the severity and impact of tinnitus on quality of life and changes related to its treatment.

Auditory and vestibular symptoms after COVID-19 infection: a preliminary Brazilian report

ABSTRACT Purpose: to present preliminary data on the influence of COVID-19 on the appearance and/or worsening of auditory and vestibular symptoms in the population of a Brazilian state. Methods: an observational, descriptive and quantitative approach of research, carried out from September 2020 to May 2021, in Paraíba, Northeastern Brazil. The research consisted of a self-report questionnaire on the manifestation of COVID-19, general post-infection symptoms, and audio-vestibular symptoms before and after COVID-19, posted on social media using the snowball technique. Results: the sample consisted of 173 people, 89% reporting symptomatic manifestations of COVID-19 with home treatment, 6.9% being asymptomatic, and 4% symptomatic with hospital treatment. A decrease in smell was reported by 126 patients, headache by 76, tinnitus by 76, and dizziness by 72, after infection by COVID-19. An increase in audio-vestibular symptoms was observed, affecting even those who did not present them before COVID. Conclusions: the preliminary results of the research point to a high occurrence and worsening of auditory and vestibular symptoms, following COVID-19.

Simplified assessment of central auditory processing in individuals presented with trisomy 21 / Avaliação simplificada do processamento auditivo central em indivíduos com a presença da trissomia 21

ABSTRACT Purpose: to analyze the performance of individuals with trisomy 21 (T21) in the simplified assessment of central auditory processing, identify the impaired skills, and compare it with the results of the hearing self-perception questionnaire administered to the parents. Methods: a descriptive, observational, quantitative study conducted at the Speech-Language-Hearing Teaching Clinic of a public university. The sample comprised 16 individuals with T21, aged 8 to 33 years. Simplified assessment tests of central auditory processing were conducted, namely, sounds localization and sequential memory for verbal and nonverbal sounds, diotically. Then, the Scale of Auditory Behaviors (SAB) was administered to the subjects' parents/guardians. The descriptive statistical analysis with the chi-square test considered p<0.05. Results: in the simplified assessment, 81.3% had abnormal results in the memory tests for verbal sounds; 75%, in the memory tests for nonverbal sounds; and 37.5%, in the sound localization test. In the Scale of Auditory Behaviors, 62.5% of the answers indicated changes in the central auditory processing, demonstrating that the scale can be useful to identify such changes. However, there was no significant association between the questionnaire and the behavioral test results. Conclusion: the results point to impaired sequential memory skills for verbal and nonverbal sounds in most individuals assessed. The simplified assessment results indicate the need for assessments of central auditory processing. Hence, the simplified assessment is highly important to detect possible changes in the central auditory processing that might interfere with the communication and overall learning of individuals presented with trisomy 21.

RESUMO Objetivo: analisar o desempenho de indivíduos com Trissomia 21 (T21) na avaliação simplificada com processamento auditivo central, identificando as habilidades alteradas, e comparar com o resultado obtido no questionário de autopercepção da audição aplicado aos pais. Métodos: estudo descritivo, observacional e de caráter quantitativo realizado na Clínica Escola de Fonoaudiologia de uma universidade pública. A amostra foi composta por 16 indivíduos com T21, com idade entre 8 e 33 anos. Foram realizados os testes da avaliação simplificada do processamento auditivo central, tais como: localização, memória sequencial verbal e não-verbal de forma diótica. Em seguida, aplicou-se o questionário de Escala de Funcionamento Auditivo (Scale Of Auditory Behaviors-SAB) aos pais/responsáveis dos indivíduos. Para análise estatística descritiva por meio do teste Qui-quadrado, considerando p<0,05. Resultados: na avaliação simplificada, 81,3% apresentaram resultados alterados para os testes de memória para sons verbais, 75% alterados para o teste de memória para sons não verbais e 37,5% com alteração para o teste de localização sonora. No questionário Escala de Funcionamento Auditivo, 62,5% das respostas indicaram alteração para o processamento auditivo central (PAC), demonstrando que a escala pode ser útil na identificação de alterações do PAC. Entretanto, não se observou associação significante entre o questionário e os resultados dos testes comportamentais. Conclusão: os resultados apontam para alteração das habilidades de memória sequencial verbal e não-verbal na maioria dos indivíduos avaliados. Por sua vez, os resultados da avaliação simplificada indicam necessidade de avaliação do PAC. Sendo assim, considera-se de grande importância a avaliação simplificada para detectar possíveis alterações do processamento auditivo central que podem interferir no aprendizado da comunicação e global dos indivíduos com a presença da trissomia 21.

Speech profile in Down syndrome: speech apraxia x speech disorder of musculoskeletal origin / Perfil de fala na síndrome de Down: apraxia de fala x transtorno de fala de origem musculoesquelética

ABSTRACT This study presents an analysis of linguistic aspects at the segmental and suprasegmental levels in individuals with Down syndrome with or without a diagnosis of speech apraxia. Ten individuals of both sexes, aged between 13 and 32 years, participated in the study. Data collection was performed, individually and separately, in a video recorded therapeutic session. Speech tasks consisted of word repetition, repetition of sentences and automatic speech. The speech samples were submitted to phonetic transcription with a description and analysis of phonoarticulatory alterations, typology of disfluencies and prosodic alterations. The data were submitted to descriptive and inferential statistical analysis, using the Mann-Whitney test for independent samples and considering p-value≤0.05 as significant. Individuals with speech apraxia (n=6), compared with those without it (n=4), presented a higher occurrence of phonoarticulatory alterations, with a statistically significant difference between the two groups in omission (p=0.018) and articulatory inaccuracy (p=0.030) alterations; a higher occurrence of disfluencies, mainly of the syllable repetition type; and the occurrence of prosodic alterations (83.3%), which was not found in the group without speech apraxia. The importance of the differential diagnosis of speech disorders in Down syndrome is revealed with an evaluation that considers the different linguistic aspects resulting from the differentiation of the characteristics of speech. Clinical intervention should be early and guided by specific parameters.

RESUMO Este estudo apresenta análise de aspectos linguísticos, em nível segmental e suprassegmental, em indivíduos com síndrome de Down, com ou sem diagnóstico de apraxia da fala. Participaram dez indivíduos, de ambos os sexos, com idade compreendida entre 13 e 32 anos. A coleta dos dados foi realizada individual e separadamente, em uma sessão terapêutica gravada. As tarefas de fala consistiram em repetição de palavras, repetição de sentenças e fala automática. As amostras de fala foram submetidas a transcrições fonéticas, com a descrição e análise das alterações fonoarticulatórias, tipologia das disfluências e alterações prosódicas. Os dados foram submetidos a análise estatística descritiva e inferencial, utilizando o teste de Mann-Whitney para amostras independentes e considerando como significativo o p-valor≤0.05. Os indivíduos com apraxia de fala (n=6), comparados aos sem (n=4), apresentaram maior ocorrência das alterações fonoarticulatórias, com diferença estatisticamente significante entre os dois grupos nas alterações do tipo omissão (p=0,018) e imprecisão articulatória (p=0,030); maior ocorrência de disfluências, principalmente do tipo repetição de sílaba, e ocorrência de alterações prosódicas (83,3%) que não foram encontradas no grupo sem apraxia de fala. Revela-se a importância do diagnóstico diferencial das alterações de fala na síndrome de Down, com avaliação que considere os distintos aspectos linguísticos, pois as características da fala são diferenciadas e a intervenção clínica deve ser precoce e orientada por parâmetros específicos.

Auditory attention in individuals with tinnitus / Auditory attention in individuals with tinnitus

Abstract Introduction Tinnitus is characterized by the presence of a sound in the absence of external sound stimulus. In individuals with normal audiometry, it may be associated with auditory attention difficulty, especially in those who report high tinnitus annoyance. Objective To investigate auditory attention ability in individuals with tinnitus complaint. Methods Cross-sectional analytical observational study. We evaluated 30 volunteers with normal hearing (up to 25 dBHL): 15 with tinnitus (test group) and 15 with no complaints (control group), aged between 18-40 years. The volunteers answered the tinnitus handicap inventory questionnaire and a visual analogue scale. Subsequently, a basic audiological evaluation (meatoscopy, tonal and vocal audiometry, and imittanciometry) and psychoacoustic measures of tinnitus (loudness and pitch) were performed. To evaluate auditory attention, the following tests were performed: auditory cognitive evoked potential (P300), central auditory processing tests (dichotic digits test and speech-in-noise test) and sustained auditory attention ability test. Results In the tinnitus handicap inventory, individuals with tinnitus had a mean score of 37.78 (±27.05), characterized as moderate degree. In the dichotic digits test (binaural separation), a difference was observed between the groups in both ears. Moreover, there was a difference in the speech-in-noise test in both ears (RE: p = 0.044; LE: p = 0.019), in P300 (p = 0.049) and in total sustained auditory attention ability test (p = 0.032). Also, there is a negative correlation between sustained auditory attention ability test, decrease in attentiveness and binaural integration (RE: p = 0.044; LE: p = 0.048). Conclusions Individuals with tinnitus had a poorer performance compared to the control group regarding auditory attention ability. Therefore, it is inferred that tinnitus is associated with poor performance in selective and sustained auditory attention in the assessed volunteers. These aspects should be considered for the management of patients with tinnitus.

Resumo Introdução O zumbido caracteriza-se pela presença de som na ausência de estímulo sonoro externo. Em indivíduos com audiometria normal pode estar associado à dificuldade na atenção auditiva, principalmente naqueles que referem alto incômodo do zumbido. Objetivo Investigar a habilidade de atenção auditiva em indivíduos com queixa de zumbido. Método Pesquisa do tipo observacional analítica de caráter transversal. Foram avaliados 30 voluntários com audição normal (até 25 dBNA): 15 com zumbido (grupo teste) e 15 sem a queixa (grupo controle), entre 18 e 40 anos. Os voluntários responderam o questionário do handicap do zumbido - Tinnitus Handicap Inventory - e a escala visual analógica. Em seguida, fez-se a avaliação audiológica básica (meatoscopia, audiometria tonal, vocal e imitanciometria) e medidas psicoacústicas do zumbido (loudness e pitch). Para avaliar a atenção auditiva, foram usados os testes: potencial evocado auditivo cognitivo (P300), processamento auditivo central (dicótico de dígitos e de fala no ruído) e o de atenção auditiva sustentada. Resultados No Tinnitus Handicap Inventory, indivíduos com zumbido apresentaram escore médio de 37,78 (± 27,05); caracterizado por grau moderado. No teste dicótico de dígitos (separação binaural) percebeu-se diferença entre os grupos, nas duas orelhas. Além disso, houve diferença no teste de fala no ruído, em ambas as orelhas (OD: p = 0,044; OE: p = 0,019), no P300 (p = 0,049) e no teste de atenção auditiva sustentada total (p = 0,032). Além de correlação negativa entre o teste de atenção auditiva sustentada, decréscimo de vigilância e integração binaural (OD: p = 0,044; OE: p = 0,048). Conclusão Os indivíduos com zumbido apresentaram desempenho inferior ao grupo controle na habilidade de atenção auditiva. Portanto, infere-se que o zumbido está associado ao baixo desempenho na atenção auditiva seletiva e sustentada nos voluntários pesquisados. Tais aspectos devem ser considerados para o manejo do paciente com zumbido.

Tinnitus evaluation: relationship between pitch matching and loudness, visual analog scale and tinnitus handicap inventory / Análise da relação entre tinnitus handicap inventory, acufenometria e escala visualanalógica na avaliação do zumbido

Abstract Introduction: Tinnitus is a subjective auditory symptom usually associated with a sound, even in the absence of external sound sources. Its diagnosis is complex, and some of the forms of measurement alone or in combination, include self-assessment questionnaires, such as the tinnitus handicap inventory, the visual analog scale and/or pitch and loudness matching. Objective: To analyze the correlation among three tinnitus measurement methods: tinnitus handicap inventory, visual analog scale and pitch and loudness matching. Methods: The study consisted of 148 patients complaining of chronic tinnitus. An otorhinolaryngological evaluation, anamnesis directed to tinnitus, audiometry (pure tone and speech), imitanciometry, tinnitus handicap inventory, visual analog scale, and pitch and loudness matching were performed. The study was registered in the Ethics Committee of the Institution with no. 0129/12. Results: Regarding the frequency of tinnitus handicap inventory responses, a higher occurrence of the mild degree was observed. An average of 6 points was observed on the visual analog scale. The mean loudness matching in the right ear was 20 dBNS, and in the left ear was 17 dBNS. As for the type of stimulus, the most found was continuous pure tone. The frequency of the pitch sensation was 6000 Hz in the largest number of cases. Regarding the measures of tinnitus handicap inventory and the visual analogical scale, a significant correlation was observed, and as one value increases the other also increases. Pitch and loudness matching and the visual analogical scale results are also significant. Conclusion: There was a significant correlation between the values measured by the tinnitus handicap inventory, visual analogical scale (annoyance) and loudness matching in the evaluation of tinnitus. The selection of any one of the three evaluative methods for tinnitus investigation provides different dimensions of the tinnitus and complements the others.

Resumo Introdução: O zumbido é um sintoma auditivo de natureza subjetivo, normalmente associado a um som, mesmo na ausência de fontes sonoras externas. Apresenta diagnóstico complexo. Uma das formas de mensuração é o uso, isolado ou em conjunto, de questionários de autoavaliação, como o Tinnitus Handicap Inventory, a escala visual analógica e o exame de acufenometria. Objetivo: Analisar a correlação entre os métodos de mensuração do zumbido: Tinnitus Handicap Inventory, escala visual analógica e acufenometria. Método: Participaram do estudo 148 pacientes com queixa de zumbido crônico. Realizou-se avaliação otorrinolaringológica, anamnese direcionada ao zumbido, audiometria (tonal e vocal), imitanciometria, Tinnitus Handicap Inventory, escala visual analógica e acufenometria. O estudo foi registrado no comitê de ética da instituição, com nº 0129/12. Resultados: Em relação à frequência das respostas do Tinnitus Handicap Inventory, foi observada maior ocorrência do grau leve. Observou-se uma média de 6 pontos na escala visual analógica. A média da sensação de intensidade medida na acufenometria na orelha direita foi de 20 dBNS e na orelha esquerda foi de 17 dBNS. Quanto ao tipo de estímulo, o mais encontrado foi o tom puro contínuo. A sensação de frequência, no maior número de casos, foi de 6.000 Hz Entre as medidas do Tinnitus Handicap Inventory e da escala visual analógica, observou-se correlação significante. À medida que um valor aumenta o outro também aumenta. Os resultados da acufenometria e da escala visual analógica também apresentam significância. Conclusão: Houve correlação significante entre os valores medidos pelo Tinnitus Handicap Inventory, escala visual analógica (incômodo) e acufenometria (loudness) na avaliação do zumbido. A escolha de um dos três métodos avaliativos para pesquisa do zumbido fornece dimensões diferentes do zumbido e se complementam.

Escala de desenvolvimento auditivo e de linguagem na criança implantada / Hearing and language development scale in cochlear implanted children

RESUMO Objetivo Caracterizar o desempenho auditivo e de linguagem oral em crianças implantadas com menos de dois anos de idade auditiva, por meio da Escala de Desenvolvimento de Audição e Linguagem (EDAL-1) e comparar os resultados aos de crianças ouvintes até 2 anos de idade. Métodos Estudo experimental de caráter descritivo. Participaram 141 crianças, divididas em dois grupos: grupo controle, com 92 normo-ouvintes, e grupo experimental, com 49 crianças surdas acompanhadas audiologicamente, durante os dois primeiros anos após a implantação. As normo-ouvintes passaram por avaliação auditiva e os pais responderam ao questionário EDAL-1. As crianças implantadas passaram por avaliação otorrinolaringológica e fonoaudiológica a cada três meses e os pais responderam ao EDAL-1. Resultados Nos dois grupos foram observadas respostas ascendentes, com melhora de acordo com o aumento da idade cronológica. Os resultados obtidos no grupo experimental foram estatisticamente piores que no grupo controle, porém, com tendência de crescimento. O EDAL-1 mostrou-se de fácil aplicação e permitiu o monitoramento do desempenho das crianças implantadas. Conclusão O desempenho auditivo e de linguagem oral em crianças surdas, usuárias de implante coclear, foi caracterizado pelo EDAL-1 e mostrou-se em crescimento, conforme o aumento do tempo de estimulação auditiva, fato também observado nas crianças ouvintes. Apesar disso, os resultados das crianças ouvintes foram melhores que os das crianças surdas implantadas.

ABSTRACT Purpose To characterize Auditory and oral language performance in children under 2 years of age with Hearing and Language Development Scale (EDAL-1) and to compare the results to those of hearing children up to two years of age. Methods This is an experimental study of descriptive nature. A total of 141 children were divided into two groups: control group with 92 normal hearing, and the experimental group with 49 deaf children followed audiologically during the first two years after implantation. Normal hearing children underwent auditory assessment and parents responded to EDAL-1. The children implanted, every three months, underwent otorhinolaryngological and speech-language evaluation, and the parents answered EDAL-1. Results In both groups we observed upward responses, with improvement as chronological and auditory age increases. Results obtained in the study group are statistically worse than in the control group, but with a tendency to grow. EDAL-1 was easy to apply and allowed to monitor the performance of the implanted children. Conclusion Oral and auditory performance in deaf children with cochlear implants was characterized by EDAL-1, and it was shown to be growing as the time of auditory stimulation increased, a fact also seen in hearing children. Despite this, the results of the hearing children were better than those of the deaf children implanted.