Study on gene therapy for DPOAE and ABR threshold changes in adult Otof-/- mice / 临床耳鼻咽喉头颈外科杂志

Objective:This study aims to analyze the threshold changes in distortion product otoacoustic emissions（DPOAE） and auditory brainstem response（ABR） in adult Otof-/- mice before and after gene therapy, evaluating its effectiveness and exploring methods for assessing hearing recovery post-treatment. Methods:At the age of 4 weeks, adult Otof-/- mice received an inner ear injection of a therapeutic agent containing intein-mediated recombination of the OTOF gene, delivered via dual AAV vectors through the round window membrane（RWM）. Immunofluorescence staining assessed the proportion of inner ear hair cells with restored otoferlin expression and the number of synapses.Statistical analysis was performed to compare the DPOAE and ABR thresholds before and after the treatment. Results:AAV-PHP. eB demonstrates high transduction efficiency in inner ear hair cells. The therapeutic regimen corrected hearing loss in adult Otof-/- mice without impacting auditory function in wild-type mice. The changes in DPOAE and ABR thresholds after gene therapy are significantly correlated at 16 kHz. Post-treatment,a slight increase in DPOAE was observeds,followed by a recovery trend at 2 months post-treatment. Conclusion:Gene therapy significantly restored hearing in adult Otof-/- mice, though the surgical delivery may cause transient hearing damage. Precise and gentle surgical techniques are essential to maximize gene therapy's efficacy.

A fase terminal do filho com câncer: percepções dos profissionais hospitalares / The terminal phase of children with cancer: perceptions of hospital professionals / La fase terminal del hijo con cáncer: percepciones de los profesionales del hospital

O confronto com o câncer de um filho e a percepção da sua morte como inevitável dão lugar a experiências parentais relevantes para a pesquisa científica. Este estudo teve como objetivo investigar, por meio da percepção dos profissionais hospitalares, o modo como os pais experienciam a fase terminal e fim de vida do filho com câncer para melhor compreender os processos psicoemocionais experienciados por esses pais diante da cronicidade da doença e da morte do filho. No sentido de alcançar esse objetivo, realizou-se um estudo qualitativo de tipo fenomenológico envolvendo 17 profissionais de dois hospitais portugueses de referência em oncologia pediátrica. Os dados foram recolhidos com recurso a um guia de entrevista semiestruturada. Na percepção dos profissionais hospitalares, os resultados evidenciam que esses pais experienciam múltiplas dificuldades e preocupações na fase terminal da doença do filho e no pós-morte, bem como um sofrimento extremo e desestruturação biopsicossocial e espiritual na família. O conhecimento aprofundado da fenomenologia desses processos é essencial para o desenho e a implementação de intervenções emocionais, cognitivas, comportamentais e sociais mais ajustadas às dificuldades e preocupações parentais vividas no fim de vida e pós-morte.(AU)

Coping with children's cancer and the perception of their inevitable death give rise to parental experiences that are important to study. This study aimed to investigate, based on hospital professionals' perspectives, how parents experience the terminal phase and end of life of their children suffering from cancer to better understand the psycho-emotional processes these parents experienced in face of the chronicity of the disease and their children's death. To achieve this objective, a qualitative phenomenological study was carried out involving 17 professionals of two Portuguese hospitals that are reference in pediatric oncology. Data were collected using a semi-structured interview guide. From the perspective of hospital professionals, results show that these parents experience multiple difficulties and concerns in the terminal phase of their children's disease and postmortem, as well as the extreme suffering and biopsychosocial and spiritual disruption of the family. A deeper understanding of the phenomenology of these processes is essential to design and implement better adjusted emotional, cognitive, behavioral, and social interventions aimed at the parental difficulties and concerns experienced at the end of life and after death.(AU)

El enfrentamiento del cáncer de un hijo y la percepción de su muerte como inevitable dan lugar a experiencias parentales importantes que deben ser estudiadas. Este estudio pretende identificar desde la percepción de los profesionales del hospital cómo los padres viven la fase terminal y el final de la vida de su hijo con cáncer con el fin de comprender mejor los procesos psicoemocionales que viven estos padres ante la cronicidad de la enfermedad y la muerte de su hijo. Para ello, se realizó un estudio cualitativo, con enfoque fenomenológico, en el que participaron 17 profesionales de dos hospitales portugueses de referencia en oncología pediátrica. Para recoger los datos se aplicó un guion de entrevista semiestructurada. En cuanto a la percepción de los profesionales del hospital, estos padres experimentaron múltiples dificultades y preocupaciones en la fase terminal de la enfermedad de su hijo y postmuerte, así como un sufrimiento extremo y una desestructuración biopsicosocial y espiritual en la familia. El conocimiento en profundidad de la fenomenología de estos procesos es esencial para elaborar e implementar intervenciones emocionales, cognitivas, conductuales y sociales más acordes a las dificultades y preocupaciones parentales que se experimentan al final de la vida y la postmuerte.(AU)

Efeito da infecção por COVID-19 na via auditiva até tronco encefálico / Effect of COVID-19 infection on the auditory pathway to the brainstem / Efecto de la infección por COVID-19en la vía auditiva hacia el tronco del encéfalo

Introdução: A COVID-19 pode afetar o sistema auditivo, justificando a avaliação da audição de indivíduos infectados. Objetivo: analisar a via auditiva até o tronco encefálico de indivíduos acometidos por COVID-19 comparados ao grupo controle. Método: Estudo observacional transversal analítico realizado em uma amostra não probabilística de adultos que tiveram COVID-19, que foram comparados com um grupo controle, sem queixa auditiva. A avaliação consistiu em: medidas de imitância acústica, audiometria tonal liminar (ATL), emissões otoacústicas evocadas por estímulo transiente (EOET) e potencial evocado auditivo de tronco encefálico (PEATE). Resultados: Foram avaliados 77 indivíduos, sendo, 41 participantes do grupo COVID-19 (idade média de 26,3) e 36 do grupo controle (idade média de 25,8). Os limiares auditivos estavam dentro dos padrões da normalidade para todos os indivíduos do grupo COVID-19, sendo significativamente maiores para as frequências de 1000, 2000 e 3000 Hz à direita. A amplitude das EOET foi significativamente menor na banda de frequência de 1500 à direita. Houve correlação significativa e negativa para as frequências de 1000 Hz e 3000 Hz à direita e para as frequências de 1000, 2000 e 3000 Hz à esquerda, entre EOET e ATL. Foi verificado aumento da latência absoluta da onda I, do PEATE, na orelha esquerda. Conclusão: a COVID-19 afetou locais específicos do sistema auditivo. Houve diminuição da acuidade auditiva e do funcionamento das células ciliadas externas da cóclea, bem como aumento do tempo de condução neural do som na porção distal do VII par craniano à esquerda. (AU)

Introduction: COVID-19 can affect the auditory system, justifying the evaluation of the hearing of infected individuals. Objective: to analyze the auditory pathway to the brainstem of individuals affected by COVID-19 compared to the control group. Method: Analytical cross-sectional observational study carried out in a non-probabilistic sample of adults who had COVID-19, who were compared with a control group, without hearing complaints. The evaluation consisted of: acoustic immittance measurements, pure tone audiometry (PTA), transient stimulus-evoked otoacoustic emissions (TEOAE) and brainstem auditory evoked potential (BAEP). Results: 77 individuals were evaluated, 41 participants in the COVID-19 group (average age of 26.3) and 36 in the control group (average age of 25.8). Hearing thresholds were within normal limits for all individuals in the COVID-19 group, being significantly higher for the frequencies of 1000, 2000 and 3000 Hz on the right. TEOAE amplitude was significantly lower in the 1500 frequency band on the right. There was a significant and negative correlation for the frequencies of 1000 Hz and 3000 Hz on the right and for the frequencies of 1000, 2000 and 3000 Hz on the left, between TEOAE and PTA. An increase in the absolute latency of wave I, of the BAEP, was observed in the left ear. Conclusion: COVID-19 affected specific locations in the auditory system. There was a decrease in auditory acuity and the functioning of the outer hair cells of the cochlea, as well as an increase in the neural conduction time of sound in the distal portion of the VII cranial nerve on the left. (AU)

Introducción: COVID-19 puede afectar el sistema auditivo, justificando la evaluación de la audición de individuos infectados. Objetivo: analizar la vía auditiva hacia el tronco encefálico de individuos afectados por COVID-19 en comparación con el grupo control. Método: Estudio observacional analítico transversal realizado en una muestra no probabilística de adultos que padecieron COVID-19, quienes fueron comparados con un grupo control, sin escuchar quejas. La evaluación consistió en: mediciones de inmitancia acústica, audiometría de tonos puros (ATP), otoemisiones acústicas provocadas por estímulos transitorios (OAET) y potenciales evocados auditivos del tronco encefálico (PEATE). Resultados: Se evaluaron 77 individuos, 41 participantes en el grupo COVID-19 (edad promedio de 26,3 años) y 36 en el grupo control (edad promedio de 25,8 años). Los umbrales de audición estaban dentro de los límites normales para todos los individuos del grupo de COVID-19, siendo significativamente más altos para las frecuencias de 1000, 2000 y 3000 Hz de la derecha. La amplitud de OAET fue significativamente menor en la banda de frecuencia de 1500 de la derecha. Hubo correlación significativa y negativa para las frecuencias de 1000 Hz y 3000 Hz a la derecha y para las frecuencias de 1000, 2000 y 3000 Hz a la izquierda, entre OAET y ATP. Se observó un aumento de la latencia absoluta de la onda I, del PEATE, en el oído izquierdo. Conclusión: COVID-19 afectó ubicaciones específicas del sistema auditivo. Hubo una disminución de la agudeza auditiva y del funcionamiento de las células ciliadas externas de la cóclea, así como un aumento del tiempo de conducción neural del sonido en la porción distal del VII par craneal izquierdo. (AU)

Ações socioeducativas em saúde auditiva para jovens utilizando educação híbrida / Social-educational hearing health activities based on blended learning / Actividades socioeducativas en salud auditiva basadas en la educación híbr

Introdução: O uso frequente de música amplificada pelos jovens traz a reflexão da importância de projetos de promoção de saúde auditiva, visando a conscientização dos jovens e mudança de comportamento. Objetivo: promover o aprendizado sobre o tema, avaliar o conhecimento sobre saúde auditiva e multiplicar o conhecimento adquirido junto à comunidade. Métodos: foi realizado uma ação socioeducativa em saúde auditiva com 12 alunos do sétimo ano do Ensino Fundamental II de uma Escola Publica no Sudeste do Brasil. A ação foi organizada com base em educação híbrida (encontros presenciais e uso do AIA), utilizando a metodologia do Projeto Jovem Doutor. Para a avaliação, os alunos responderam a um questionário sobre conhecimento prévio, comportamento auditivo e um questionário situação-problema. O AIA foi avaliado por meio da Ficha de Pesquisa Motivacional, foi realizada a análise do Impacto através de um questionário para os professores. Resultados: observou-se que houve mudança no comportamento dos alunos no que diz respeito ao tempo de uso e volume dos fones de ouvido, verificou-se que 100% melhoraram seu conhecimento sobre os riscos de altas intensidades sonoras para a audição. Ao avaliarmos o AIA, a análise descritiva evidenciou que os valores da média de melhor desempenho foram para as dimensões organizado e fácil de usar. Na última etapa, 802 pessoas foram envolvidas, nas atividades interativas em sala de aula e nos Espaços Culturais em saúde auditiva, criando uma cadeia produtiva em saúde. Conclusão: Por meio desta ação, foi possível atingir diretamente os jovens, promovendo o aprendizado, mudança de comportamento e melhora na qualidade de vida desses jovens. (AU)

Introduction: young people often listen to amplified music, which calls attention to the importance of projects to promote their hearing health, raise their awareness, and change their behaviors. Objective:to promote learning on the topic, assess knowledge on hearing health, and spread acquired knowledge to the community. Methods: a hearing health social-educational program was carried out with 12 seventh graders at a public school in Southeastern Brazil. The program was organized for blended learning (in-person meetings and virtual learning environment [VLE] activities), using the Young Doctor Project methodology. For the assessment, students answered a questionnaire on their previous knowledge and auditory behavior, as well as a problem-situation questionnaire. VLE was assessed with a motivational survey sheet, and the impact of the program was analyzed through a questionnaire administered to the teachers. Results: there were changes in the students' behaviors regarding the time and volume at which they used the earphones. Also, 100% of them improved their knowledge of the risks high sound levels pose to hearing. The VLE descriptive analysis indicated that the mean values of the "organized" and "easy to use" domains had the best performances. The last stage involved 802 people in the classroom interactive activities and hearing health cultural spaces, which created a health production chain.Conclusion: the program directly reached young people, promoting their learning, behavior changes, and improved quality of life. (AU)

Introducción: El uso frecuente de música amplificada por parte de los jóvenes, trae la reflexión sobre la importancia de los proyectos de promoción de la salud auditiva, orientados a la sensibilización de los jóvenes y al cambio de comportamiento. Objetivo: promover el aprendizaje sobre el tema de la salud auditiva, evaluar conocimientos y multiplicar los conocimientos adquiridos en la comunidade. Métodos: una acción socioeducativa en salud auditiva con 12 alumnos del séptimo año de la Escuela Primaria II de una escuela pública del sudeste de Brasil. La acción se organizó y basó en la educación híbrida (encuentros presenciales y uso del entorno de aprendizaje interactivo), utilizando la metodología del Proyecto Doctor Joven. Para la evaluación, los estudiantes respondieron un cuestionario sobre conocimientos previos, comportamiento auditivo y un cuestionario de situación problema. La entorno de aprendizaje interactivo se evaluó mediante el Formulario de Investigación Motivacional, el análisis de Impacto se realizó en un cuestionario para docentes. Resultados: se observó que hubo un cambio en el comportamiento de los estudiantes con respecto al tiempo de uso y volumen del audífono, se encontró que el 100% mejoró sus conocimientos sobre los riesgos de alta intensidad sonora para audiencia. Al evaluar el entorno de aprendizaje interactivo, el análisis descriptivo mostró que los valores del promedio de mejor desempeño fueron para las dimensiones organizadas y fáciles de usar. Durante la etapa final, 802 personas se involucraron en actividades interactivas en el aula y en los Espacios Culturales en salud auditiva, creando una cadena productiva en salud. Conclusión: A través de esta acción se logró llegar directamente a los jóvenes, promoviendo el aprendizaje, el cambio de comportamiento y mejorando la calidad de vida de estos jóvenes. (AU)

Noise Exposure and Stress Hormone Levels:A Review / 中国医学科学院学报

Noise is one of the most common environmental hazards to which people are exposed,and the exposure to noise can cause not only hearing but also non-hearing damage.Although noise under safety limits may not affect the auditory system,it can cause changes in stress hormone levels,which is harmful to health.However,the current studies about the impact of noise on health mainly focus on the auditory system,and little is known about the relationship between noise and stress hormone levels.Therefore,this paper reviews the studies involving noise exposure and stress hormone levels,aiming to provide ideas for strengthening the prevention and control of noise hazards.

Genetic analysis of a patient with Alport syndrome due to compound heterozygous variants of COL4A4 gene / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical phenotype and genetic characteristics of a patient with Alport syndrome.@*METHODS@#A patient with Alport syndrome who had visited the First Affiliated Hospital of Zhengzhou University in November 2020 was selected as the study subject. Clinical data of the patient were collected. High-throughput sequencing was carried out to detect potential variant of the COL4A3, COL4A4 and COL4A5 genes, and Sanger sequencing was carried out for verification of candidate variants in the family.@*RESULTS@#The main clinical manifestations of the patient included hematuria, proteinuria, and impaired hearing. Audiometric testing suggested symmetrical cochlear sensory neural hearing loss on both sides. Renal biopsy revealed mild mesangial proliferative glomerulonephritis. Genetic testing revealed that the patient has harbored compound heterozygous variants of the COL4A4 gene, namely c.940G>A (p.Gly314Ser) and c.3773G>A (p.Gly1258Asp), which were respectively inherited from her father and mother. Neither variant has been reported before, and were predicted to be pathogenic based on the guidelines from the American College of Medical Genetics and Genomics.@*CONCLUSION@#The c.940G>A (p.Gly314Ser) and c.3773G>A (p.Gly1258Asp) compound heterozygous variants of the COL4A4 gene probably underlay the Alport syndrome in this patient. Above finding has enriched the mutational spectrum of the COL4A4 gene.

Analysis of verification results of protective effects of hearing protectors in different industries / 中华劳动卫生职业病杂志

Objective: To get insight into the current practice of noise reduction effect of workers as they wore hearing protectors in different domestic enterprises and the possible affected factors. Methods: From October 2020 to April 2021, using a random sampling method, 1197 workers exposed to noise in petrochemical factories, textile factories, and parts manufacturing factories were selected as the study subjects. The noise reduction effect of hearing protectors worn by workers in daily use was tested using a hearing protector suitability testing system. The personal sound attenuation level (PAR) was compared among workers in three enterprises, Targeted intervention and repetitive testing were conducted for workers who did not meet the noise reduction effect required by the enterprise, and the changes in PAR of workers before and after the intervention were compared. The comparison of baseline PARs between two or more groups was performed using the Mann Whitney test, the comparison of baseline PARs with post intervention PARs was performed using the Wilcoxon signed rank sum test, and the comparison of qualitative data between two or more groups was performed using the Chi square test. Results: The median baseline PAR for all workers was 15 dB. Men, age<30 years old, education level at or above college level, working experience of 5 to 15 years, and those who used hearing protectors for 5 to 15 years had higher PARs, with statistically significant differences (P<0.05). The median difference in baseline PAR among workers from three enterprises was statistically significant (H=175.06, P<0.01). The median PAR of subjects who did not pass the baseline increased from 3 dB to 21 dB after intervention (Z=-27.92, P<0.01) . Conclusion: Some workers wearing hearing protectors do not meet the required PAR, and low PARs may be related to incorrect wearing methods and incorrect selection of hearing protectors. As a tool for testing, training, and assisting in selection, the hearing protector suitability testing system is of great significance for worker hearing protection.

Preliminary application of combined auditory monitoring technique in resection of vestibular neurinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the value of electrically evoked auditory brainstem response (EABR) monitoring combined with brainstem auditory evoked potential (BAEP) and compound action potential (CAP) monitoring during vestibular schwannoma resection for the protection of the cochlear nerve. Methods: Clinical data from 12 patients with vestibular schwannomas who had useful hearing prior to surgery were analyzed at the PLA General Hospital from January to December 2021. Among them, there were 7 males and 5 females, ranging in age from 25 to 59 years. Before surgery, patients underwent audiology assessments (including pure tone audiometry, speech recognition rate, etc.), facial nerve function evaluation, and cranial MRI. They then underwent vestibular schwannoma resection via the retrosigmoid approach. EABR, BAEP, and CAP were simultaneously monitored during surgery, and patients' hearing preservation was observed and analyzed after surgery. Results: Prior to surgery, the average PTA threshold of the 12 patients ranged from11 to 49 dBHL, with a SDS of 80% to 100%. Six patients had grade A hearing, and six patients had grade B hearing. All 12 patients had House-Brackman grade I facial nerve function prior to surgery. The MRI indicated tumor diameters between 1.1 and 2.4 cm. Complete removal was achieved in 10/12 patients, while near-total removal was achieved in 2/12 patients. There were no serious complications at the one-month follow-up after surgery. At the three-month follow-up, all 12 patients had House-Brackman grade I or II facial nerve function. Under EABR with CAP and BAEP monitoring, successful preservation of the cochlear nerve was achieved in six of ten patients (2 with grade B hearing, 3 with grade C hearing, and 1 with grade D hearing). Successful preservation of the cochlear nerve was not achieved in another four patients (all with grade D hearing). In two patients, EABR monitoring was unsuccessful due to interference signals; however, Grade C or higher hearing was successfully preserved under BAEP and CAP monitoring. Conclusion: The application of EABR monitoring combined with BAEP and CAP monitoring during vestibular schwannoma resection can help improve postoperative preservation of the cochlear nerve and hearing.

Comparative study of surgical effects on patients with mixed deafness and otosclerosis with different air bone conduction differences / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the surgical efficacy of patients with mixed hearing loss and otosclerosis with different air bone gap (ABG) before surgery, and to provide reference for the prognosis evaluation of otosclerosis surgery. Methods: The clinical data of 108 cases(116 ears) of otosclerosis who had undergone stapes fenestration technique artificial stapes implantation in Xiangya Hospital of Central South University from November 2013 to May 2020 and had mixed hearing loss before surgery were collected, including 71 women(76 ears)and 37 men (40 ears), with an average age of 38.5 years. According to preoperative pure tone audiometry ABG, they were divided into three groups: group S, 15 dB≤ABG<31 dB, a total of 39 ears; group M, 31 dB≤ABG<46 dB, a total of 58 ears; and group L, ABG≥46 dB, 19 ears in total. The hearing outcomes of three groups of patients at 6-12 months after surgery were compared and analyzed using SPSS 24.0 statistical software. Results: A total of 3 patients (group S: 2 cases; group L: 1 case) experienced severe sensorineural hearing loss after surgery and were not included in the statistical analysis. After surgery, the pure tone hearing threshold of patients with otosclerosis in each group was significantly improved compared to before surgery, with an average air conduction threshold improvement of(21.6±13.4) dB. The difference between before and after surgery was statistically significant(t=17.13, P<0.01). The average bone conduction threshold improved by(3.7±7.6) dB, and the difference was statistically significant before and after surgery(t=5.20, P<0.01). The postoperative ABG was(18.3±9.3) dB, which was significantly reduced compared to preoperative(36.2±8.6)dB. Among the three groups of patients, the L group had the highest improvement in air conduction threshold[(29.9±10.8)dB], while the S group had the lowest improvement[(15.7±11.4)dB]. There was no statistically significant difference in post operative pure tone hearing thresholds between the three groups(P>0.05). The postoperative ABG in group S was the smallest[(16.5±9.0)dB], while in group L, the postoperative ABG was the largest[(20.5±10.0)dB]. Compared with group S, group M and group L still had a large residual ABG at 2 000 Hz after surgery. The bone conduction threshold of both S and M groups improved to some extent after surgery compared to before (P<0.01). Conclusions: Surgery can benefit patients with mixed hearing loss and otosclerosis with different preoperative ABG. Patients with small preoperative ABG have better surgical results and ideal ABG closure at all frequencies after surgery. Patients with large preoperative ABG can significantly increase the gas conduction threshold during surgery, but certain frequencies of ABG may still be left behind after surgery. The improvement effect of surgery on bone conduction threshold is not significant. Patients should be informed of treatment methods such as hearing aids based on their actual situation for selection.

Results of combined newborn hearing and deafness gene screening in Yuncheng area of Shanxi Province / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical significance of combined newborn hearing and deafness gene screening in Yuncheng area of Shanxi Province.@*METHODS@#Results of audiological examinations, including transient evoked otoacoustic emission and automatic discriminative auditory brainstem evoked potentials, for 6 723 newborns born in Yuncheng area from January 1, 2021 to December 31, 2021, were retrospectively analyzed. Those who failed one of the tests were considered to have failed the examination. A deafness-related gene testing kit was used to detect 15 hot spot variants of common deafness-associated genes in China including GJB2, SLC26A4, GJB3, and mtDNA12S rRNA. Neonates who had passed the audiological examinations and those who had not were compared using a chi-square test.@*RESULTS@#Among the 6 723 neonates, 363 (5.40%) were found to carry variants. These have included 166 cases (2.47%) with GJB2 gene variants, 136 cases (2.03%) with SLC26A4 gene variants, 26 cases (0.39%) with mitochondrial 12S rRNA gene variants, and 33 cases (0.49%) with GJB3 gene variants. Among the 6 723 neonates, 267 had failed initial hearing screening, among which 244 had accepted a re-examination, for which 14 cases (5.73%) had failed again. This has yielded an approximate prevalence of hearing disorder of 0.21% (14/6 723). Among 230 newborns who had passed the re-examination, 10 (4.34%) were found to have carried a variant. By contrast, 4 out of the 14 neonates (28.57%) who had failed the re-examination had carried a variant, and there was a significant difference between the two groups (P < 0.05).@*CONCLUSION@#Genetic screening can provide an effective supplement to newborn hearing screening, and the combined screening can provide a best model for the prevention of hearing loss, which can enable early detection of deafness risks, targeted prevention measures, and genetic counseling to provide accurate prognosis for the newborns.

Categorias auditivas e de linguagem em crianças usuárias de Implante / CoclearAuditory and language categories in children with cochlear implant / Categorías auditivas y de lenguaje en niños con implantes cocleares

Introdução: O implante coclear beneficia o indivíduo com perda auditiva tanto no desenvolvimento da linguagem, quanto no aprimoramento da percepção dos sons da fala. A cirurgia do implante coclear bem-sucedida, somada à estimulação adequada e ao monitoramento correto, proporcionam um melhor desenvolvimento das habilidades auditivas e de linguagem das crianças. Nesse sentido, além de controlar as variáveis de idade na cirurgia e acesso à terapia fonoaudiológica para o desenvolvimento das habilidades auditivas e de linguagem, conhecer as famílias e de que maneira ela influencia no desempenho das crianças é extremamente válido, pois pode melhorar o acolhimento e direcionar melhor o aconselhamento. Objetivo: verificar a relação entre as categorias de audição e de linguagem considerando a idade na cirurgia e a relação entre as categorias de audição, linguagem e de envolvimento familiar em crianças usuárias de implante coclear. Método: A amostra estudada foi composta por 15 crianças com idade entre 2,2 e 8,3 anos. Foram utilizados questionários que mensuravam a percepção auditiva, a percepção de fala e o uso da linguagem pelas crianças. Foi aplicada também a escala de avaliação do envolvimento familiar para o auxílio na categorização das crianças a partir da audição e da linguagem. Resultados: Houve relação significante entre categorias de audição e envolvimento familiar e audição e linguagem. Não houve relação entre a idade da criança na cirurgia e as categorias de audição e de linguagem. Também não houve relação entre o envolvimento familiar e linguagem. Conclusão: A idade da criança na implantação do dispositivo não se relacionou com a classificação das categorias de audição e de linguagem. As crianças de famílias mais participativas apresentaram melhores índices de desenvolvimento auditivo.

Introduction: Cochlear implant benefits the individual with hearing loss both in language development and in improving the perception of speech sounds. Successful cochlear implant surgery, coupled with adequate stimulation and correct monitoring, provide a better development of children's hearing and language skills. In this sense, in addition to controlling the variables of age at surgery and access to speech therapy for the development of auditory and language skills, knowing the families and how it influences the children's performance is extremely valid, as it can improve the reception and better target counseling. Objective: To verify the relationship between the categories of hearing and language considering the age at surgery and the relationship between the categories of hearing, language and family involvement in children with cochlear implants. Method: The studied sample consisted of 15 children aged between 2.2 and 8.3 years. Questionnaires were used that measured auditory perception, speech perception and language use by children. The family involvement assessment scale was also applied to help categorize children based on hearing and language. Results: There was a significant relationship between hearing and family involvement and hearing and language categories. There was no relationship between the child's age at surgery and the hearing and language categories. There was also no relationship between family involvement and language. Conclusion: The child's age at device implantation was not related to the classification of hearing and language categories. Children from more participatory families presented better rates of auditory development.

Introducción: El implante coclear beneficia al individuo con pérdida auditiva tanto en el desarrollo del lenguaje como en la mejora de la percepción de los sonidos del habla. La cirugía exitosa de implante coclear, aunada a una estimulación adecuada y un correcto monitoreo, brindan un mejor desarrollo de las habilidades auditivas y del lenguaje de los niños. En este sentido, además de controlar las variables edad de la cirugía y acceso a logopedia para el desarrollo de las habilidades auditivas y del lenguaje, conocer a las familias y cómo influye en el desempeño de los niños es de gran validez, ya que puede mejorar la recepción y mejor asesoramiento de destino. Objetivo: Verificar la relación entre las categorías de audición y lenguaje considerando la edad en la cirugía y la relación entre las categorías de audición, lenguaje y envolvimiento familiar en niños con implante coclear. Método: La muestra estudiada estuvo constituida por 15 niños con edades comprendidas entre 2,2 y 8,3 años. Se utilizaron cuestionarios que midieron la percepción auditiva, la percepción del habla y el uso del lenguaje por parte de los niños. También se aplicó la escala de evaluación de la participación familiar para ayudar a categorizar a los niños en función de la audición y el lenguaje. Resultados: Hubo una relación significativa entre las categorías de audición y participación familiar y audición y lenguaje. No hubo relación entre la edad del niño en el momento de la cirugía y las categorías de audición y lenguaje. Tampoco hubo relación entre la participación familiar y el lenguaje. Conclusión: La edad del niño en el momento de la implantación del dispositivo no se relacionó con la clasificación de las categorías de audición y lenguaje. Los niños de familias más participativas presentaron mejores índices de desarrollo auditivo.

Aspectos audiológicos e cognitivos em adultos com Diabetes Mellitus tipo 2 / Auditory and cognitive aspects in adults with type 2 Diabetes Mellitus / Aspectos auditivos y cognitivos en adultos con Diabetes Mellitus tipo 2

Introdução: A Diabetes Mellitus (DM) é um distúrbio metabólico causado pela ausência ou diminuição da secreção de insulina ou por alterações do funcionamento deste hormônio no organismo, podendo envolver alterações físicas e cognitivas. Objetivo: Analisar os aspectos audiológicos e cognitivos de adultos com Diabetes Mellitus tipo 2. Método: Estudo transversal realizado em pessoas com idade entre 18 e 59 anos, de ambos os gêneros. Os participantes foram divididos em dois grupos: Grupo Estudo (GE) - pessoas com diagnóstico de Diabetes Mellitus e o Grupo Controle (GC) - pessoas sem Diabetes. Todos foram submetidos à avaliação glicêmica, cognitiva e audiológica. Para análise estatística foi utilizado o teste de Mann-Whitney, sendo estipulado o nível de significância de 0,05. Resultados: Participaram do estudo 32 indivíduos sendo 19 (59,4%) no GE e 13 (40,6%) no GC. A média de idade dos participantes foi de 46,8 ± 8,3 anos, com escolaridade média de 6,8 ± 6 anos, sendo 25 (78,1%) do gênero feminino e 7 (21,9%) do masculino. Foi observada diferença estatisticamente significativa entre os grupos para a pontuação referente à atenção e cálculo, recordação e escore total do MEEM, com pior desempenho no GE. Não foi observada diferença estatisticamente significante entre os grupos nos aspectos audiológicos avaliados. Conclusão: Indivíduos com Diabetes Mellitus tipo 2 não apresentaram riscos para alterações audiológicas com os instrumentos utilizados, entretanto apresentaram um alto risco para alterações cognitivas. Os achados demonstram que o acompanhamento fonoaudiológico constante é essencial para identificar as alterações precocemente.

Introduction: Diabetes Mellitus (DM) is a metabolic disorder caused by the absence or reduction of insulin secretion or by changes in the functioning of this hormone in the body, which may involve physical and cognitive changes. Objective: To analyze the audiological and cognitive aspects of type 2 Diabetes Mellitus in adults. Method: Cross-sectional study carried out in people aged between 18 and 59 years, of both genders. Participants were divided into two groups: Study Group (SG) - people diagnosed with Diabetes Mellitus and the Control Group (CG) - people without Diabetes. All underwent glycemic, cognitive and auditory assessment. Mann-Whitney's test was used for statistical analysis, with a significance level of 0.05. Results: 32 individuals participated in the study, 19 (59.4%) in the EG and 13 (40.6%) in the CG. The mean age of the participants was 46.8 ± 8.3 years, with a mean education of 6.8 ± 6 years, with 25 (78.1%) females and 7 (21.9%) males. A statistically significant difference was observed between the groups for the score related to attention and calculation, recall and total Mini-Mental State Examination (MMSE) score, with worse performance in the EG. There was no statistically significant difference between the groups regarding the audiological aspects evaluated. Conclusion: Individuals with type 2 Diabetes Mellitus did not present risks for audiological alterations, however they presented a high risk for cognitive alterations. the findings demonstrate that constant speech therapy monitoring is essential to identify changes early.

Introducción: La Diabetes Mellitus (DM) es un trastorno metabólico causado por la ausencia o reducción de la secreción de insulina o por alteraciones en el funcionamiento de esta hormona en el organismo que puede implicar alteraciones físicas y cognitivas. Objetivo: Analizar los aspectos audiológicos y cognitivos de adultos con Diabetes Mellitus tipo 2. Método: Estudio transversal realizado en personas de entre 18 y 59 años, de ambos sexos. Los participantes se dividieron en dos grupos: Grupo de Estudio (GE) - personas diagnosticadas con diabetes mellitus y Grupo Control (GC) - personas sin Diabetes. Todos se sometieron a evaluación glucémica, cognitiva y audiológica. Para el análisis estadístico se utilizó la prueba de Mann-Whitney, con un nivel de significancia de 0.05. Resultados:Treinta y dos individuos participaron en el estudio, 19 (59,4%) en el GE y 13 (40,6%) en el GC. La edad media de los participantes fue de 46,8 ± 8,3 años, con una educación media de 6,8 ± 6 años, con 25 (78,1%) mujeres y 7 (21,9%) hombres. Se observó diferencia estadísticamente significativa entre los grupos para la puntuación relacionada con atención y cálculo, recuerdo y puntuación total del MEEM, con peor desempeño en el GE. No hubo diferencia estadísticamente significativa entre los grupos en los aspectos audiológicos evaluados. Conclusión: Los individuos con Diabetes Mellitus tipo 2 no presentaban riesgo de alteraciones audiológicas, sin embargo presentaban un alto riesgo de alteraciones cognitivas. Los resultados demuestran que el monitoreo constante de la terapia del habla es esencial para identificar cambios temprano.

Identificação de alterações auditivas em crianças pré-escolares / Identification of hearing disorders in preschool children / Identificación de trastornos auditivos en niños en edad preescolar

Programas de saúde auditiva estão voltados predominantemente para crianças entre 0 e 3 anos de idade ou para os maiores de 7. As crianças entre estas duas faixas etárias não estão em nenhum destes programas, porém é neste grupo que mais ocorrem problemas de orelha média, e, é, neste grupo, possível detectar as perdas auditivas mínimas, leves ou unilaterais que não foram identificadas nos programas de triagem auditiva neonatal. Objetivo: Identificar alterações auditivas em crianças pré-escolares por meio de um programa de triagem auditiva. Método: Trata-se de estudo descritivo, transversal e observacional realizado em duas escolas municipais do município de Mauá. A amostra foi composta por crianças de cinco e seis anos de idade. O programa de triagem auditiva foi composto: a. otoscopia; b. timpanometria, e c. registro das emissões otoacústicas transiente (EOAT) e produto de distorção (EOAPD). Em vista da pandemia iniciada em março de 2020, não foi possível avaliar as crianças de três e quatro anos. Resultados: 28,44% (n= 31) de crianças falharam na otoscopia. Das 78 (71,55%) crianças que passaram na otoscopia, 30,8% falharam na timpanometria; 16,7% nas Emissões Otoacústicas Produto de Distorção (DPOAE) e 19,2% nas Emissões Otoacústicas por estímulo Transiente (TPOAE); 30,76% (n= 24) das crianças falharam em pelo menos um dos três procedimentos. Conclusão: foram identificadas 30,76% de crianças com risco de alteração auditiva que devem ser encaminhadas para avaliação médica e audiológica.

Hearing health programs are predominantly aimed at children between 0 and 3 years of age or those older than 7. Children between these two age groups are not in any of these programs, but it is in this group that the most middle ear problems occur, and, it is in this group, possible to detect minimal, mild, or unilateral hearing loss that was not identified in neonatal hearing screening programs. Objective: To identify hearing alterations in preschool children through a hearing screening program. Method: This is a descriptive, cross-sectional, and observational study conducted in two municipal schools in the municipality of Mauá. The sample consisted of children aged five and six years. The hearing screening program was composed of a. otoscopy; b. tympanometry and, c. recording of transient otoacoustic emissions (TOAE) and distortion product (DPOAE). In view of the pandemic that began in March 2020, it was not possible to evaluate the three and four-year-old children. Results: 28.44% (n= 31) of the children failed otoscopy. Of the 78 (71.55%) children who underwent otoscopy, 30.8% failed tympanometry: 16.7% in Distortion Product Otoacoustic Emissions (DPOAE) and 19.2% in Transient Stimulus Otoacoustic Emissions (TPOAE); 30.76% (n= 24) of the children failed at least one of the three procedures. Conclusion: 30.76% of children at risk of hearing impairment were identified and should be referred for medical and audiological evaluation.

Los programas de salud auditiva están dirigidos principalmente a niños entre 0 y 3 años o mayores de 7 años. Los niños entre estos dos grupos de edad no están en ninguno de estos programas, pero es en este grupo que ocurren la mayoría de los problemas del oído medio, y, es en este grupo, posible detectar la pérdida de audición mínima, leve o unilateral que no se identificó en los programas de cribado auditivo neonatal. Objetivo: Identificar las alteraciones auditivas en niños en edad preescolar a través de un programa de detección auditiva. Método: Se trata de un estudio descriptivo, transversal y observacional realizado en dos colegios municipales del municipio de Mauá. La muestra estuvo constituida por niños de cinco y seis años y sus padres/tutores. El programa de detección de audición estuvo compuesto por: a. Cuestionario para padres/tutores sobre la historia de la salud auditiva de los niños; b. otoscopia; c. timpanometria y, d. Registro de emisiones otoacústicas transitorias (EOT) y producto de distorsión (DPOAE). Ante la pandemia que comenzó en marzo de 2020, no fue posible realizar los reexámenes ni evaluar a los niños de tres y cuatro años. Resultados: 28,44% (n= 31) de los niños no pasaron la otoscopia. De los 78 (71,55%) niños que se sometieron a otoscopia, 30,8% fallaron la timpanometria; 16,7% en emisiones otoacústicas de productos de distorsión (DPOAE) y 19,2% en emisiones otoacústicas de estímulo transitorio (TPOAE); 30,76% (n= 24) de los niños fallaron por lo menos uno de los tres procedimientos. Conclusión: 30,76% de los niños con riesgo de deficiencia auditiva fueron identificados y deben ser referidos para evaluación médica y audiológica.

Percepção de idosos na promoção da saúde auditiva / Older people's perception of hearing health promotion / Percepción del mayor en la promoción de la salud auditiva

Objetivo: analisar as reflexões acerca da saúde auditiva vivenciadas por idosos em Círculos de Cultura, na perspectiva da promoção da saúde. Método: estudo qualitativo, tipo ação participante, fundamentado no Itinerário de Pesquisa de Paulo Freire que consiste de três etapas: investigação temática, codificação e descodificação, e o desvelamento crítico. Foram realizados quatro Círculos de Cultura com 13 idosos participantes de uma Universidade Aberta da Terceira Idade de um município do sul do país. O desvelamento foi realizado com base na metodologia Freireana, que prevê o processo analítico. Resultados: Os participantes, por meio de debates e reflexões, expressaram por escrito e verbalmente suas percepções acerca da audição. Foram investigados 22 temas geradores que revelaram as percepções, as transformações, os medos, as dificuldades de aceitação e superação das dificuldades relacionadas à temática sobre a audição. Os participantes desvelaram interesse em realizar exames auditivos para monitorar suas habilidades auditivas. Conclusão: Os Círculos de Cultura realizados com idosos participantes desvelou a possibilidade de ampliar seus conhecimentos a respeito da saúde auditiva e contribuir para melhoria da sua qualidade de vida.

Objetivo: analizar las reflexiones sobre la salud auditiva que viven las personas mayores en los círculos culturales, desde la perspectiva de la promoción de la salud. Método: estudio cualitativo, tipo acción participante, basado en el Itinerario de Investigación de Paulo Freire, que consta de tres etapas: investigación temática, codificación y decodificación y develación crítica. Se realizaron cuatro Círculos Culturales de 13 adultos mayores participantes de una Universidad Abierta para Mayores en un municipio del sur del país. La inauguración se realizó con base en la metodología freireana, que prevé el proceso analítico. Resultados: Los participantes, a través de debates y reflexiones, expresaron por escrito y verbalmente sus percepciones sobre la audición. Veintidós temas generadores fueron investigados, reveladoras percepciones, transformaciones, miedos, dificultades para aceptar y superar las dificultades relacionadas con el tema de la audiencia. Los participantes mostraron interés en realizar pruebas auditivas para monitorear sus habilidades auditivas. Conclusión: Los Círculos Culturales realizados con participantes de edad avanzada revelaron la posibilidad de ampliar sus conocimientos sobre salud auditiva y contribuir a mejorar su calidad de vida.

Objective: To analyze, from the perspective of health promotion, older people's reflections on hearing health experiences shared in Cultural Circles. Method: Qualitative participant action study based on Paulo Freire's line of research, comprising three stages: topic investigation, coding and decoding, and critical unveiling. Four Cultural Circles were carried out with 13 older people from an Open University for Older People in a municipality in Southern Brazil. The unveiling was based on Freire's methodology, which indicates the analytical process. Results: The participants pointed out in oral and written debates and reflections their perceptions of hearing. Altogether, 22 generating topics were investigated, as they revealed perceptions, transformations, fears, difficulties with acceptance, and overcoming difficulties related to topics on hearing. The participants showed interest in having auditory examinations to monitor their hearing skills. Conclusion: The Cultural Circles with older people revealed the possibility of obtaining more in-depth knowledge of hearing health and helping improve their quality of life.

Development of High-performance Hearing Test System / 中国医疗器械杂志

This paper analyzes the shortcomings of the existing pure tone audiometers, and proposes a system to realize pure tone audiometry and speech audiometry with a new DSP processor. The pure tone test signal produced by the system has accurate frequency, high signal-to-noise ratio, and small harmonic distortion. The noise generator that comes with DSP adds a band-pass filter to realize the generation of narrow-band noise. At the same time, due to the modular structure of software design, the system has good ease of use and scalability. The test results show that the hearing test system has excellent performance and can be better used in hearing medical diagnosis.

Prestin-Mediated Frequency Selectivity Does not Cover Ultrahigh Frequencies in Mice / 神经科学通报·英文版

In mammals, the piezoelectric protein, Prestin, endows the outer hair cells (OHCs) with electromotility (eM), which confers the capacity to change cellular length in response to alterations in membrane potential. Together with basilar membrane resonance and possible stereociliary motility, Prestin-based OHC eM lays the foundation for enhancing cochlear sensitivity and frequency selectivity. However, it remains debatable whether Prestin contributes to ultrahigh-frequency hearing due to the intrinsic nature of the cell's low-pass features. The low-pass property of mouse OHC eM is based on the finding that eM magnitude dissipates within the frequency bandwidth of human speech. In this study, we examined the role of Prestin in sensing broad-range frequencies (4-80 kHz) in mice that use ultrasonic hearing and vocalization (to >100 kHz) for social communication. The audiometric measurements in mice showed that ablation of Prestin did not abolish hearing at frequencies >40 kHz. Acoustic associative behavior tests confirmed that Prestin-knockout mice can learn ultrahigh-frequency sound-coupled tasks, similar to control mice. Ex vivo cochlear Ca2+ imaging experiments demonstrated that without Prestin, the OHCs still exhibit ultrahigh-frequency transduction, which in contrast, can be abolished by a universal cation channel blocker, Gadolinium. In vivo salicylate treatment disrupts hearing at frequencies <40 kHz but not ultrahigh-frequency hearing. By pharmacogenetic manipulation, we showed that specific ablation of the OHCs largely abolished hearing at frequencies >40 kHz. These findings demonstrate that cochlear OHCs are the target cells that support ultrahigh-frequency transduction, which does not require Prestin.

Audiología pediátrica: el arte de armar rompecabezas / Pediatric Audiology: The Art of Putting Puzzles Together

La audición funcional ­para fines prácticos­ consiste en la posibilidad de despertar sensaciones precisas en regiones específicas del cerebro, a partir del procesamiento y extracción de mensajes ocultos en los cambios en la presión de las moléculas del aire que nos rodea. Medir la funcionalidad de la audición en un ser humano se convierte en un reto titánico que implica que nuestra vida profesional transcurra analizando información tanto subjetiva como objetiva de nuestros pacientes, ambas con un valor diagnóstico innegable. En cuanto a la primera, la historia clínica, las observaciones de la conducta auditiva del paciente, los reportes de la casa, la escuela y la terapia, o de estudios como la audiometría tonal y la logoaudiometría, resultan fundamentales no solo para el diagnóstico, sino para el seguimiento de nuestros pacientes. Sin embargo, en el caso de los pacientes más pequeños, o ante la necesidad de evaluar aspectos como la presión del oído medio, la función de las células ciliadas, o la presencia de microfónica coclear, la utilidad de esas herramientas subjetivas se encuentra limitada y entonces los registros, trazos, curvas y cifras relativas a intensidades, presiones, latencias, frecuencias, amplitudes y demás datos obtenidos a través de estudios objetivos, son los recursos que usamos para diagnosticar e iniciar la habilitación o rehabilitación de nuestros pacientes.

Functional hearing ­ for practical purposes ­ consists of the possibility of awakening precise sensations in specific regions of the brain from the processing and extraction of hidden messages in changes in the pressure of the molecules of the air that surrounds us. Measuring the functionality of hearing in a human being becomes a titanic challenge that implies that our professional life is spent analyzing both subjective and objective information from our patients, both with an undeniable diagnostic value: as for the first, the clinical history, observations of the patient's listening behavior, reports from home, school and therapy, or studies such as pure tone audiometry and speech audiometry, are essential not only for diagnosis but also for the follow-up of our patients. However, in the case of smaller patients, or when faced with the need to evaluate aspects such as middle ear pressure, hair cell function, or the presence of cochlear microphonics; The usefulness of these subjective tools is limited and therefore the records, traces, curves and figures related to intensities, pressures, latencies, frequencies, amplitudes and other data obtained through objective studies are the resources we use to diagnose and start the investigation. rehabilitation or rehabilitation of our patients.

Hipoacusia sensorineural asimétrica en el diagnóstico de schwannoma vestibular / Asymmetric sensorineural hearing loss in the diagnosis of vestibular schwannoma

Introducción: se ha descrito que los pacientes con hipoacusia asimétrica cursan en un 2% con lesiones retrococleares. La conducta de escrutinio se ha basado en la audiometría. Existen varias definiciones de asimetría audiométrica descritas en la literatura, pero sin llegar a un consenso. Aunque la prueba de oro para el diagnóstico de schwannoma vestibular es la resonancia magnética con gadolíneo, la sospecha clínica se hace en base a la asimetría audiométrica. Objetivo: hacemos una revisión de los trabajos publicados al respecto en la literatu-ra y comentamos nuestra experiencia. Reflexión: queremos enfatizar en la importancia de estudiar a los pacientes con hipoacusia asimétrica con el fin de descartar patología retrococlear. Conclusión: a pesar de que no existe un consenso claro en la definición de hi-poacusia asimétrica, la sospecha clínica de un schwannoma vestibular se basa en la audiometría

Background: It is described that 2% of patients with asymmetric hearing loss have retrocochlear lesions. The scrutiny behavior has been based on audiometry. There are several definitions of audiometric asymmetry described in the literature, but without reaching a consensus. Although the gold standard for the diagnosis of vestibular schwannoma is gadolinium magnetic resonance imaging, the clinical sus-picion is based on audiometric asymmetry. Objective: we review the results published in this regard in the literature and com-ment on our own experience. Reflection: we want to emphasize the importance of studying asymmetric hearing loss patients in order to rule out retrocochlear etiology. Conclusions: although there is no clear consensus on the definition of asym-metric hearing loss, the clinical suspicion of a vestibular schwannoma is based on the audiometry.