The Auditory Steady-State Response and the Relationship between Electrophysiological and Behavioural Thresholds.

BACKGROUND: This study examined the relationship between behavioural thresholds as measured by pure tone audiometry and electrophysiological thresholds measured by the Auditory Steady-State Response (ASSR) in children with normal hearing and sensorineural hearing loss. MATERIALS AND METHODS: After being assessed, 45 children of both sexes, ranging in age from 5 to 15, were split into four groups: 10 with moderate to moderately severe sensorineural hearing loss (G2M); 10 with steeply sloping sensorineural hearing loss (G2D); 10 with profound and severe sensorineural hearing loss (G2S); and 15 with normal hearing (G1). ASSR, tympanometry, acoustic reflex testing, pure tone audiometry, and speech audiometry (SRT and SDT) were performed. RESULTS: The electrophysiological maximum in the group with normal hearing thresholds varied from 19 to 27 dB NA. The correlation in the group with moderate to moderately severe hearing loss was 0.42-0.74. The correlation in the steeply sloping hearing loss group was 0.68-0.94. The correlation in the group of people with profound and severe hearing loss was 0.59-0.86. The normal hearing group's mean differences in ASSR threshold and audiometric threshold ranged from -0.3 to 12 dB, in the moderate and moderately severe hearing loss group from -9 to 2 dB, in the steeply sloping hearing loss group from 1.4 to 7.5 dB, and in the severe and profound hearing loss group from -0.40 to 8.5 dB. CONCLUSION: As expected, there was no strong relationship between behavioural and electrophysiological thresholds in the group with normal hearing. But in children with hearing loss, there was a strong correlation between electrophysiological and behavioural thresholds; this relationship was especially evident in children with severe and profound hearing loss and those with steeply sloping hearing loss.

Audiometric evaluation in different clinical presentations of otitis media.

OBJECTIVES: To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. METHODS: Cross sectional, controlled study. We performed conventional audiometry (500-8000Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. RESULTS: Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n=31; suppurative COM, n=18; cholesteatomatous COM, n=23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). CONCLUSION: All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p<0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.

Audiometric evaluation in different clinical presentations of otitis media

Abstract Objectives To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. Methods Cross sectional, controlled study. We performed conventional audiometry (500-8000 Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. Results Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n = 31; suppurative COM, n = 18; cholesteatomatous COM, n = 23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000 Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). Conclusion All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p < 0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.

Reabilitação auditiva com sistemas Baha® transcutâneo e percutâneo / Hearing rehabilitation with Baha® transcutaneous and percutaneous systems

RESUMO Objetivo Verificar longitudinalmente a influência dos limiares tonais auditivos obtidos com as próteses auditivas ancoradas no osso transcutâneas e percutâneas na percepção da fala em indivíduos com malformação de orelha externa e/ou média e Otite Média Crônica. Método Estudo observacional, retrospectivo, de seguimento longitudinal de 30 indivíduos usuários unilaterais de sistema Baha® transcutâneo e percutâneo, para coleta de dados secundários dos limiares tonais obtidos por meio da audiometria em campo livre e do limiar de reconhecimento de sentenças no silêncio e no ruído nas condições: sem a prótese; no momento de ativação; no primeiro mês de uso (pós 1); e no terceiro mês (pós 2). Resultados Houve diferença significante entre os limiares tonais obtidos nas frequências de 3 e 4kHz, com melhores resultados para o percutâneo em todos os momentos de avaliação. Para os dois sistemas, observou-se melhor desempenho no reconhecimento de sentenças no silêncio e ruído, com diferença significante na ativação (p<0,001), porém manteve-se estável nos demais momentos de avaliação. O sistema percutâneo mostrou melhor benefício no reconhecimento de sentenças no ruído apenas na ativação (p=0,036), quando comparado ao transcutâneo. Conclusão O sistema percutâneo possibilitou melhor audibilidade para as frequências altas; contudo, tal audibilidade não influenciou no reconhecimento de sentenças na situação de silêncio para ambos os sistemas. Para a situação de ruído, melhores respostas foram observadas no sistema percutâneo; porém, a diferença não se manteve no decorrer do tempo.

ABSTRACT Purpose Longitudinally verify the influence of auditory tonal thresholds obtained with transcutaneous and percutaneous bone-anchored hearing aids on speech perception in individuals with external and/or middle ear malformation and chronic otitis media. Methods Observational, retrospective, longitudinal follow-up study of 30 unilateral users of the transcutaneous and percutaneous Baha® system for the collection of secondary data on pure tone thresholds obtained through free field audiometry and sentence recognition threshold in silence and noise in conditions: without the prosthesis; at the time of activation; in the first month of use (post 1); and in the third month (post 2). Results There was a significant difference between pure tone thresholds obtained at frequencies of 3 and 4kHz with better results for the percutaneous technique at all evaluation moments. For both systems, better performance was observed in sentence recognition in silence and in noise, with a significant difference in activation (p<0.001), but it remained stable during the other evaluation moments. The percutaneous system showed better benefit in recognizing sentences in noise only on activation (p=0.036), when compared to the transcutaneous system. Conclusion The percutaneous system provided better audibility for high frequencies; however, such audibility did not influence sentence recognition in the silent situation for both systems. For the noise situation, better responses were observed in the percutaneous system, however, the difference was not maintained over time.

Hearing Thresholds at High Frequencies: Age as a Predictor of Values.

Introduction The audiological evaluation has the main objective of determining the integrity of the auditory system. Pure tone audiometry is a standardized behavioral procedure that aims to investigate auditory thresholds to describe auditory sensitivity. Despite being recognized since the mid-1960s, high frequency audiometry is still little used and explored in clinical practice, and its use is more considered as an audiological monitoring tool or as a research tool. Objective To analyze the audiological thresholds of high frequency audiometry in normal hearing individuals, and to verify the predictive capacity of age in the auditory thresholds of high frequency audiometry. Methods This is a retrospective, cross-sectional, and quantitative study that was approved by the Research Ethics Committee under number 5.039.583/21. The procedures were: clinical evaluation, pure tone audiometry, acoustic immittance measurements, and high frequency audiometry. All data collected from the exams were tabulated in an Excel spreadsheet and analyzed using appropriate statistical tests in the Statistical Package Social Sciences software. Results A total of 980 medical records were analyzed. The right and left ears presented similar tonal hearing thresholds for the frequencies of 12 kHz and 16 kHz. The threshold variance of 29.8% in the 12 kHz frequency can be explained by the variance of age, while, for the frequency of 16 kHz, this percentage is of 46.4%. Conclusion For 12 kHz hearing thresholds, an increase of 1 year leads to a 0.66 dBHL increase in hearing threshold. For 16 kHz hearing thresholds, an increase of 1 year leads to a 1.02 dBHL increase in hearing threshold.

Obstructive Sleep Apnea and Hearing Loss: Is There Any Correlation?

Abstract Introduction Obstructive sleep apnea (OSA) is a breathing disorder related to sleep that has a negative effect on the behavior and health of people around the globe. Chronic hypoxemia and variations in the concentration of oxygen in the blood noticed in OSA individuals may have adverse effects on the process of auditory transduction and transmission. Objective To assess the effect of OSA on hearing and to find out the parameters that have more influence on hearing recorded during polysomnography of patients with OSA. Methods The present is a hospital-based, observational, analytical, cross-sectional study conducted over a period of one year. After application of the exclusion criteria, the patients were then submitted to the application of the Berlin questionnaire, as well as polysomnography, impedance, and pure tone audiometry (PTA). Results A total of 58 individuals were studied. Age, gender, and height were comparable among cases and controls, while weight, body mass index (BMI), and neck circumference were significantly higher in cases in comparison to controls. The mean PTA was significantly higher at 10 kHz or higher frequencies in cases in comparison to controls. Conclusion We observed that there is evidence that the auditory mechanism is affected in OSA patients. We recommend early auditory screening of OSA patients for timely diagnosis and to raise awareness about its prevention.

Obstructive Sleep Apnea and Hearing Loss: Is There Any Correlation?

Introduction Obstructive sleep apnea (OSA) is a breathing disorder related to sleep that has a negative effect on the behavior and health of people around the globe. Chronic hypoxemia and variations in the concentration of oxygen in the blood noticed in OSA individuals may have adverse effects on the process of auditory transduction and transmission. Objective To assess the effect of OSA on hearing and to find out the parameters that have more influence on hearing recorded during polysomnography of patients with OSA. Methods The present is a hospital-based, observational, analytical, cross-sectional study conducted over a period of one year. After application of the exclusion criteria, the patients were then submitted to the application of the Berlin questionnaire, as well as polysomnography, impedance, and pure tone audiometry (PTA). Results A total of 58 individuals were studied. Age, gender, and height were comparable among cases and controls, while weight, body mass index (BMI), and neck circumference were significantly higher in cases in comparison to controls. The mean PTA was significantly higher at 10 kHz or higher frequencies in cases in comparison to controls. Conclusion We observed that there is evidence that the auditory mechanism is affected in OSA patients. We recommend early auditory screening of OSA patients for timely diagnosis and to raise awareness about its prevention.

Automated detection of auditory response: non-detection stopping criterion and repeatability studies for multichannel EEG.

An Auditory Steady-State Response (ASSR) is a valuable tool for determining auditory thresholds in individuals who are either unable or unwilling to cooperate with conventional behavioral testing methods. This study proposes a sequential test technique for automatic detection of ASSRs, incorporating a non-detection stopping criterion. The electrophysiological thresholds of a normal hearing volunteer were established using data collected from multichannel EEG signals. The detection probabilities and critical values were obtained via Monte Carlo simulations. Remarkably, application of the non-detection stopping criterion resulted in a 60% reduction in exam time in the absence of a response. These findings clearly demonstrate the significant potential of the sequential test in enhancing the performance of automatic audiometry.

Auditory function in symptomatic patients recovered from SARS-CoV-2 and unexposed patients: An analytical cross-sectional study.

Objective: To describe audiological symptoms, audiometric profile, and distortion product otoacoustic emission in symptomatic patients recovering from SARS-CoV-2 infection (positive RT-PCR test) and asymptomatic patients (negative RT-PCR test). Methods: An analytical cross-sectional study was conducted using data obtained from clinical charts, physical examination, audiometry, and distortion product otoacoustic emission on 40 patients [case patients (CP)] recovering from SARS-CoV-2 infection diagnosed by a positive RT-PCR test and 22 asymptomatic participants with a negative RT-PCR test [non-case (NC)]. Results: Sixty-two patients (mean age: 31.1 and 28.2 years in the CP and NC groups, respectively) were included. All participants were young without significant comorbidities, risk factors for hearing loss or otological history. Vertigo (5%), tinnitus (17.5%) and aural fullness/hearing loss (35%) were found in the CP group. A statistically significant difference was found in specific frequencies (1000, 4000, and 8000 Hz) and pure tone average (low and high conversational frequencies with increased threshold in the PC group compared with the NC group), which was not found in distortion product otoacoustic emission. Conclusion: Audiovestibular symptoms are frequent in symptomatic patients recovering from SARS-CoV-2 infection. SARS-CoV-2 infection was consistently associated with an increased audiometric hearing threshold at specific frequencies and low tone average.

Novel cochlear implant assessment tool: Comparative analysis of children and adults.

Objectives: To analyse the results of children and adults with cochlear implants (CIs) in pure tone audiometry (PTA) and speech perception tests. Tests were performed in two ways: using loudspeakers in the sound booth (SB) and with direct audio input (DAI) employing the Cochlear Latin America BOX (CLABOX). Methods: Fifty individuals (33 adults and 17 children) participated in the study, including children aged between 8 and 13 years; of these, 15 users had bilateral CIs, 35 had unilateral CIs, and all had severe to profound bilateral sensorineural hearing loss. All participants were evaluated in the SB with loudspeakers and the CLABOX with DAI. The following evaluations were conducted: PTA, speech recognition tests with the hearing in noise test (HINT). Results: The results for PTA and HINT conducted in SB and with CLABOX presented no significant difference between children and adults. Conclusion: The CLABOX tool presents a new possible method to evaluate PTA and speech recognition tests in adults and children, with results comparable to the conventional evaluation in the SB.

Nivel Auditivo Y Rendimiento Académico En Estudiantes De Una Institución Educativa De Lima

Introducción: La audición es la vía habitual para adquirir el lenguaje, lo cual permite el desarrollo del pensamiento y el conocimiento; la pérdida auditiva puede afectar la capacidad de aprendizaje y comunicación en el niño y ocasionar alteraciones en su comportamiento y rendimiento académico. Objetivo: Determinar la relación entre el nivel auditivo y el rendimiento académico en estudiantes de educación primaria de una institución educativa pública de Lima. Métodos: Estudio observacional, correlacional y transversal. Se realizó otoscopía y audiometría en 94 alumnos del sexto año de primaria de la institución educativa Santa Rosa de Lima, en Los Olivos-Lima. Se usó como instrumento el otoscopio, el audiómetro y las notas finales de cada alumno del primer semestre académico 2022. Se analizó la relación mediante el coeficiente de correlación de Rho de Spearman. Resultados: El 35,1% de estudiantes presentaron hipoacusia leve y el 64,9%, normoacusia. El rendimiento académico promedio de la muestra fue 14,74; el rendimiento académico promedio de los normoacúsicos; 14,89 y el de los hipoacúsicos, 14,48. En el análisis de correlación de Rho de Spearman, se encontró correlación positiva entre nivel de audición y rendimiento académico (0,200). Conclusiones: Existe relación positiva entre el nivel de audición y rendimiento académico en estudiantes del sexto año de primaria de la institución educativa Santa Rosa de Lima en Los Olivos.

Introduction: Hearing is the usual way to acquire language, which allows us the development of thought and knowledge; hearing loss can affect the ability to learn and communicate in children and cause alterations in their behavior and academic performance. Objective: To determine the relationship between hearing level and academic performance in primary school students from a public educational institution in Lima. Methods: Observational, correlational and cross-sectional study. Otoscopy and audiometry were performed in 94 students of the sixth year of primary school of the Santa Rosa de Lima educational institution, in Los Olivos-Lima. Was used the otoscope, the audiometer and the final grades of each student of the first academic semester 2022 as instruments. The relationship was analyzed using Spearman's Rho correlation coefficient. Results: 35.1% of students had mild hearing loss and 64.9% had normal hearing loss. The average academic performance of the sample was 14.74; the average academic performance of the normoacusic students, 14.89 and the average academic performance of the hearing impaired, 14.48. In the Spearman's Rho correlation análisis, it was found a positive correlation between hearing level and academic performance (0.200). Conclusions: There is a positive relationship between hearing level and academic performance in sixth grade students of the Santa Rosa de Lima- Los Olivos educational institution.

Endoscopic versus microscopic ossiculoplasty: Does the functional outcome vary according to the type of osciculoplasty?

Abstract Objective: To compare functional outcome of microscopic and endoscopic approach regarding type of ossiculoplasty. Methods: In this retrospective study, cases who had undergone type-II and type-III tympanoplasty between February 2007 to September 2019 were divided into two groups according to the type of approach as microscopic and endoscopic. In cases with type-II reconstruction; Partial Ossicular chain Replacement Prosthesis (PORP), incus interposition and bone cement were used in order of frequency. Whereas in cases with type-III reconstruction, only Total Ossicular chain Replacement Prosthesis (TORP) was used. The average Air Bone Gap (ABG) was determined pre- and post-operatively for the calculation of Air Conductance Gain (ACG). The ACG, pre- and post-operative ABG values of each group were compared with regard to the type of ossiculoplasty. Results: A total of 79 cases consisting of 32 females and 47 males who had undergone type-II and type-III tympanoplasty were enrolled. No statistically significant difference between microscopic and endoscopic approach was found in terms of ACG (p = 0.42), pre-(p = 0.23) and postoperative ABG (p = 0.99). We did not find any significant difference in terms of ACG, pre- and postoperative ABG between two approaches for type-II and type-III reconstructions (p>0.05). Conclusions: According to the current study, endoscopic approach in type-II and type-III reconstruction is at least reliable as microscopic approach regarding functional outcome. Since both techniques have similar functional results, other factors (anatomic characteristics, habitude of the surgeon and duration of the surgery) should be considered when choosing the technique. Level of evidence: In the current paper we present a retrospective comparative study of two different approaches of a particular type of otologic surgery. Level of evidence corresponds to level III.

Endoscopic versus microscopic ossiculoplasty: Does the functional outcome vary according to the type of osciculoplasty?

OBJECTIVE: To compare functional outcome of microscopic and endoscopic approach regarding type of ossiculoplasty. METHODS: In this retrospective study, cases who had undergone type-II and type-III tympanoplasty between February 2007 to September 2019 were divided into two groups according to the type of approach as microscopic and endoscopic. In cases with type-II reconstruction; Partial Ossicular chain Replacement Prosthesis (PORP), incus interposition and bone cement were used in order of frequency. Whereas in cases with type-III reconstruction, only Total Ossicular chain Replacement Prosthesis (TORP) was used. The average Air Bone Gap (ABG) was determined pre- and post-operatively for the calculation of Air Conductance Gain (ACG). The ACG, pre- and post-operative ABG values of each group were compared with regard to the type of ossiculoplasty. RESULTS: A total of 79 cases consisting of 32 females and 47 males who had undergone type-II and type-III tympanoplasty were enrolled. No statistically significant difference between microscopic and endoscopic approach was found in terms of ACG (p = 0.42), pre-(p = 0.23) and postoperative ABG (p = 0.99). We did not find any significant difference in terms of ACG, pre- and postoperative ABG between two approaches for type-II and type-III reconstructions (p > 0.05). CONCLUSIONS: According to the current study, endoscopic approach in type-II and type-III reconstruction is at least reliable as microscopic approach regarding functional outcome. Since both techniques have similar functional results, other factors (anatomic characteristics, habitude of the surgeon and duration of the surgery) should be considered when choosing the technique. LEVEL OF EVIDENCE: In the current paper we present a retrospective comparative study of two different approaches of a particular type of otologic surgery. Level of evidence corresponds to level III.

Test-Retest repeatability of automated threshold audiometry in Nicaraguan schoolchildren.

OBJECTIVE: Automated threshold audiometry (ATA) could increase access to paediatric hearing assessment in low- and middle-income countries, but few studies have evaluated test-retest repeatability of ATA in children. This study aims to analyse test-retest repeatability of ATA and to identify factors that affect the reliability of this method. DESIGN: ATA was performed twice in a cohort of Nicaraguan schoolchildren. During testing, the proportion of responses occurring in the absence of a stimulus was measured by calculating a stimulus response false positive rate (SRFP). Absolute test-retest repeatability was determined between the two trials, as well as the impact of age, gender, ambient noise, head circumference, and SRFP on these results. STUDY SAMPLE: 807 children were randomly selected from 35 schools in northern Nicaragua. RESULTS: Across all frequencies, the absolute value of the difference between measurements was 5.5 ± 7.8 dB. 89.6% of test-retest differences were within 10 dB. Intra-class correlation coefficients between the two measurements showed that lower SRFP was associated with improved repeatability. No effect of age, gender, or ambient noise was found. CONCLUSIONS: ATA produced moderate test-retest repeatability in Nicaraguan schoolchildren. Participant testing behaviours, such as delayed or otherwise inappropriate response patterns, significantly impacts the repeatability of these measurements.

High-resolution computed tomography and pure-tone audiometry in patients with otosclerosis in the spongiotic phase.

OBJECTIVE: There is no consensus in the literature regarding the relationship between high-resolution computed tomography findings and hearing thresholds in pure-tone audiometry in otosclerosis. This study evaluated the association between high-resolution computed tomography findings and pure-tone audiometry in otosclerosis in the spongiotic phase. METHODS: A cross-sectional study was conducted of 57 ears with surgically confirmed stapes fixation and tomographic findings. Air conduction and bone conduction thresholds on audiometry, and air-bone gap, were analysed. RESULTS: There were no correlations between sites affected by otospongiosis and air conduction threshold, bone conduction threshold or air-bone gap in the analysed tomographic images, but the diameter of the otospongiotic focus was greater in the presence of extension of the otospongiotic foci to the cochlear endosteum. CONCLUSION: There were no relevant associations between high-resolution computed tomography findings and pure-tone audiometric measurements. However, the diameter of the otospongiotic focus was greater in the presence of extension of the otospongiotic foci to the cochlear endosteum.

Hearing Thresholds at High Frequencies: Age as a Predictor of Values

Abstract Introduction The audiological evaluation has the main objective of determining the integrity of the auditory system. Pure tone audiometry is a standardized behavioral procedure that aims to investigate auditory thresholds to describe auditory sensitivity. Despite being recognized since the mid-1960s, high frequency audiometry is still little used and explored in clinical practice, and its use is more considered as an audiological monitoring tool or as a research tool. Objective To analyze the audiological thresholds of high frequency audiometry in normal hearing individuals, and to verify the predictive capacity of age in the auditory thresholds of high frequency audiometry. Methods This is a retrospective, cross-sectional, and quantitative study that was approved by the Research Ethics Committee under number 5.039.583/21. The procedures were: clinical evaluation, pure tone audiometry, acoustic immittance measurements, and high frequency audiometry. All data collected from the exams were tabulated in an Excel spreadsheet and analyzed using appropriate statistical tests in the Statistical Package Social Sciences software. Results A total of 980 medical records were analyzed. The right and left ears presented similar tonal hearing thresholds for the frequencies of 12 kHz and 16 kHz. The threshold variance of 29.8% in the 12 kHz frequency can be explained by the variance of age, while, for the frequency of 16 kHz, this percentage is of 46.4%. Conclusion For 12 kHz hearing thresholds, an increase of 1 year leads to a 0.66 dBHL increase in hearing threshold. For 16 kHz hearing thresholds, an increase of 1 year leads to a 1.02 dBHL increase in hearing threshold.

Análise de limiares tonais de crianças submetidas ao reimplante: seguimento de 10 anos / Analysis of aided thresholds in children who have undergone cochlear reimplantation: a ten-year follow-up

RESUMO Objetivo Caracterizar os limiares auditivos nas frequências de 500, 1000, 2000 e 4000 Hz em crianças submetidas ao reimplante com follow-up de no mínimo 10 anos. Método Revisão retrospectiva de prontuários de crianças submetidas a cirurgia de reimplante há pelo menos 10 anos. Foram avaliados os limiares auditivos obtidos na audiometria tonal liminar em campo livre com o implante coclear nas frequências de 500, 1000, 2000 e 4000 Hz em quatro momentos distintos: 1 (antes da falha), 2 (ativação), 3 (cinco anos após o reimplante) e 4 (dez anos após o reimplante, independentemente do tempo de uso do uso do 2o IC) em pacientes com follow-up de no mínimo 10 anos. Resultados Avaliando-se pacientes submetidos ao reimplante, observou-se que os limiares de 500, 1000, 2000, 4000 Hz apresentaram-se a longo prazo semelhante àqueles obtidos nos pacientes implantados somente uma única vez, não apresentando prejuízo assim na detecção dos sons. Conclusão O reimplante não teve efeito de longo prazo sobre os limiares auditivos obtidos em crianças que se submeteram a esta cirurgia por falha do componente interno.

ABSTRACT Purpose To characterize hearing thresholds at frequencies of 500, 1000, 2000 and 4000 Hz in children undergoing reimplantation with a follow-up of at least 10 years. Methods Retrospective review of medical records of children who underwent reimplantation surgery for at least 10 years. The auditory thresholds obtained in free-field pure tone audiometry with the cochlear implant were evaluated at frequencies of 500, 1000, 2000 and 4000 Hz at four different times: 1 (before failure), 2 (activation), 3 (five years after reimplantation) and 4 (ten years after reimplantation, regardless of the time of use of the 2nd CI) in patients with a follow-up of at least 10 years. Results Evaluating patients who underwent reimplantation, it was observed that the thresholds of 500, 1000, 2000, 4000 Hz were similar in the long term to those obtained in patients who were implanted only once, thus not presenting damage in the detection of sounds. Conclusion Reimplantation had no long-term effect on the hearing thresholds obtained in children who underwent this surgery due to internal component failure.

Analysis of clinical parameters as predictors of hearing recovery in patients with sudden sensorineural hearing loss

Abstract Objective: To investigate the impact of certain clinical parameters on likelihood of hearing recovery after SSNHL and to detect potential variables that predict its outcome. Methods: A retrospective study was conducted in order to identify the clinical parameters which influence hearing recovery after SSNHL. Medical charts of 87 patients diagnosed with SSNHL and treated in the clinic from January 2015 to December 2019 were retrospectively reviewed. The effects of several parameters on the success of the treatment were statistically evaluated. Such parameters studied were age, gender, the severity of hearing loss, audiometric curve pattern, the time treatment was initiated, and metabolic factors. Results: Patient categorization according to tonal audiometric curve results statistically differed in terms of recovery (complete, partial, no recovery) (x2 = 32.5; p< 0.001). There are 2× more diabetic patients in the group no recovery than in the group partial recovery (OR = 3.1; 95% CI 0.95-10; p = 0.061), and 5.3× more than in the group complete recovery (OR = 10.4; 95% CI 2.3-45; p = 0.002) (χ2 = 11.2; p = 0.004). There is a statistically significant correlation between onset of therapy and recovery on a scale of significance of 93% (χ2 = 5.3, p= 0.069). Conclusion: In our study tonal audiometry results, diabetes mellitus and onset of therapy were shown to be a statistically significant negative predictive factors for recovery. Results of pure tone audiometry suggest a flat profound curve is statistically associated with the no recovery rates, and a down sloping curve proved to be statistically associated with complete recovery rates. Level of evidence: Level 1.

Reconstruction of the Long Process of the Incus by Use of Glass Ionomer Cement: Our Experience

Abstract Introduction Chronic suppurative otitis media is one of the most common causes of reversible conductive hearing loss which can lead to necrosis of the ossicles. The incus, especially its long process, is the most common ossicle affected. Objectives The present study aims to assess the use of glass ionomer cement for the reconstruction of the long process of the incus. Methods The present study was conducted on 27 patients with chronic suppurative otitis media with central perforation with dry and quiescent ears with an eroded long process of the incus submitted to tympanoplasty. The audiological evaluations were done on all patients, including preoperative and postoperative evaluation of the airbone gap; the average pure tone threshold was done 6 months postoperatively. Results The average air pure tone threshold was 42.8 dB preoperatively and 22.5 dB postoperatively. The postoperative air pure tone thresholds were significantly smaller than the preoperative values (p < 0.01). The air-bone gap was 30.5 dB at 500 Hz, 31.6 dB at 1 KHz, and 24.1 dB at 2 kHz preoperatively, and 7.7 dB at 500 Hz, 7.2 dB at 1 KHz, and 7.1 dB at 2 kHz postoperatively at the end of 6 months of follow-up. There were significant hearing gains in the air-bone gap (p < 0.001). Conclusion Glass ionomer cement is a useful and effective material for bridging the defect of the long process of the incus.

Reconstruction of the Long Process of the Incus by Use of Glass Ionomer Cement: Our Experience.

Introduction Chronic suppurative otitis media is one of the most common causes of reversible conductive hearing loss which can lead to necrosis of the ossicles. The incus, especially its long process, is the most common ossicle affected. Objectives The present study aims to assess the use of glass ionomer cement for the reconstruction of the long process of the incus. Methods The present study was conducted on 27 patients with chronic suppurative otitis media with central perforation with dry and quiescent ears with an eroded long process of the incus submitted to tympanoplasty. The audiological evaluations were done on all patients, including preoperative and postoperative evaluation of the air-bone gap; the average pure tone threshold was done 6 months postoperatively. Results The average air pure tone threshold was 42.8 dB preoperatively and 22.5 dB postoperatively. The postoperative air pure tone thresholds were significantly smaller than the preoperative values ( p < 0.01). The air-bone gap was 30.5 dB at 500 Hz, 31.6 dB at 1 KHz, and 24.1 dB at 2 kHz preoperatively, and 7.7 dB at 500 Hz, 7.2 dB at 1 KHz, and 7.1 dB at 2 kHz postoperatively at the end of 6 months of follow-up. There were significant hearing gains in the air-bone gap ( p < 0.001). Conclusion Glass ionomer cement is a useful and effective material for bridging the defect of the long process of the incus.