Hearing Aid Use and Auditory Verbal Therapy Improve Voice Quality of Deaf Children.

BACKGROUND: Adequate phonation is self-regulated by auditory feedback. Children with bilateral profound hearing loss (PHL) lack this feedback resulting in abnormal voice. Adequate hearing aid use and auditory-verbal therapy (AVT) may improve voice quality in deaf children. OBJECTIVE: To study whether hearing aid use and AVT approach improve acoustic parameters of voice of children with bilateral PHL. MATERIALS AND METHODS: Nineteen children with bilateral PHL were studied. Age range 2-5 years (X = 53.04 months; SD = 9.54). All children were fitted with hearing aids according to auditory testing and they underwent a 1-year auditory habilitation period using the AVT approach. Acoustic analysis of voice including F0, shimmer, and jitter was performed at the onset and at the end of the auditory habilitation period. Final acoustic data were compared to a matched control group of 19 children, age range 2-5 years (X = 52.85; SD = 9.74) with normal hearing. RESULTS: Mean fundamental frequency (F0) was significantly increased after AVT intervention. Shimmer and jitter significantly (P < 0.05) improved after the intervention period. However, despite the improvements, mean F0 at the end of the intervention period was still significantly (P < 0.05) decreased as compared to controls. Also, mean shimmer and jitter at the end of the habilitation period were still significantly (P < 0.05) higher as compared to controls. CONCLUSIONS: The results of this preliminary study suggest that hearing aid use and auditory habilitation with AVT approach improved acoustic voice parameters of children with PHL. However, acoustic parameters persisted abnormal as compared to matched normal hearing controls. AVT approach and regular hearing aid use seem to be safe and reliable clinical tools for improving voice quality of children with PFL.

Utilidad diagnóstica del reflejo acústico para predecir audición en población pediátrica / Diagnostic utility of the acoustic reflex in predicting hearing in paediatric populations

Introducción y objetivos: La sensibilidad de predicción del reflejo acústico determina el nivel de pérdida auditiva, útil sobre todo en población pediátrica. Se basa en la diferencia entre el umbral del reflejo estapedial con tono puro y con ruido blanco contralateral. El umbral con ruido blanco es de 60 dB y con tono puro de 80 dB. El objetivo de este estudio fue determinar la utilidad diagnóstica de la sensibilidad de predicción del reflejo acústico. Métodos: Previo consentimiento informado, se estudió a niños menores de 10 años, de octubre del 2011 a mayo del 2012, midiendo el reflejo estapedial con ruido blanco y tono puro. Se realizaron pruebas de contraste con χ2 y t de Student. La concordancia se midió con kappa. Se consideró significativo un valor de p ≤ 0,05. El proyecto fue aprobado por el Comité de Ética. En todos los casos se obtuvo el consentimiento informado de los padres. Resultados: Predicción de audición normal: 0,84 para el oído derecho y 0,78 en el oído izquierdo y para hipoacusia sin especificar el grado: 0,98 para el oído derecho y 0,96 en el oído izquierdo. Valor de kappa de 0,7 para el oído derecho y 0,6 para el oído izquierdo. Conclusiones: La utilidad diagnóstica del reflejo acústico tiene muy poco valor para predecir el grado de pérdida auditiva, pero predice en más del 80% la audición normal. Por lo que se sugiere utilizar como una prueba objetiva obligada como parte del Cribado auditivo (AU)

Introduction and objectives: The sensitivity of prediction of acoustic reflex, in determining the level of hearing loss, is especially useful in paediatric populations. It is based on the difference between the pure tone stapedius reflex threshold and contralateral white noise. The white noise threshold was 60 dB and that of pure tone was 80 dB. Our objective was to determine the diagnostic sensitivity of the prediction of the acoustic reflex. Methods: We studied children aged <10 years, from October 2011 to May 2012, by measuring the acoustic reflex with white noise and pure tone. We used contrast tests, with X2 and student t-test. Concordance was measured with Kappa. Results were considered significant at P≤.05. Our protocol was approved by Institutional Ethics Committee. Informed consent was obtained from the parents in all cases. Results: Prediction of normal hearing was 0.84 for the right ear and 0.78 in left ear, while for hearing loss of an unspecified grade, it was 0.98 for the right ear and 0.96 in the left ear. Kappa value was 0.7 to 0.6 for the right ear and left ear. Conclusions: The acoustic reflex is of little diagnostic utility in predicting the degree of hearing loss, but it predicts more than 80% of normal hearing. The clinical utility of the reflex is indisputable, as it is an objective method, simple and rapid to use, that can be performed from birth and whose results are independent of the cooperation and willingness of the subject. It is proposed as an obligatory part of hearing screening (AU)

Diagnostic utility of the acoustic reflex in predicting hearing in paediatric populations.

INTRODUCTION AND OBJECTIVES: The sensitivity of prediction of acoustic reflex, in determining the level of hearing loss, is especially useful in paediatric populations. It is based on the difference between the pure tone stapedius reflex threshold and contralateral white noise. The white noise threshold was 60 dB and that of pure tone was 80 dB. Our objective was to determine the diagnostic sensitivity of the prediction of the acoustic reflex. METHODS: We studied children aged <10 years, from October 2011 to May 2012, by measuring the acoustic reflex with white noise and pure tone. We used contrast tests, with X2 and student t-test. Concordance was measured with Kappa. Results were considered significant at P≤.05. Our protocol was approved by Institutional Ethics Committee. Informed consent was obtained from the parents in all cases. RESULTS: Prediction of normal hearing was 0.84 for the right ear and 0.78 in left ear, while for hearing loss of an unspecified grade, it was 0.98 for the right ear and 0.96 in the left ear. Kappa value was 0.7 to 0.6 for the right ear and left ear. CONCLUSIONS: The acoustic reflex is of little diagnostic utility in predicting the degree of hearing loss, but it predicts more than 80% of normal hearing. The clinical utility of the reflex is indisputable, as it is an objective method, simple and rapid to use, that can be performed from birth and whose results are independent of the cooperation and willingness of the subject. It is proposed as an obligatory part of hearing screening.