Study of the prevalence of impaired hearing and its determinants in the city of Itajaí, Santa Catarina State, Brazil.

UNLABELLED: The number of people with impaired hearing is increasing; knowing its magnitude is essential for public health. OBJECTIVE: To study the prevalence and determinants of impaired hearing in Itajaí/SC. METHODS: A population-based survey based on a World Health Organization protocol. Field research was carried out from July 2008 to 2011. Procedures for evaluating hearing in households: questionnaire, measurement of noise, otoscopy, pure tone audiometry at 1000, 2000, and 4000 Hz, tympanometry, and acoustic reflexes: individuals above 4 years; children under 4 years: evoked otoacoustic emissions (OAE), cocleo-palpebral reflex(CPR), tympanometry, and acoustic reflexes. In the elderly population a questionnaire of perception of hearing loss was applied. RESULTS: The study sample consisted of 379 individuals--45.38% were males and 54.62% were females. Age-range: 11.34% up to 10 years; 64.39% 10 to 60 years, 24.27% over 60 years. Evaluation of the best hearing ear showed that 74.1% of residents had normal hearing, 18.9% had mild hearing loss, 5.1% had moderate hearing loss, 1.9% had severe hearing loss. Disabling impaired hearing was detected in 26 subjects: one child (otitis media); four adults (one otitis, one noise-induced, two idiopathic); 21 elderlies (presbyacusis). Of eight children under 4 years all presented CPR, three were normal examinations, two had absent OAE bilaterally, one had absent OAE in the right ear and one in the left ear. CONCLUSION: The prevalence of disabling impaired hearing in Itajaí was 7%; the highest prevalence was in the 50-year and above age group--the main cause was presbyacusis.

Estudo da prevalência e fatores determinantes da deficiência auditiva no município de Itajaí, SC / Study of the prevalence of impaired hearing and its determinants in the city of Itajaí, Santa Catarina State, Brazil

O número de pessoas com deficiência auditiva vem aumentando e o conhecimento de sua magnitude é fundamental no planejamento das gestões públicas em saúde. OBJETIVO: Estudar a prevalência e os determinantes da deficiência auditiva no Município de Itajaí/SC. MÉTODOS: O estudo foi de amostragem populacional, seguindo protocolo da Organização Mundial de Saúde. A pesquisa de campo foi realizada entre julho de 2008 e 2011. Procedimentos realizados nos domicílios: questionário, medição do ruído, otoscopia, limiares auditivos em 1000, 2000 e 4000 Hertz, timpanometria e reflexos acústicos: indivíduos acima de 4 anos; crianças até 4 anos: emissões otoacústicas evocadas (OEA), reflexo cócleo-palpebral (RCP), timpanometria e reflexos acústicos. Nos idosos, aplicou-se questionário de percepção da perda auditiva. RESULTADOS: A amostra foi constituída por 379 indivíduos; 45,38% do sexo masculino e 54,62% feminino. Quanto às faixas-etárias: 11,34% até 10 anos; 64,39% 10 a 60 anos e 24,27% acima de 60 anos. Avaliando-se a audição da melhor orelha, os moradores apresentaram: 74,1% audição normal, 18,9% deficiência auditiva leve, 5,1% moderada, 1,9% grave. As deficiências auditivas incapacitantes foram detectadas em 26 indivíduos: uma criança (otite média); quatro adultos (um otite média, um induzido por ruído, dois idiopáticas); 21 idosos (presbiacusia). Das oito crianças menores de 4 anos avaliadas, todas apresentaram RCP presente, três exames normais, duas OEA ausentes bilateralmente, uma OEA ausentes à direita e uma ausentes à esquerda. CONCLUSÃO: A prevalência de deficiência auditiva incapacitante em Itajaí foi de 7%, com predominância acima dos 50 anos e tendo como principal causa a presbiacusia.

The number of people with impaired hearing is increasing; knowing its magnitude is essential for public health. OBJECTIVE: To study the prevalence and determinants of impaired hearing in Itajaí/SC. METHODS: A population-based survey based on a World Health Organization protocol. Field research was carried out from July 2008 to 2011. Procedures for evaluating hearing in households: questionnaire, measurement of noise, otoscopy, pure tone audiometry at 1000, 2000, and 4000 Hz, tympanometry, and acoustic reflexes: individuals above 4 years; children under 4 years: evoked otoacoustic emissions (OAE), cocleo-palpebral reflex(CPR), tympanometry, and acoustic reflexes. In the elderly population a questionnaire of perception of hearing loss was applied. RESULTS: The study sample consisted of 379 individuals - 45.38% were males and 54.62% were females. Age-range: 11.34% up to 10 years; 64.39% 10 to 60 years, 24.27% over 60 years. Evaluation of the best hearing ear showed that 74.1% of residents had normal hearing, 18.9% had mild hearing loss, 5.1% had moderate hearing loss, 1.9% had severe hearing loss. Disabling impaired hearing was detected in 26 subjects: one child (otitis media); four adults (one otitis, one noise-induced, two idiopathic); 21 elderlies (presbyacusis). Of eight children under 4 years all presented CPR, three were normal examinations, two had absent OAE bilaterally, one had absent OAE in the right ear and one in the left ear. CONCLUSION: The prevalence of disabling impaired hearing in Itajaí was 7%; the highest prevalence was in the 50-year and above age group - the main cause was presbyacusis.

Caracterização da audição de crianças em um estudo de base populacional no município de Itajaí / SC / Characterization of hearing in children in a population base study in the city of Itajaí / SC

Introdução: A audição é o sistema sensorial que auxilia o ser humano na aquisição e desenvolvimento da linguagem oral, possibilitando sua inserção no ambiente sociocultural. Objetivo: Caracterizar a audição de crianças do nascimento até os 14 anos e 11 meses de idade, residentes em Itajaí. Método: Estudo prospectivo cuja população foi constituída por moradores da área urbana do Município de Itajaí, SC. Foram incluídos na avaliação audiológica todos os indivíduos residentes nas casas sorteadas, sendo excluídos domicílios coletivos, casas comerciais e desabitadas. As crianças com idade superior a quatro anos passavam pela avaliação do meato acústico, triagem audiológica nas frequências de 1.000, 2.000 e 4.000 Hz,pesquisa dos reflexos acústicos e timpanometria. Nas crianças com idade inferior a três anos e 11 meses era realizada avaliação comportamental e emissões otoacústicas transientes. Resultados: Das 119 crianças avaliadas, a ocorrência de algum tipo de deficiência auditiva foi de 16,84% nas crianças acima de quatro anos, analisando a melhor orelha. Não foi encontrado nenhum caso de deficiência auditiva incapacitante. Ao combinar os resultados da avaliação comportamental de crianças com idade até três anos e 11 meses com os resultados da timpanometria da pesquisa dos reflexos acústicos ipsilaterais e emissões otoacústicas transientes,constatou-se a ocorrência de 59,10% de alterações audiológicas, sendo que destas houve, predominantemente, alterações na timpanometria e reflexos acústicos,sugerindo problemas condutivos. Conclusão: Evidencia-se a importância de atuar na promoção e prevenção das perdas auditivas condutivas, buscando propiciar às crianças o desenvolvimento da linguagem e aprendizagem de forma integral e eficaz.

Introduction: Hearing is the sensorial system that helps mankind in the acquisition and development of the oral language and enables their insertion into the socio-cultural environment. Objective: To characterize the hearing of children since birth until 14 years and 11 months of age, living in Itajaí. Method: Prospective study whose population was composed by inhabitants of the urban region of the city of Itajaí, SC. All individuals living in the sorted houses were included in the audiological evaluation, and the collective, commercial and non-inhabited dwellings were excluded. The children older than 4 years old were evaluated as for the acoustic meatus, audiological selection in the frequencies of 1000, 2000 and 4000 Hz, research of acoustic reflexes and tympanometry. In the children younger that 3 years and 11 months the behavioral and transient evoked otoacoustic emissions evaluations were carried out. Results: From the 119 children evaluated, the occurrence of some kind of auditory deficiency was of 16.84% in the children older than four years, in the analysis of the best ear. No case of incapacitating auditory deficiency was found. When we matched the behavioral evaluation results of children aged up to three years and 11 months with the results from the tympanometry of the research of ipsilateral acoustic reflexes and transient otoacoustic emissions, we confirmed the occurrence of 59.10% of audiological alterations, and from these there were alterations predominantly in the tympanometry and acoustic reflexes, which suggested conductive problems. Conclusion: This confirms the importance of acting for the promotion and prevention of conductive hearing losses, by attempting to provide the children with the development of language and learning fully and effectively.

Triagem auditiva neonatal: um estudo na cidade de Curitiba - PR / Newborn hearing screening: a study in Curitiba-PR

OBJETIVO: verificar a prática de Triagem Auditiva Neonatal na cidade de Curitiba-PR. MÉTODOS: inicialmente foi realizado um levantamento do número de maternidades e/ou hospitais com maternidades existentes na cidade de Curitiba, mediante a consulta no Cadastro Nacional de Estabelecimentos de Saúde. Constatou-se a existência de um total de 59 hospitais cadastrados, sendo que três destes são maternidades e 18 são hospitais com maternidade. A partir do levantamento feito, foi estabelecido um contato com o profissional responsável por cada uma das instituições, sendo questionado quanto à existência de um programa de Triagem Auditiva Neonatal e para aqueles que o apresentavam foi entregue um questionário a fim de obter informações a respeito do referido serviço. RESULTADOS: constatou-se que apenas 23,8 por cento das maternidades realizam Triagem Auditiva Neonatal, sendo que destas, 20 por cento é universal para neonatos a termo e 80 por cento universal para neonatos de alto risco. A triagem em todos os serviços é realizada com Emissões Otoacústicas Evocadas por Estímulo Transiente. CONCLUSÃO: mediante o estudo realizado verificou-se que a lei número 14588 - 22/12/2004 não está sendo rigorosamente cumprida. Apesar da demanda aliada à importância da detecção precoce, a Triagem Auditiva Neonatal não é realizada em todas as maternidades existentes e mesmo naquelas nas quais há um fonoaudiólogo e a triagem auditiva é realizada, esta não é universal.

PURPOSE: to check the practice of newborn hearing screening in Curitiba-PR. METHODS: a survey was initially conducted to check the number of existing maternities and hospitals with maternities included in the National Register of Health's Establishments. We found that 59 hospitals were registered; three are maternities and 18 are hospitals that include a maternity. We asked each of the professionals in charge for the institution if some kind of newborn hearing screening was conducted and, for those who had the service, a questionnaire was given in order to collect information on the program. RESULTS: we found that 23.8 percent of the institutions perform newborn hearing screening. In 20 percent of them, this service is universal for full term babies, while in 80 percent of them it is available for premature/high risk babies. All of the services use Transient Evoked Otoacoustic Emissions (TEOAE). CONCLUSION: we concluded that the Brazilian law number 14588 - 22/12/2004 is not being followed. Despite of the need and the importance for early detection of hearing loss, hearing screening is not accomplished in all maternities. In places where such screening takes place, it is not universal.

Mismatch negativity in patients with (central) auditory processing disorders.

UNLABELLED: Mismatch Negativity (MMN) is a long-latency auditory evoked potential that provides an objective index of discrimination skills and auditory sensorial memory. It may, therefore, be used as an electrophysiological evaluation of central auditory processing. AIM: To study MMN in patients with Central Auditory Processing Disorder - CAPD. STUDY METHOD: A prospective clinical study. MATERIAL AND METHOD: Eight individuals with CAPD, aged between nine and 14 years, were evaluated; there was also a control group. MMN was elicited for tone stimuli (tone bursts), differing in terms of frequency (MMNf - standard stimulus: 750 Hz and deviant stimulus: 1,000 Hz ), as well as duration (MMNd - standard stimulus: 100 ms and deviant stimulus: 50 ms; at 1,000 Hz). RESULTS: The presence of MMNf and of MMNd was statistically demonstrated in both groups. No significant statistical differences, however, were observed between MMNf and MMNd latencies and amplitude values in the two groups. Also, no significant statistical differences were observed between the MMNf and the MMNd among the groups. CONCLUSION: The CAPD individuals that were evaluated showed no changes in MMNf or MMNd.

O Mismatch Negativity em pacientes com distúrbios do processamento auditivo (central) / Mismatch negativity in patients with (central) auditory processing disorders

O Mismatch Negativity (MMN) é um potencial evocado auditivo de longa latência que fornece uma medida objetiva das habilidades de discriminação e memória sensorial auditiva. Assim, pode ser utilizado como uma avaliação eletrofisiológica do processamento auditivo (central). OBJETIVO: Estudar o MMN em pacientes com Distúrbios do Processamento Auditivo (Central) - DPA(C). FORMA DO ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram avaliados oito sujeitos com DPA(C), na faixa etária de nove a 14 anos, bem como um grupo controle. O MMN foi eliciado para estímulos tonais (tone bursts) diferindo quanto à freqüência (MMNf - estímulo padrão: 750Hz e estímulo diferente: 1000Hz ), bem como quanto à duração (MMNd - estímulo padrão: 100 ms e estímulo diferente: 50 ms; na freqüência de 1000Hz). RESULTADOS: A presença do MMNf e do MMNd foi comprovada estatisticamente em ambos os grupos estudados. Não foram constatadas diferenças significantes estatisticamente entre os valores de latência e de amplitude do MMNf e do MMNd obtidos nos dois grupos. Também não foram verificadas diferenças significantes estatisticamente entre o MMNf e o MMNd em nenhum dos grupos estudados. CONCLUSÃO: Os sujeitos com DPA(C) avaliados não apresentaram alterações no MMNf, nem no MMNd.

Mismatch Negativity (MMN) is a long-latency auditory evoked potential that provides an objective index of discrimination skills and auditory sensorial memory. It may, therefore, be used as an electrophysiological evaluation of central auditory processing. AIM: To study MMN in patients with Central Auditory Processing Disorder - CAPD. STUDY METHOD: A prospective clinical study. MATERIAL AND METHOD: Eight individuals with CAPD, aged between nine and 14 years, were evaluated; there was also a control group. MMN was elicited for tone stimuli (tone bursts), differing in terms of frequency (MMNf - standard stimulus: 750 Hz and deviant stimulus: 1,000 Hz ), as well as duration (MMNd - standard stimulus: 100 ms and deviant stimulus: 50 ms; at 1,000 Hz). RESULTS: The presence of MMNf and of MMNd was statistically demonstrated in both groups. No significant statistical differences, however, were observed between MMNf and MMNd latencies and amplitude values in the two groups. Also, no significant statistical differences were observed between the MMNf and the MMNd among the groups. CONCLUSION: The CAPD individuals that were evaluated showed no changes in MMNf or MMNd.

Newborn hearing screening: the relation between bathing and the retesting rate.

UNLABELLED: One of the goals of a Newborn Hearing Screening Program (NHSP) is to have a low retesting rate. AIM: To investigate the association between the retesting rate and the bath of newborn babies. STUDY DESIGN: cross-sectional contemporary cohort. MATERIALS AND METHODS: Transient otoacoustic emissions (TOE) results have been compared to the information received from the nurse's aide who bathed the babies on the day of the test (373 newborns), and the time interval between the TOE study and the last bath (350 newborns). RESULTS: Significant statistical differences were found in relation to the percentage of retesting when babies were bathed by certain nurse's aides. On the other hand, the percentage of retesting decreased significantly when the time interval between the last bath and the TOE study was longer than 7 hours and 50 minutes. CONCLUSION: Moisture of the external acoustic meatus, caused by inappropriate protection against water during bath, and the short interval between the bath and the ETOE study, could be considered as possible factors causing retesting in NHSP programs.

Triagem Auditiva Neonatal: relação entre banho e índice de reteste / Newborn Hearing Screening: the relation between bathing and the retesting rate

Uma das metas de um Programa de Triagem Auditiva Neonatal (TAN) consiste numa porcentagem baixa de retestes. OBJETIVO: Investigar a relação entre o índice de retestes e o banho do neonato. Forma de Estudo: Coorte contemporânea com corte transversal. MATERIAL E MÉTODO: Os resultados das Emissões Otoacústicas Evocadas por Estímulo Transiente (EOET) foram comparados às informações referentes a auxiliar de enfermagem que ministrou o banho no dia do exame (373 neonatos), bem como ao tempo transcorrido entre a pesquisa das EOET e o último banho (350 neonatos). RESULTADOS: Foram constatadas diferenças significantes estatisticamente entre as porcentagens de encaminhamento para reteste quando o banho foi ministrado por algumas auxiliares de enfermagem. Além disso, a porcentagem de retestes diminuiu significantemente quando o tempo transcorrido entre o último banho e a pesquisa das EOET foi superior a 7 horas e 50 minutos. CONCLUSÃO: A umidade do meato acústico externo, ocasionada por uma proteção inadequada contra a entrada de água no momento do banho e o curto intervalo de tempo entre o banho e a pesquisa das EOET podem ser considerados como possíveis fatores geradores de retestes nos programas de TAN.

One of the goals of a Newborn Hearing Screening Program (NHSP) is to have a low retesting rate. AIM: To investigate the association between the retesting rate and the bath of newborn babies. Study design: cross-sectional contemporary cohort. MATERIALS AND METHODS: Transient otoacoustic emissions (TOE) results have been compared to the information received from the nurse's aide who bathed the babies on the day of the test (373 newborns), and the time interval between the TOE study and the last bath (350 newborns). RESULTS: Significant statistical differences were found in relation to the percentage of retesting when babies were bathed by certain nurse's aides. On the other hand, the percentage of retesting decreased significantly when the time interval between the last bath and the TOE study was longer than 7 hours and 50 minutes. CONCLUSION: Moisture of the external acoustic meatus, caused by inappropriate protection against water during bath, and the short interval between the bath and the ETOE study, could be considered as possible factors causing retesting in NHSP programs.