Effect of Tinnitus on Sleep Quality and Insomnia

Abstract Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objectives To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.

Effect of Tinnitus on Sleep Quality and Insomnia.

Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objective To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.

Translation, adaptation, and cross-cultural validation into Brazilian portuguese of the hearing protection assessment questionnaire (HPA). / Tradução, adaptação e validação transcultural para o português brasileiro do questionário de Avaliação da Proteção Auditiva (APA).

PURPOSE: The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA). METHODS: The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam. RESULTS: The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency. CONCLUSION: This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).

OBJETIVO: O objetivo do presente estudo foi traduzir, adaptar e validar transculturalmente a versão para língua portuguesa brasileira do questionário Hearing Protection Assessment Questionnaire (HPA). MÉTODO: O instrumento original, desenvolvido na língua inglesa, buscou avaliar as barreiras e suportes relacionados ao uso dos dispositivos de proteção auditiva (DPA), assim como o conhecimento, hábitos e atitudes dos trabalhadores frente ao ruído ocupacional. A tradução, adaptação e validação transcultural do questionário foi composta de cinco etapas: Tradução do questionário do inglês para o português; 2) Processo inverso de tradução do português para o inglês; 3) Análise do instrumento por três especialistas na área; 4) Pré-teste do questionário com 10 trabalhadores; 5) Aplicação do instrumento em 509 trabalhadores de uma indústria frigorífica após o exame admissional. RESULTADOS: os resultados indicam a validade de construção e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora e a consistência interna do mesmo. CONCLUSÃO: Este estudo resultou na tradução, na adaptação cultural e validação do questionário Hearing Protection Assessment Questionnaire (HPA) com a finalidade de ser usado para avaliar o uso de proteção auditiva individual em âmbito ocupacional, denominado Questionário de Avaliação da Proteção Auditiva (APA).

Tradução, adaptação e validação transcultural para o português brasileiro do questionário de Avaliação da Proteção Auditiva (APA) / Translation, adaptation, and cross-cultural validation into Brazilian portuguese of the hearing protection assessment questionnaire (HPA)

RESUMO Objetivo O objetivo do presente estudo foi traduzir, adaptar e validar transculturalmente a versão para língua portuguesa brasileira do questionário Hearing Protection Assessment Questionnaire (HPA). Método O instrumento original, desenvolvido na língua inglesa, buscou avaliar as barreiras e suportes relacionados ao uso dos dispositivos de proteção auditiva (DPA), assim como o conhecimento, hábitos e atitudes dos trabalhadores frente ao ruído ocupacional. A tradução, adaptação e validação transcultural do questionário foi composta de cinco etapas: Tradução do questionário do inglês para o português; 2) Processo inverso de tradução do português para o inglês; 3) Análise do instrumento por três especialistas na área; 4) Pré-teste do questionário com 10 trabalhadores; 5) Aplicação do instrumento em 509 trabalhadores de uma indústria frigorífica após o exame admissional. Resultados os resultados indicam a validade de construção e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora e a consistência interna do mesmo. Conclusão Este estudo resultou na tradução, na adaptação cultural e validação do questionário Hearing Protection Assessment Questionnaire (HPA) com a finalidade de ser usado para avaliar o uso de proteção auditiva individual em âmbito ocupacional, denominado Questionário de Avaliação da Proteção Auditiva (APA).

ABSTRACT Purpose The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA). Methods The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam. Results The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency. Conclusion This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).

Evaluation of the Dangerous Decibels Brazil Program in Workers Exposed to Noise.

Introduction: Noise-induced hearing loss can be avoided by taking preventive measures. Objective: To assess the effectiveness of the Brazilian version of the Dangerous Decibels® program for noise-exposed workers, using the ecological model as an educational intervention plan. Method: Non-randomized interventional study with a quantitative, experimental trial design, conducted at a meatpacking company. The participants were divided into two groups-the first one (n = 132, divided into 6 subgroups) received the Dangerous Decibels® Brazil educational intervention (DDBEI) adapted to workers while the second group (n = 138, divided into 5 subgroups) received a conventional educational intervention (CEI). The interventions lasted 50 min. The Hearing Protection Assessment Questionnaire (HPA-5) was administered before and after the interventions. The five dimensions (attitude, behavior, knowledge, supports, and barriers) were compared using the Student's t-test for paired data (<0.05). Results: After both the DDBEI and CEI training, workers improved significantly in barriers, supports, knowledge, attitudes, and behavior around noise. By chance, the CEI group scored lower in all measures than the DDBEI group before training, and though both groups improved, the difference was maintained after training. Conclusion: The Brazilian version of the Dangerous Decibels® program for noise-exposed workers was effective, influencing positively the factors at different levels of the ecological model. Though the DDBEI was no more effective than the CEI, the CEI participants began at much lower levels, so the effectiveness of the DDBEI may have been underestimated.

Hearing impairment among workers and satisfaction with the use of hearing aids.

BACKGROUND: Hearing problems can have adverse effects on an individual's job performance, as well as on unemployment or underemployment and increased risk of stress-related sick leave. OBJECTIVE: To investigate hearing impairment among workers and satisfaction with the use of hearing aids. METHODS: Cross-sectional study with workers who are hearing aid users. Subjects underwent pure tone audiometry and answered the Hearing Handicap Inventory for Adults and the Satisfaction with Amplification in Daily Life questionnaires. RESULTS: Participants were 36 workers between 36 and 75 years old, with an average age of 53.47 years, 52.7% male and 47.3% female. There was a mild to moderate hearing handicap perception, with worse results for women in the emotional domain. As hearing loss increased, workers' frustration increased when talking to coworkers. Everyone was satisfied with the use of their hearing aids. Satisfaction increased with increasing age and decreased with increasing hearing loss. The greater the frustration when talking to co-workers, the lower the overall satisfaction with hearing aid use; the lower the satisfaction with the competence of the professional who assisted in adapting the hearing aid; the lower the satisfaction in environments with background noise and overall worse personal image. The worse the attitudes and emotional responses of workers regarding their hearing impairment, the lower the overall satisfaction with the hearing aid. CONCLUSIONS: Despite the use of hearing aids, workers perceive having a hearing impairment, especially women. As hearing loss and frustration in talking with co-workers increased, satisfaction decreased.

Accuracy of Acoustic Evaluation of Swallowing as a Diagnostic Method of Dysphagia in Individuals Affected by Stroke: Preliminary Analysis.

After a stroke, more than half of the patients have some kind of disability, and dysphagia is frequently found. Cervical auscultation by Doppler sonar is an innovative technique with gain of credibility in the clinical evaluation of swallowing. To verify the diagnostic accuracy of Doppler sonar along with the DeglutiSom® software as an auxiliary method in the evaluation of oropharyngeal dysphagia in patients after stroke. The research is a cross-sectional, uncontrolled, blind, quantitative study with systematic random sampling. Patients from inpatient and outpatient units of a reference hospital with a stroke care unit were concomitantly submitted to both Doppler sonar and Fiberoptic Endoscopic Evaluation of Swallowing (FEES®). Seventy-three audio files collected from 26 patients through Doppler sonar were analyzed using DeglutiSom® software and confronted with the FEES® report, regarding three food consistencies offered to them during the exam. The study showed that the Doppler sonar correctly identified, among all the analyzed files, those that actually presented tracheal aspiration as well as it effectively identified patients who did not aspirate. The Youden index of 0.91 corroborates this information, showing a promising accuracy in detecting tracheal aspiration in the studied sample. The study evaluates the diagnostic accuracy of Doppler sonar, showing that it can be used as a valuable tool in the diagnosis of tracheal aspiration in patients after stroke. It is important to emphasize that the identification of residue by this method requires further studies. Also, larger sample size and more than one blind evaluator should be considered in future researches to increase the reliability of the proposed method.

Findings on the Central Auditory Functions of Endemic Disease Control Agents.

This study aimed to assess the central auditory functions of endemic disease control agents. This cross-sectional cohort study comprised two groups: the exposed group, with 38 male endemic disease control agents with simultaneous occupational noise and pesticide exposure; and the control group, with 18 age- and sex-matched workers without occupational noise and/or pesticide exposure. All participants underwent pure-tone audiometry, brainstem auditory evoked potentials, dichotic digits test, and transient-evoked otoacoustic emissions suppression effect. There was a significant inter-group difference in waves III and V absolute latencies, and interpeak I-III and I-V latencies bilaterally, with worse results found in the exposed group. Abnormal dichotic digits test results occurred more often in the exposed group, with a significant association between pesticide- and noise-exposure and the abnormal results (p = 0.0099). The transient-evoked otoacoustic emissions with suppression effect did not yield significant inter-group differences. It was concluded that pesticide and noise exposure induce harmful effects on the central auditory functions, particularly on the brainstem and figure-ground speech-sound auditory skills.

The Use of Exergames in the Neurorehabilitation of People with Parkinson Disease: The Impact on Daily Life.

Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results a) The instrumental subscale of the questionnaire showed statistically significant result ( p = 0.022; 95% CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale ( p = 0.011; 95% CI -0.85; -0.17) first and ( p = 0.002, 95% CI -0.88; -0.31) second assessments, and the functional subscale was only verified in the second assessment ( p = 0.011, 95% CI -0.85; -0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk ( p = 0.034, 95% CI -12.5; -0.3) and ski slalom games ( p = 0.005, 95% CI -34.8; -6.6). Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.

The Use of Exergames in the Neurorehabilitation of People with Parkinson Disease: The Impact on Daily Life

Abstract Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results a) The instrumental subscale of the questionnaire showed statistically significant result (p = 0.022; 95 % CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale (p = 0.011; 95 % CI -0.85; -0.17) first and (p = 0.002, 95 % CI -0.88; -0.31) second assessments, and the functional subscale was only verified in the second assessment (p = 0.011, 95 % CI -0.85; -0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk (p = 0.034, 95 % CI -12.5; -0.3) and ski slalom games (p = 0.005, 95 % CI -34.8; -6.6). Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.

Brainstem Auditory Evoked Potentials in infants aged 1 to 24 months during a hearing health care service.

OBJECTIVES: Assessing infants' hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss. METHODS: This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook. RESULTS: A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process. CONCLUSION: There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.

Qualidade de vida de surdos usuários de libras no sul do Brasil / Quality of life of deaf sign language users in the south of Brazil

O objetivo deste estudo foi investigar a qualidade de vida (QV) de surdos usuários da Língua Brasileira de Sinais que vivem no sul do Brasil, por meio do WHOQOL-Bref, e analisar os fatores que influenciam uma qualidade de vida mais favorável a esta parcela da população. Trata-se de um estudo transversal de natureza quantitativa, cuja coleta de dados se deu por meio da aplicação do questionário WHOQOL-Bref e de um questionário de caracterização da amostra. Participaram 60 surdos usuários de Libras moradores da região Sul do Brasil. Utilizou-se análise estatística por meio de métodos de estatística descritiva e métodos inferenciais considerando-se o nível de significância de 0,05 (5%). Os resultados apontaram que a média do escore total do WHOOQL-Bref foi de 43,3%. O domínio com maior escore foi o de relações sociais (64,31%) e o de menor escore o meio ambiente (54,77%). Os participantes surdos com nível maior de escolaridade e que se percebem proficientes no uso da língua portuguesa tiveram melhores escores de qualidade de vida. O compromisso com a QV da população brasileira, incluindo, a parcela surda, foco deste trabalho, pressupõe a formulação e o cumprimento de políticas públicas que visem o desenvolvimento de ações afirmativas direcionadas a superar condições de desigualdade e exclusão dessas pessoas, a fim de auxiliá-las a eliminar as barreiras que impedem ou dificultam sua participação na sociedade.

This study aims to investigate deaf users of the Brazilian Sign Language, who live in the South of Brazil, quality of life using the WHOQOL-Bref, and to analyze health related quality of life factors that influence this population. It is a quantitative transversal study, and data was collected by application of WHOOQL-Bref, in addition of a questionnaire with the sample profile. Sixty deaf sign language users from the South of Brazil participated in the survey. Statistical analysis was used by description statistic methods and inferential methods at a 5% level of significance. The results showed that the mean score of the WHOOQL-Bref questionnaire was 43,3%. The highest scores was in the domain of social relations (64,31%), and the lowest ones is in the environment domain (54,77%). Deaf participants with better education levels, which perceive themselves as proficient users of the Portuguese language, had higher quality of life scores. The commitment to the QoL of the Brazilian society, including deaf population, focus of this research work, presupposes the formulation and fulfillment of public policies that aim the development of affirmative action's that should overcome conditions of inequality and exclusion of these people, in order to assist the elimination of barriers that impede or hinder their participation in society.

Noise exposure and effects on hearing in Brazilian fishermen.

BACKGROUND: Several health conditions among professional fishermen have been reported. Among the risks to the health of fishermen, it should be noted that high noise levels cause hearing loss and general health problems. OBJECTIVE: to investigate the effects of exposure to occupational noise on hearing in professional fishermen at the main large-scale commercial fishing center in Brazil. METHODS: A cross-sectional study, 466 Brazilian commercial fishermen participated in the study, all males, ages range 18-67 years. A total of 15 vessels were included in the study. The first phase involved assessment of the sound pressure levels (SPLs) in the vessels, the second phase involved the use of a questionnaire and audiological assessment. RESULTS: Most compartments registered SPLs greater than 80 dBA and the noisiest compartment was the engine-room, where the vessel pilot works. Among the fishermen, tinnitus was the most commonly reported symptom (48.63%). A higher prevalence of hearing loss was observed in engine-room keepers. Longer the length of time in service, and consequently, exposure to noise (in years), were associated with higher auditory thresholds. CONCLUSION: the tolerance limits to noise exposure were exceeded according to legislation. Fishing activities are associated with noise-induced hearing loss, with the risk increasing with the length of service.

Hearing prevention program: how speech-language pathologists and audiologists work in the occupational health area / Programa de preservação auditiva: como atuam os fonoaudiólogos da área da saúde do trabalhador

ABSTRACT Objective: to characterize speech-language pathologists/audiologists and their interventions in the occupational health area, regarding the Hearing Prevention Program (HPP). Methods: a cross-sectional, quantitative study with 74 speech-language pathologists/audiologists from several regions of Brazil, working in the areas of Occupational Health and Audiology. The participants answered a questionnaire on their professional and educational profile, as well as on their work related to the HCP components. For data analysis, statistical procedures were used (Chi-Square Test and the test of difference in proportions, at the significance level of 0.05 - 5%), in relation to the variables of gender, age, job position, time since their graduation and academic training in occupational safety and health. Results: the speech-language pathologists/audiologists, mostly women, who reported performing the HPP, were older than 30 years, had specific postgraduate courses, but still had doubts about the Program implementation, they worked for companies with over 1,000 employees, disregarding their employment status, performing interventions, such as: hearing management and guidance on the correct use of ear protectors. Conclusion: a high number of speech-language pathologists in the Occupational Health area have not developed a complete hearing conservation program to this date.

RESUMO Objetivo: caracterizar os fonoaudiólogos e as ações que desenvolvem na área da saúde do trabalhador com relação ao Programa de Preservação Auditiva (PPA). Métodos: estudo quantitativo, transversal, com 74 fonoaudiólogos de diversas regiões do Brasil que trabalham em Saúde do Trabalhador e Audiologia. Os participantes responderam a um questionário sobre seu perfil profissional, formação e atuação em relação aos componentes do PPA. Para a análise dos dados utilizou-se procedimentos estatísticos (teste Qui-Quadrado e o teste de diferença de proporções, ao nível de significância 0,05 - 5%) em relação às variáveis sexo, idade, função, tempo de formado e formação acadêmica em saúde e segurança do trabalho. Resultados: os fonoaudiólogos, a maioria mulheres, que relataram realizar o PPA, tinham idade superior a 30 anos; fizeram cursos de pós-graduação específica, mas ainda apresentavam dúvidas em relação à implantação do Programa; estavam em empresas com mais de 1000 funcionários, independentemente de seu regime de trabalho, realizando ações como: gerenciamento auditivo e orientação sobre utilização correta de protetores auriculares. Conclusão: há ainda um número elevado de fonoaudiólogos na área de Saúde do Trabalhador que não desenvolvem um programa de preservação auditiva na íntegra.

Brainstem Auditory Evoked Potentials in infants aged 1 to 24 months during a hearing health care service

OBJECTIVES: Assessing infants' hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss. METHODS: This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook. RESULTS: A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process. CONCLUSION: There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.

Achados audiológicos em pacientes portadores de disfunção temporomandibular / Audiological findings in patients with temporomandibular dysfunction

RESUMO Objetivo Analisar os achados audiológicos em indivíduos com desordem temporomadibular e comparar esses achados com indivíduos sem desordem temporomanbibular. Métodos A amostra foi composta por 39 participantes adultos, de ambos os gêneros, com diagnóstico prévio de desordem temporomandibular (grupo de estudo) e 39 participantes adultos, sem desordem temporomandibular (grupo controle). Todos os participantes foram submetidos à audiometria tonal limiar em altas frequências, imitanciometria e pesquisa das emissões otoacústicas evocadas por produto de distorção. Resultados Observou-se prevalência de desordem temporomandibular no gênero feminino e a média de idade ficou acima da quarta década de vida. Na audiometria tonal limiar, foi observada ocorrência de perda auditiva do tipo neurossensorial e condutiva, no grupo de estudo, além de piores limiares auditivos em altas frequências. Em ambos os grupos, houve maior ocorrência de curva timpanométrica do tipo A, bem como diferenças entre os grupos na pesquisa do reflexo acústico ipsilateral e contralateral e no registro das emissões otoacústicas evocadas por produto de distorção. Conclusão Indivíduos com desordem temporomandibular apresentam piores resultados nos limiares auditivos, na timpanometria, nos reflexos acústicos ipsilaterais e contralaterais e nas emissões otoacústicas evocadas, quando comparados com o grupo controle.

ABSTRACT Purpose To analyze the audiological findings in individuals with temporomandibular disorder and compare these findings with individuals without temporomandibular disorder. Methods The sample was composed by 39 adult participants, both genders, with previous diagnosis of temporomandibular disorder (study group) and 39 adult participants, without temporomandibular disorder (control group). All the participants were submitted to audiometry including high frequencies, Immittance acoustic (Tympanometry and contralateral acoustic reflexes) and distortion product evoked otoacoustic emissions. Results The prevalence of temporomandibular disorder on female gender was observed, average age was over forty years old. In the audiometry, it was observed the incidence of hearing loss of a sensorineural and conductive type in the Study Group, besides worst hearing thresholds in high frequencies. In both groups, there was a bigger incidence of a type A tympanometric curve, as well as there were differences between the groups in the research of the ipsilateral and contralateral acoustic reflex and in the recording of distortion product evoked otoacoustic emissions. Conclusion It's possible to conclude that individuals with temporomandibular disorder show worst results in the hearing thresholds, in the tympanometry, in the ipsilateral and contralateral acoustic reflexes, in the evoked otoacoustic emissions, when compared to the control group.

Percepção de idosos sobre a restrição da participação relacionada à perda auditiva / Perception of elderly people about the restriction of participation related to hearing loss / Restrición de la participación en idosos relacionada a la pérdida auditiva

Introdução: Dentre as alterações fisiológicas do processo de envelhecimento humano, a perda auditiva relacionada à idade é uma das mais frequentes e incapacitantes, pois diminui o contato social do idoso, podendo afetar suas condições de saúde. Objetivo: Verificar a percepção de idosos sobre a restrição da participação relacionada à perda auditiva. Método: Estudo transversal e quantitativo com idosos maiores de 60 anos que têm perda auditiva, usuários ou não de aparelho de amplificação sonora. Analisou-se a audiometria tonal convencional e aplicou-se o questionário Hearing Handicap Inventory for the Elderly. Resultado: A amostra foi composta por 46 indivíduos, sendo 43,48% (n=20) do sexo feminino e 56,52% (n=26) do sexo masculino. A idade média foi 74,78 anos, com desvio padrão de 7,96 anos. A perda auditiva de maior ocorrência, em 73,91% (n=34) da amostra, foi do tipo neurossensorial bilateral e de configuração descendente, sendo que 50% (n=23) não usava aparelho de amplificação sonora individual, 45,65% (n=21) afirmou usá-lo e 4,35 (n=2) não respondeu essa questão. Quanto à participação, 82,6% dos idosos relatou restrições para participar de atividades sociais, sendo 50% da amostra (n=23) com percepção significativa. No geral, tal restrição foi maior no gênero masculino, na perda auditiva neurossensorial de grau moderado e configuração descendente, com idade até 79 anos e que não utilizavam o referido aparelho. Conclusão: Os idosos com perda auditiva apresentaram percepção significativa da restrição da participação, principalmente os que não utilizam aparelho de amplificação sonora individual, impactando negativamente sua qualidade de vida.

Introduction: Among the physiological alterations of the human aging process, age-related hearing loss is one of the most frequent and disabling, since it reduces the social contact of the elderly, and can generate impact on health conditions. Objective: to verify the perception of the elderly about the restriction of participation related to hearing loss. Method: A cross-sectional and quantitative study with elderly individuals over 60 years of age, all with hearing loss, users of hearing aids or not. The Hearing Handicap Inventory for the Elderly (HHIE) questionnaire was applied. Results: The sample consisted of 46 individuals, 43.48% (n = 20) of the female sex and 56.52% (n = 26) of the male sex. The average age was 74.78 years, with a standard deviation of 7.96 years. The most frequent hearing loss, in 73.91% (n = 34) of the sample, was bilateral sensorineural type with a descending configuration, with 50% (n = 23) not using hearing aids, 45.65% (n = 21) stated using it and 4.35% (n = 2) did not answer that question. The results showed that 82.6% of the elderly reported restrictions to participate in social activities, being 50% of the sample (n = 23) with significant perception. In general, such a restriction was higher in males, sensorineural hearing loss of moderate degree and descending configuration, ages up to 79 years, who did not use hearing aids, although the differences between the variables were not significant. Conclusion: Elderly people with hearing loss had a significant perception of the restriction of participation, especially among those who did not use PSAPI, which could negatively impact quality of life.

Introducción: Entre las alteraciones fisiológicas del proceso de envejecimiento humano, la pérdida auditiva relacionada a la edad es una de las más frecuentes e incapacitantes, pues disminuye la participación social del anciano, pudiendo generar impacto en las condiciones de salud. Objetivo: verificar la percepción de los ancianos, sobre la restricción de la participación relacionada a la pérdida auditiva. Método: Estudio transversal y cuantitativo con ancianos mayores de 60 años, con pérdida auditiva, usuarios o no de audífonos. Se analizó la audiometría tonal convencional y se aplicó el cuestionario Hearing Handicap Inventory for the Elderly. Resultado: La muestra fue compuesta por 46 individuos, siendo 43,48% (n = 20) del sexo femenino y 56,52% (n = 26) del sexo masculino. La edad media fue 74,78 años, con desviación estándar de 7,96 años. La pérdida auditiva de mayor ocurrencia, el 73,91% (n = 34) de la muestra, fue del tipo neurosensorial bilateral y de configuración descendente, siendo que el 50% (n = 23) no usaba audífonos, 45,65 % (n = 21) afirmó usarlo y 4,35 (n = 2) no respondió esta cuestión. Los resultados mostraron que el 82,6% de los ancianos relató restricciones para participar en actividades sociales, siendo el 50% de la muestra (n = 23) con percepción significativa. En general, tal restricción fue mayor en el género masculino, en la pérdida auditiva neurosensorial, de grado moderado y configuración descendente, con edad de hasta 79 años y que no utilizaban audífonos, aunque las diferencias entre las variables no fueron significativas. Conclusión: Los ancianos con pérdida auditiva presentaron percepción significativa de la restricción de la participación, principalmente aquellos que no utilizan audífonos, pudiendo así impactar negativamente en la calidad de vida.

Benign rolandic epilepsy of childhood and central auditory processing disorder: A noncasual neurophysiological association.

PURPOSE: The purpose of this study was to demonstrate the association between benign rolandic epilepsy of childhood (BREC) and central auditory processing disorders (CAPDs) and to test the hypothesis that an early onset of BREC could be associated with more cases of CAPD. METHOD: This study has a retrospective cross-sectional design conducted from January 2006 to January 2016 including 93 patients with BREC and without intellectual disability, dyslexia, and attention-deficit hyperactivity disorders. All patients were evaluated for central auditory processing (CAP), and its presence or absence was compared with age of seizure onset. RESULTS: In all patients, audiometric test results were normal, and in 43 cases (46.2%), CAPD was detected. There was no significant statistical difference in the mean age of seizure onset. CONCLUSION: A significant proportion of children with BREC will have a diagnosis of CAPD at school age.

Influence of osteopathic cervical manipulation on blood flow velocity of the cerebral circulation in chronic neck pain: analysis of three groups / Influência da manipulação osteopática cervical na velocidade de fluxo sanguíneo da circulação cerebral em indivíduos com cervicalgia crônica: análise de três grupos

ABSTRACT BACKGROUND AND OBJECTIVES: Spinal manipulation (SM) can reduce or improve the pain and dizziness originated in the neck. However, there is some criticism against SM. The objective of this study was to check if the osteopathic manipulation (OM) with a cervical rhythmic articulatory technique (CRAT) provides oscillations of the blood flow velocity (BFV) in the internal carotid arteries (ICA), vertebral arteries (VA) and basilar artery (BA), and if this technique is a risk factor for this circulatory system. METHODS: The study was conducted with 73 individuals (men and women) with mechanical cervicalgia, with an average age of 37.7±6.4 years. Fifty-eight had mild to moderate pain, randomly divided into control group (CG) and experimental-1 (EG-1), and 15 with severe pain in the experimental-2 group (EG-2). All subjects were submitted to the artery ultrasound (ICA, VA, and BA) in a blind methodology for the tests 1 (E1) and 2 (E2). Between E1 and E2, one single OM-CRAT was performed in the EGs 1 and 2 and resting for the CG. RESULTS: In the EG-1 there was a slight reduction of the BFV in the right ICA. In the EG-2 there was a significant increase of the BFV in the right VA. All samples presented normality. In the CG there was a reduction of the BFV in the left VA. When comparing the three groups, there was significance for the CG as EG-2 of the BFV in the right ICA (in E1) and of the BFV in the left ICA (in E2). CONCLUSION: Despite the BFV oscillations, one can conclude that the OM-CRAT generates oscillation in the BFV within the normality parameters and it is not a risk factor for cerebral circulation.

RESUMO JUSTIFICATIVA E OBJETIVOS: A manipulação vertebral cervical (MVC) pode reduzir ou melhorar a dor e a tontura de origem cervical. No entanto, há críticas contra a MVC. O objetivo deste estudo foi verificar se a manipulação osteopática (MO) com técnica articulatória rítmica cervical (TARC) proporciona oscilações de velocidade de fluxo sanguíneo (VFS) nas artérias carótidas internas (ACI), vertebrais (AV) e basilar (AB), e se essa técnica é um fator de risco para esse sistema circulatório. MÉTODOS: A casuística foi constituída de 73 indivíduos (homens e mulheres) com cervicalgia mecânica, com idade média de 37,7±6,4 anos, sendo 58 com dor leve a moderada, divididos por aleatorização em grupos controle (GC) e experimental-1 (GE-1), e 15 com dor intensa no grupo experimental-2 (GE-2). Todos foram submetidos à ultrassonografia arterial (em ACI, AV e AB) em metodologia encoberta para os exames 1 (E1) e 2 (E2). Entre E1 e E2 foi realizado única MO-TARC para os GE 1 e 2, e repouso para o GC. RESULTADOS: Em GE-1 houve pequena redução de VFS da ACI direita. Em GE-2 houve aumento significativo de VFS na AV direita. Todas as amostras apresentaram normalidade. Em GC houve redução de VFS da AV esquerda. No comparativo entre os três grupos houve significância para o GC como GE-2 na VFS da ACI direita (em E1) e na VFS da ACI esquerda (em E2). CONCLUSÃO: Apesar das oscilações de VFS, concluiu-se que a MO-TARC gera oscilação de VFS dentro dos parâmetros de normalidade e não é um fator de risco para a circulação cerebral.

Otoneurological findings prevalent in hereditary ataxias.

Objective To describe and compare the vestibular findings most evident among the hereditary ataxias, as well as correlate their clinical features with the nervous structures affected in this disease. Methods Seventy-five patients were evaluated and underwent a case history, otorhinolaryngological and vestibular assessments. Results Clinically, the patients commonly had symptoms of gait disturbances (67.1%), dizziness (47.3%), dysarthria (46%) and dysphagia (36.8%). In vestibular testing, alterations were predominantly evident in caloric testing (79%), testing for saccadic dysmetria (51%) and rotational chair testing (47%). The presence of alterations occurred in 87% of these patients. A majority of the alterations were from central vestibular dysfunction (69.3%). Conclusion This underscores the importance of the contribution of topodiagnostic labyrinthine evaluations for neurodegenerative diseases as, in most cases, the initial symptoms are otoneurological; and these evaluations should also be included in the selection of procedures to be performed in clinical and therapeutic monitoring.